Most Extreme Elimination Challenge, also known as MXC, pits teams of both men and women against each other in different pshysical tasks, often risking injury. Such tasks may include crossing over a bridge, jumping on a circling spoon, trying to bring down walls, etcetera.

At the end of each show, the ten most painful moments of the show are chosen.

In the American version of the show, each contestant has been nicknamed, by the show's translators, after a famous celebrity. Therefore, it is not uncommon on the United States to see participants with names of famous athletes or Hollywood stars competing at the show.