James Stark, aka Sandman Slim, must confront the consequences of his actions as the forces of Hell and Heaven converge on Los Angeles. Stark finds himself caught between the machims of Lucifer and God, each seeking to control him and the power he wields. Navigating a treacherous landscape of supernatural politics and ancient grudges, he must fight to protect the few allies he has left and carve out his own destiny in a world where damnation is always a heartbeat away. The narrative unfolds through Stark's cynical first-person perspective, detailing his brutal encounters and internal struggles.

The Sandman Slim series, and by extension Perdition Score, is recognized for its smart, kick-arse urban fantasy elements. Readers often praise Richard Kadrey's distinctive voice and the series' blend of dark humor, visceral action, and intricate supernatural world-building. The books are known for their fast pacing and the compelling, often morally ambiguous, protagonist. This installment continues to deliver the gritty, high-stakes supernatural conflict that fans have come to expect from the series.