This album continues the musical tradition of the previous album, Hatebreeder, only with a more straightforward direction. Much of the black metal and symphonic metal elements are present—mainly in the keyboards, vocals, and fast tempos—as well as a stronger emphasis on power metal. Many songs on the album became live setlist favorites, such as "Everytime I Die", "Hate Me!", and the title track. The song "Mask of Sanity" is quite similar to the song "Talking of the Trees" from their early demo Shining (released as IneartheD).
Follow the Reaper was recorded and mixed at Peter Tägtgren's Abyss studio in Sweden, instead of the Finnish Astia-studio from Anssi Kippo, in which they had recorded all of their previous releases, including the demos from IneartheD. On this album, Children of Bodom used D standard tuning (D,G,C,F,A,D), which was also used on Hatebreeder.
The album features sampled quotes from the 1990 film The Exorcist III.
A deluxe edition featuring two bonus tracks was released in 2006.