Extreme Pinball was Epic's successor to their hit pinball game Epic Pinball.

It contains four pinball tables: Rock Fantasy, Medieval Knights, Urban Chaos, and Monkey Mayhem, each with a different theme. Compared to Epic Pinball, it has a larger, 320x400 resolution, as well as taller tables, both allowing for more objects. It also has a typical Dot Matrix Display where the scoreboard shows 3D-rendered animations as well.

The controls are more sensitive with a faster ball. This is less true to real pinball gameplay, but it speeds up the game's pace and gives more power to the player to influence the movement.