Unlike the GTA games, it is not possible to kill innocent civilians as Tony (despite this game being even more violent than GTA when it comes to battles).

Also, there are hidden 'Sperm Banks' in the game, these look just like the 'blood banks' (which are used to refill health) however, the player can sell his sperm from his balls meter for cash, the amount of cash the player receives depends on Reputation Level. Not only can he use any type of gun but also use melee weapons, in addition, the balls meter can also be refilled through other means, such as hitting another car while driving and immediately taunting them, or talking in conversations with citizens and NPCs. While in this mode, Tony is impervious to attack, has unlimited ammo, and every kill gives him 200 health.

This balls meter, when full, will allow you to go into Blind Rage mode, where the game temporarily shifts to a 'first-person shooter' perspective. The game features a Balls Meter that can be activated by shooting certain spots on the enemy's body (example: head, right shoulder, groin), after Tony kills somebody he can taunt them to increase his balls meter. In the year of 1984 in Miami, Florida, 3 months after escaping from Sosa's Attack, Tony now has to build his empire from scratch and take back what's his and eventually get his revenge on Sosa.

'What happens when the world is yours and then you lose it?' ― Frank Lopez (Narrator) Setting Tony escapes, barely alive, and a surviving assassin informs Sosa that Tony's empire is destroyed over a phone call. Tony fights his way around the mansion, witnessing his tiger eat Jose, and is almost killed but the police and S.W.A.T who arrive and wipe out the remaining assassins. Tony then fights his way through the underground to his pool to escape to his awaiting car, the Ambassador, but the exit is blown up by a bazooka. Tony then fights his way through his mansion, where several of his henchmen are gunned down and explosions rock around the mansion made by Antonio. Instead of dying, Tony kills the assassin that killed him in the movie, the Skull. The game begins with the movie's final scene in 1983 The Bolivian Cartel raiding Tony's Mansion.

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