Frustrated, Sweet Tooth decides to enter the Twisted Metal contest, intent on having Calypso send him to wherever his daughter is hiding. The mid-story cinematic reveals that he came close to finding her in the psychiatric ward of a hospital (having slaughtered his way through the building to reach it), only to find she had checked out only moments before. After slaughtering his own family, Sweet Tooth became obsessed with finding 'the one that got away', revealed to be his daughter Sophie, to finish the job he started years ago. Formerly known as Marcus Kane, a family man working out of an ice cream truck, he developed dissociative identity disorder and became possessed by his dark side, embodied in his clown mask. The first arc features Sweet Tooth, also known as 'Needles Kane', a demented clown-themed serial killer.

Plot The Twisted Fate of Sweet Tooth the Clown The former having been announced as being inspired by Sweet Tooth and Dollface. There are four factions: the Clowns, the Dolls, the Skulls, and the Holy Men. In order to win the opposing team has to repeat the process 3 times before the statue is destroyed for a team to win. The person who sacrifices the leader and launches the missile has to control it to hit the opposing teams statue in the air. In order to destroy these statues, the player must abduct the enemy team's leader, then sacrifice the leader to a missile launcher that will, in turn, launch a nuclear missile. In this mode, each faction has a giant metal statue that is being held in the air by a helicopter, which the opposing team must try to destroy.

For example, the Nuke Mode is a new online game mode where the players choose a faction to play against an opposing faction. The game focuses heavily on multiplayer combat, including various online game modes with up to 4 player split-screen and 16-players online (the online gameplay was discontinued in early 2019). The game was originally planned to be released in October 2011 but was delayed to early 2012. It is another reboot of the Twisted Metal series. Twisted Metal is a vehicular combat video game developed by Eat Sleep Play and published by Sony Computer Entertainment for the PlayStation 3.

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