This was the second and final "Extreme Rules" event to take place in the WTX Universe. The pay per view followed the gimmick implied by the title in that every match had some variation of an extreme stipulation. It was the follow up to late April's event Backlash 2013, the next event to take place was June's Cyber Sunday 2013.
There were seven professional wrestling matches on the event's card. Opening the card was a Ladder match between Rob Van Dam and Ted DiBiase Jr. for the Light Heavyweight Championship. Following this was a tornado tag team table match between "Team D-Z" Dolph Ziggler & Daniel Bryan and "The Nation of Domination" Mark Henry & Farooq for the World Tag Team Championships. The third match was a Last Man Standing match between The Rock and Ryback for the Intercontinental Championship. Next was a Steel Cage match between Kharma and Beth Phoenix for the Women's Championship. The first major title match was between Shelton Benjamin and Kevin Thorn in a Tables, Ladders and Chairs match for the World Heavyweight Championship. The second major title match was a Triple Threat Extreme Rules match between Samoa Joe, CM Punk & Rhyno for the NXT Championship. The main event of the Extreme Rules card and the third major title match was between The Undertaker, Dean Ambrose, Seth Rollins, & Roman Reigns in a Fatal 4-Way Extreme Rules match for the WWE Championship.
Five championships changed hands and two championships were retained. Ted DiBiase defeated Rob Van Dam in the first match after continuously punishing Van Dam, and then climbing the ladder to retrieve the Light Heavyweight Championship. Mark Henry and Faarooq (The Nation of Domination) defeated Dolph Ziggler and Daniel Bryan (Team D-Z) for the World Tag Team Championships after Mark Henry performed a Splash through the table to Dolph Ziggler. Ryback defeated The Rock in the third match after The Rock could not answer the referee's count of ten, therefore Ryback became the Intercontinental Champion. Kharma then defeated Beth Phoenix in the next match, which was contested under steel cage rules, thus retaining the Women's Championship.
Shelton Benjamin quickly defeated Kevin Thorn after incapacitating Thorn enough to retrieve the World Heavyweight Championship. CM Punk defeated Samoa Joe after hitting a Go To Sleep and getting the three count to win the NXT Championship. Dean Ambrose defeated The Undertaker, Seth Rollins and Roman Reigns after last eliminating Seth Rollins to win the WWE Championship.
|1||Ted DiBiase Jr. def. Rob Van Dam (c)||Ladder Match for Light Heavyweight Championship||7:12|
|2||Tornado Tag Team Table Match for World Tag Team Championship||10:34|
|3||Ryback def. The Rock (c)||Last Man Standing Match for Intercontinental Championship||10:18|
|4||Kharma (c) def. Beth Phoenix||Steel Cage Match for Women's Championship||8:32|
|5||Shelton Benjamin (c) def. Kevin Thorn||TLC Match for World Heavyweight Championship||3:21|
|6||CM Punk def. Samoa Joe (c) & Rhyno||Triple Threat Extreme Rules Match for NXT Championship||5:33|
|7||Dean Ambrose def. The Undertaker (c), Seth Rollins * Roman Reigns||Fatal 4-Way Extreme Rules Elimination Match for WWE Championship||13:32|
WWE Championship Eliminations
|Order of Elimination||Wrestler||Eliminated By||Method of Elimination||Time|
|1||Roman Reigns||The Undertaker||Pinned after an Old School||9:17|
|2||The Undertaker||Seth Rollins||Pinned after a Russian Legsweep||13:02|
|3||Seth Rollins||Dean Ambrose||Pinned after a Roll Up||13:32|