In Blood Drive, the player takes part in the Blood Drive Tournament in Las Ruletas. The eight participants are hardened criminals who managed to survive the zombie apocalypse. Weapons mounted on the cars are used to deal with the opposition and roaming zombies alike.

There are seven match variations to choose from, e.g. regular races, checkpoint races, killing as many opponents respectively zombies as possible or King of the Skull (the goal is to hold on a golden skull as long as possible and ownership changes by ramming the car which holds it at the moment). Before the match, the player can choose between the racers (who all use different cars) and ten weapon setups. During the races, there are hidden places with power-ups (speed boosts, missiles shooting in all directions) to find.