 PC Zone praised Angel Studios for avoiding gimmicks, instead presenting "accurately modelled cars and a meticulously recreated city" to the player. AllGame said Midtown Madness "possesses superb, immersive graphics", using the different times of day and weather as an example. However, it complained that cars not controlled by the player were lacking in detail. Computer and Video Games said that as well as being "structurally and visually consistent", the Chicago setting in Midtown Madness was "brought to life" — for instance, a "city bus legitimately pulling out at a four-way junction" can end the race for a player by destroying their car. However, Total Video Games called the game's presentation "far from optimal" even at the recommended system requirements. Reviewer Noel Brady pointed out "a serious lack of detail" and blockiness, especially without a graphics card. He was critical of the AI, declaring that cars often drive "without noticing [the player] at all". In his book AI Game Engine Programming, Brian Schwab described Midtown Madness' gameplay as "arcade style" and "fast and loose", and said the in-game traffic was satisfactory.
