Those looking for a challenge or a custom difficulty level can try to complete Trial of the Worm with a high score to reach the top of the online leaderboard. Add corruption modifiers or choose the more active paths to earn even more supply points. In this cooperative PvE mode, players determine their path along four maps, earning supply points along the way. In addition, Trial of the Worm is available as a free update for all Back 4 Blood owners and will be released alongside the River of Blood expansion.

River of Blood also includes eight exclusive character skins and 12 exclusive weapon skins, in addition to new weapons, accessories, and maps. Jeff causes ultimate chaos when he is summoned with a whistle by Tala or other Cleaners from her team. To better assist the Cleaners with their mission, the expansion introduces Tala, a former cultist who has transformed into a Cleaner and is joined by Ridden Jeff, a friendly Tallboy you can summon to help the team. River of Blood features an all-new story campaign with an immersive mission consisting of five maps, in which players travel upstream and make several stops to stock up on supplies and fend off enemy threats. This new DLC expansion will be released on the 6th of December 2022 as part of the Back 4 Blood Annual Pass, Back 4 Blood: Deluxe Edition, and Back 4 Blood: Ultimate Edition, but will also be available separately. Games and Turtle Rock Studios today announced details of the next major DLC expansion for Back 4 Blood, which has received the title River of Blood.

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