The comic's setting is an alternate universe branched off of the Mirage continuity's volume 1 with influences from both the Image continuity and the 2003 cartoon, and its character designs are patterned after the 2003 cartoon, and the overall visuals adopt additional shōnen manga influences with sound effects written out in katakana. Compared to most other TMNT incarnations, MNT Gaiden is far darker and more brutal, with stronger language and more graphic violence. MNT Gaiden also explores and deconstructs topics of mental illness and ethical dilemma in ways that greatly blur the distinction between hero and villain.