Liviu Librescu is the only real victim to appear in this segment. During this level, a song created by Lambourn plays while audio clips praise, laugh at murder, or scold the player for merely wounding. In the third, he barricades the exit of a school building and must shoot everyone inside in 90 seconds before the police arrive to arrest him. This is the only section with an appreciable challenge. In the second, he must walk across the same campus while avoiding the searchlights of police investigators. Emily's death is witnessed by Ryan Clark, Cho's second victim, who also must be killed. Hilscher, Cho's real-life first victim, without killing too many other people or scaring Emily away. In the first level, the player must walk across the Virginia Tech campus to shoot Emily J. The player controls Seung-Hui Cho, the killer, through '3 levels of stealth and murder!' in a slanted overhead view.

Its graphics and controls are both intentionally and amusingly clumsy. The game is a one-person work released 3 weeks after the Virginia Tech massacre. Unlike V-Tech Rampage, however, The Slaying of Sandy Hook Elementary was created to support gun control laws. In 2013, Lambourn caused further controversy with his game The Slaying of Sandy Hook Elementary, which re-created the Sandy Hook Elementary School shooting. V-Tech Rampage was created to be offensive The previous prominent virtual school shooting reenactment, Super Columbine Massacre RPG!, is a role-playing video game and has received praise for artistic merit as well as condemnation. The Flash-based game came to light when it was uploaded to Newgrounds using Lambourn's screen name Master PiGPEN. The game was created by 21-year-old Ryan Lambourn from Australia. V-Tech Rampage is a controversial amateur action video game that recreates the 2007 Virginia Tech shooting on the campus of Virginia Tech in Blacksburg, Virginia, United States.

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