The film opens with a sequence designed to look like a classic video game, depicting Chev Chelios's fall from a helicopter during the final moments of the original film. Immediately after his fall, he is scooped off the street via snow shovel by a group of Chinese medics and removed from the scene.
He wakes up in a makeshift hospital and sees doctors removing his heart while Johnny Vang (Art Hsu) watches. The doctors place Chelios's heart in a white cooler with a padlock, and place a clear plastic artificial heart in his chest. Chelios passes out. He wakes up, and escapes. He notices a yellow battery pack is attached to him. After a gunfight and interrogation of a thug, he learns the location of Johnny Vang - the Cypress Social Club.
Chelios calls Doc Miles (Dwight Yoakam), who tells him that he has been fitted with an AbioCor Artificial heart. Once the external battery pack runs out, the internal battery will kick in and he will have 60 minutes before it stops working. He crashes his car right after the conversation, destroying his external battery pack. In order to keep going, Chelios has the driver of another car use his jumper cables on Chelios, and runs to the Club.
He loses Vang at the club but picks up a hooker named Ria (Bai Ling) who sends him to a strip club where Vang is hiding out. In the club, Chev finds Eve, now a stripper.
Back outside of the strip club, Chev is met by a group of police, who begin beating him down. He is weakened, but one of them inadvertently charges Chelios by using a stun gun on him. Another stripper tells Chelios that he should look at the Hollywood horse racetrack for Johnny Vang. They encounter a group of porn stars protesting low wages, and Chelios is forced to escape, leaving Eve in the back of the cop car. Chelios is picked up by Venus (Efren Ramirez), who reveals himself to be Kaylo's brother. It is revealed he also has Tourette's Syndrome. At first, Chelios tells Venus that he killed everyone responsible for his brother's death, but this prompts Venus to leave. Wanting his help, Chelios tells Venus that El Huron was involved but escaped.
At the horse tracks, Chelios is losing energy. He learns that the heart can be charged through the skin by means of friction. Eve shows up and they have sex on the racetrack while the crowd cheers, and Chelios is restored to full energy. Chelios spots Vang and once again leaves Eve behind. Vang escapes, and Chev is about to be subdued by security when Don Kim picks Chev up in his limo. He informs Chev that there is a leader in the Triads named Poon Dong (David Carradine), who was in need of a heart transplant. When he heard of Chelios's ability to withstand the Chinese adrenaline poison, he put out an order for Chelios's heart. Don Kim then tells Chev Chelios that he wishes to return him to Poon Dong for a reward. Upon hearing this, Chev kills all of Don Kim's henchmen, including the limo driver, and shoots Don Kim several times. Meanwhile, Eve is arrested, and Venus calls in Orlando (Reno Wilson) to assist in tracking down El Huron.
While driving, Chev is cut off by an ambulance. He boards the ambulance and is surprised to see the EMTs are working on Don Kim. He demands a new battery pack for his artificial heart, and the EMT is forced to stop working while he hooks it up. Don Kim dies, and Chelios exits the ambulance upon seeing Johnny Vang on the street outside. Vang tries to escape in a car, but the car drives off without him, and Chev chases Vang to an electric plant, where there is a Godzilla-inspired fight between Chelios and Vang. Upon winning, Chev discovers that Vang's red cooler holds something other than his heart (the contents of which are unknown, but make Chelios recoil in disgust). Chelios learns from Doc Miles that his heart is already transplanted into Poon Dong, but promises to find him for Chev. Chelios goes to ask Johnny Vang, but Johnny Vang is shot and killed by Chico, and they knock Chelios unconscious.
There is a dream sequence showing Chelios as a youngster, with his mother (Geri Halliwell) on the Luke Canard show talking about his violent tendencies as a boy. Eve is interrogated by police, but refuses to rat Chev out. Doc Miles uses his assistant Chocolate to lure Poon Dong in, and knocks him out.
Chelios is awakened by electric shocks to his testicles, and is dragged by speedboat to an island where El Huron awaits. El Huron explains to Chev that he is the third Verona brother, and is very upset that Chelios killed Ricky (Jose Pablo Cantillo) and Alex Verona (Jay Xcala). He reveals Ricky Verona's head being kept alive in a tank by a group of scientists, speaking in an electronic voice. Chelios is whipped for Verona's pleasure, and is about to die when Orlando, Venus, and Ria show up, each with their own group of gunfighters, and chaos breaks out.
Chev smashes open Verona's tank and kicks his head into the swimming pool, but starts to slow down. He climbs an electric pylon nearby and grabs the insulators to recharge, but is flung off of it upon contact. Venus is fighting El Huron and is about to lose when Chev reappears, still partially on fire from the electricity. He beats El Huron to death (while still burning), and throws his body in the pool next to Ricky's head. In a hallucinogenic state, Chelios then tries to hug Ria (thinking she is Eve) but accidentally sets her on fire as well, and she runs off screaming. His flesh burning and his face melting, Chelios walks towards the camera, giving the middle finger to the audience in the final moment of the film.
During the credits, Doc Miles places Chev Chelios's heart back in. At first, it looks like a failure, but after everyone leaves, Chelios's eyes open, and his heart is heard beating.
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