Nothing spectacular but all the cars that your are driving or racing against look pretty good. The other cars are a bit blocky. No real pop-up draw ins. Buildings look reasonable and the pedestrians look pretty good. I was able to run at higher resolutions without any problems.
Sound is acceptable.
You hear the tires squeal and the sounds of crashing are pretty good. The people whose days your are ruining by doing hit and runs have just a couple of phrases to belt out so that gets old pretty quick although they are funny the first couple of times you hear them and are not over used in any given race. Well, this is the first of the series of Midtown Madness, and I must admit that it is very good. It has everything a PC gamer wants in a driving game, nothing more you want, basically. It is a very good game for a start, and the gameplay is even better.