
It is revealed that after the events of the first game, The Dishwasher and Chef destroyed the world after it became uninhabitable. The Dishwasher emerges victorious from this battle and Yuki dies in his hands. The game begins with a playable flashback segment of the first game where the player leads The Dishwasher through the Grace Chapel, building up to the boss fight against Yuki. The guitar minigame also makes a return however, the Psycho Picks that were granted in the original game for finishing them do not.

A new gameplay feature is the addition of collectible Beads that can be equipped to give various status effects such as improved strength against specific enemies or attacks draining health. Guns are now automatically mapped to function on the right trigger, and normal enemies no longer have exclusive executions as they are all down to weaponry. Combat revisions have been made: now the player can stock up to four weapons at once with the help of two sets of load outs that can be interchanged at all times.

There are five new weapons in the game, including a large syringe dubbed The Painkiller and an oversized pair of scissors titled The Guillotine. Co-op has also been fully integrated into the story-mode allowing for an exclusive campaign. The biggest addition is a new playable character, Yuki, who controls differently from The Dishwasher in combat. Recurring elements from the original include Dish Magic and Shop Bots where one can buy upgrades and items with money received through defeating enemies. The game is a side-scrolling beat 'em up where the player must violently dispense of enemies with the help of numerous weapons. Gameplay remains largely similar to that of its predecessor.
