The band started writing and recording the album Hell Chose Me in 2009. Upon its release, the album received positive reception and acclaim for its musical styling, structure, and concepts. Carnifex maintained that this was due to having more time during the writing and recording process than their previous albums.
On January 5, the band uploaded the first single from Hell Chose Me. They began streaming the entire album to the public on February 10, 2010, less than 6 days before they released it.
On May 28, 2010, the band embarked on a European Tour with supporting acts Veil of Maya and Suffokate beginning in Bochum, Germany and ending on June 19, 2010 at the Summerblast Festival in Trier, Germany. The tour included shows in Spain, France, UK, the Netherlands, Sweden, Slovakia, Hungary, Austria, Italy and Switzerland. The tour was presented by Avocado Booking. An error occurred in the production of tour posters when the words "Hell Choose Me" appeared rather than "Hell Chose Me". Despite the error, it remained the official poster all the way through the tour.
Once Hell Chose Me was released, the album cover depicting a reincarnated priest bearing an inverted cross on his chest and holding a cornucopia of goat heads in hand generated controversy[vague] and was taken to offense by some religious groups and protesters[vague]. The cover had its display censored at many music retailers before a purchase of the album was made.