Houston's The Voices in My Head have been delivering punishing slam death metal since 2014, leaning hard into guttural vocals, chunky slam breakdowns, and the kind of surgical brutality that defines the Texas underground's more extreme end.

Rochester, New York's Thy Hideous Bake emerged in 2025 as a brutal death and slam act, channeling the goregrind and slam underground's fixation on grotesque heaviness and low, gutted riffing. A new entry into a genre that prizes extremity above all else, they arrive from a city with a long history of underground metal.

North Dakota's Tire Iron occupy a brutal niche even within extreme metal — slam and brutal death metal infused with hardcore nastiness, a 2016 project that brings blue-collar ferocity to a sound usually associated with larger urban scenes.

Ironton, Ohio's Titanosauria are a 2025 slam and brutal death metal project with prehistoric appetites — dense, low-tuned, and devoted to the maximally heavy end of the spectrum where breakdowns hit like extinction-level events.

Madison, Wisconsin's Toiletectomy play slam-inflected brutal death metal with a grotesque premise and an equally grotesque sound, formed in 2023 and committed to the subgenre's signature low-tuned savagery and guttural absurdity.

A brand new Houston, Texas outfit formed in 2025, Torso Mastectomy dives straight into slam and brutal death metal's most visceral territory, adding to Texas' deep tradition of extreme heaviness.

Chicago's Torture takes an experimental approach to slam and brutal death metal, pushing the genre toward gorenoise territory with a boundary-defying ugliness that distinguishes them from more straightforward acts.

Philadelphia's Traumatic Insemination are specialists in slam and brutal death metal, formed in 2021 and committed to the sub-genre's most physically imposing qualities — crushing downtuned riffs, guttural vocals, and rhythms built to devastate.

Truckstop Dickpill is a slam and brutal death metal band from Knoxville, Tennessee, formed in 2024, specializing in the genre's characteristic down-tuned, syncopated slam breakdowns and guttural vocal extremity.