As countless years pass, the way the trials are played have changed. Before it was a matter of survival, but it has become more of a game of cat and mouse. While the Survivors have indeed grown close and more efficient, so to have the Killers. Now all the killers have become best friends, coming together to mingle and enjoy each other's company between trials.

No longer satisfied with souls from the survivors, the Entity now turns her never ending hunger on the killers she herself had chosen. Knowing how tough the task is, the Entity summons the only being capable of slaying such monsters, the Doom Slayer himself. Transported from Hell into the Entity's hunting grounds, the Doom Slayer must defeat all the Killers to return to Hell.