Oakland's Palace of Worms began as raw black metal and evolved over the years into something far more grotesque — a churning death-doom force that sounds like the Bay Area underground rotting from within. Since 2007, the band has been one of the West Coast's most singular and unsettling metal acts.

Denver's Primitive Man are one of the most suffocating and sonically devastating acts in American heavy music, fusing doom, death, sludge, and noise into an experience that functions less like music and more like psychological weight. Since forming in 2013 they've released a string of albums — including the landmark 'Caustic' — that have established them as essential figures in the modern extreme metal landscape. Ethan McCarthy's project is defined by a commitment to bleakness so thorough it verges on transformative.

Procession are a death/doom band from Cleveland, Ohio whose sound draws equally from the suffocating weight of doom and the rotting fury of death metal — a fitting combination for a city with one of America's most storied underground metal legacies. Active since 2010, they move at a funeral pace without sacrificing the visceral menace that separates genuine death/doom from mere slow metal.