Metal Slug 5 was released for the MVS arcade platform in 2003. In the United States and South Korea, the game was bundled along with Metal Slug 4 on the PlayStation 2 and the Xbox. It was also a part of the Metal Slug Anthology collection.
This time around players must fight against the Ptolemaic Army, who stole secret documents concerning the Metal Slug projects. The game presents new backgrounds, all hand drawn specially for the game as well as new settings.