Rating issues
This game contains sustained depictions of death or injury to human-like and animal-like characters, as well as realistic looking violence towards fantasy characters. In a distant, top-down view, the player fights hordes of enemies in each level. The enemies range from humanoid to completely fantastical. Enemies bleed large amounts when hit, and due to the amount of enemies, the scene can become quite saturated with blood effects. The camera is distant so any pain or suffering as a result of the violence is difficult to make out, and there is no dismemberment as a result of violence.
Other issues
There are moderately disturbing images in the game, such as the sight of dead bodies that do not contain gore.