Explicitly asserted as a tribute to the legacy of Death, Gruesome was born out of guitarist/vocalist Matt Harvey (Exhumed) and drummer Gus Rios' mutual involvement with the "Death to All" tours.

Gruesome is an intentional homage to the first wave death metal scene of Tampa, Florida, specifically Death's early period. This is an absolutely top notch filthy slab of old school death metal, played by the some of the scene's most legit players.