Blood In, Blood Out received another positive review from Ray Van Horn, Jr. of Blabbermouth.net, who gave the album a rating of nine out of ten and states, "As Souza last appeared on Exodus' 2004 Tempo of the Damned album, for most fans, Blood In, Blood Out is going to ring true, no matter how monstrously heavy the band was with Dukes at the helm. For all of the hullabaloos behind Zetro's past tenures in Exodus, he's all over this album in a major way and by attrition, the band throws its own retro, gang-shouting speed metal party, one finding Metallica (and one-time Exodus) guitarist Kirk Hammett on the guest list."
