Seattle, Washington's Psychosis formed in 2017, delivering death metal from the Pacific Northwest — their sound carries the darker, atmosphere-tinged quality of the region's extreme underground, married to the genre's core brutalist impulses.

Richmond, Virginia's Psychotic Defilement have been operating in the brutal death metal underground since 2016, building a reputation for relentless low-end punishment and technical brutality that fits naturally into Richmond's historically extreme metal scene.

Portland, Oregon's Psychotropic carve an unusual niche in the Pacific Northwest underground, combining the corrosive weight of sludge metal with black and death metal's extremity — a murky, suffocating blend that suits Portland's reputation for genre-defying heaviness.

Salem, Ohio's Psyclosarin formed in 2019 playing a grinding hybrid of groove and death metal — the combination of rhythmic heaviness and technical death metal aggression gives them a distinct character within Ohio's active and underrated heavy underground.

Out of Cranston, Rhode Island, Ptarmigan have been grinding and blasting since 2009 with a hybrid of brutal death metal's technical gore and grindcore's no-frills velocity. Their approach favors relentless tempo shifts and suffocating low-end density over melodic concession.

Chattanooga, Tennessee's Puke play blunt-force brutal death metal without apology, delivering the genre's trademark gutturals and pulverizing rhythm work with a Southern rawness since forming in 2013. They operate in the uglier, less polished corner of the brutal death scene.

Pulchra Morte — Latin for "beautiful death" — are a US doom/death outfit that leans into funereal pacing and thick, mournful atmosphere, marrying cavernous death metal riffs to the slow-drag sorrow of traditional doom. Active since 2018, their sound is dense, deliberate, and uncompromising.

Devastating Slam / Brutal Death Metal from Corpus Christi, Texas / Kansas / New Mexico.

Mitchell, Indiana's Purgatorium have been playing melodic death metal since 2017, blending the genre's twin guitar harmonies and anthemic structure with darker death metal undertones. A small-town Midwest act committed to one of extreme metal's most technically demanding subgenres.