Following the loss of longtime guitarist and songwriter Bobby Gustafson, Overkill added two new guitarists in Cannavino (who had been Gustafson's guitar technician) and Gant (previously from thrash metal band Faith or Fear). During the Horrorscope tour in 1992, Sid Falck left the band. Admittedly never a big fan of thrash metal music, he said that he had initially wanted to push his drumming to the limit by playing the most complex type of music (of the era), and in time he decided to pursue other musical interests. He was replaced by former M.O.D. drummer Tim Mallare.
Reviews for Horrorscope have been very positive. AllMusic's Eduardo Rivadavia awards the album four-and-a-half stars out of five, and states, "The insecurity felt among Overkill fans by the departure of founding guitarist and key songwriter Bobby Gustafson in 1990 ultimately proved unfounded when the New York thrashers' expanded two-guitar lineup -- featuring Rob Cannavino and Merritt Gant -- arguably delivered the finest effort of the group's career in 1991's Horrorscope."
Horrorscope peaked at #29 Billboard Top Heatseekers chart. A music video was made for the title track and received a decent amount of airplay on stations such as MTV. "Coma" and "Infectious" were released as singles. The cover version of Edgar Winter's "Frankenstein" also saw regular airplay on radio stations, such as Los Angeles, California's KNAC.Horrorscope is Overkill's best-selling album of the SoundScan era and one of their best-selling overall, selling over 120,000 copies in the U.S.