Cutthroat: Life on the Highway is a roleplaying game about a gang of bikers who roam across the country, raiding towns and then challenging each other afterwards at a Rally. The goal of the PCs is to become the Top Dog of the gang, whether through coercion and force.

Each PC plays two characters: A Biker, and a Girlfriend. Both characters are defined by their Stat (Status, generated by rolling 2d6), which is both their rank within the gang and their ability to perform actions, a Talent (a skill, usually related to violence for Bikers, or used to influence Bikers for Girlfriends), and a Vice. In addition, Bikers have a a Bike (affects Stat), a Girlfriend, and a Secret. Girlfriends have a Leash (why she sticks with her Biker), and a Desire (something the Biker can acquire on a raid, and is needed to keep her satisfied). The Biker with the lowest stat is the Rat, who starts the game knowing knows everyone's Vice and Secrets, and gets to choose the winner at the bragging sessions (Rallies).

Basic tasks use 2d6, with a roll less than or equal to the Biker's Stat meaning success. When a biker Challenges another biker in an attempt to assert dominance, or when a girlfriend Approaches a biker to learn a vice or secret, both sides roll 2d6 and add their Stats. Action happens during the Raids, but the real center of the game is the Rally where the bikers brag and try to protray their actions during the latest raid in the best light.