101 Damnations establishes the band's style, musically fusing drum machines, samples and guitars, and lyrically concerned with poverty and misery, and using extensive cultural references and puns. Ned Raggett of Allmusic characterised the album's musical style as "brash, quick, punk/glam via rough early eighties technology pump-it-up pogoers" and described the heavy usage of puns as "Carter's calling card as much as anything".
"Sheriff Fatman" was highlighted as displaying the album's characteristic sound; Raggett said "the song itself may be about a total rat-bastard of a slumlord, but the name of the game is energy and fun." "Good Grief Charlie Brown" alludes to broken families, and "An All-American National Sport" is about a homeless person set on fire by two strangers. "G. I. Blues" is an anti-war song which closes the album.
The album was recorded on a shoestring budget, and was widely praised at the time of its release in the music press ("Staggering.." concluded the Melody Maker review for example) as a refreshing antidote to the drug-infused 'baggy' scene that was prevailing at the beginning of the 1990s. Whilst most of the chart contemporaries were extolling the virtues of ecstasy and hedonism, Carter USM offered a bleak worldview of social injustice, moral decay and urban violence. Their twin guitars, played over banks of keyboards, programmed sequencers and a drum-machine, drew comparisons in some critics' eyes to a 'punk Pet Shop Boys'.
One single was released from the album, "Sheriff Fatman", a commentary on unscrupulous private landlords, which became a major indie hit before being reissued again a couple of years later and finally peaking at number 23 in the UK singles charts. A 2011 reissue featured five bonus tracks including the single which followed the release of the album, "Rubbish", plus their cover version of Pet Shop Boys' "Rent".
In a retrospective review, Ned Raggett of Allmusic gave the album four and a half stars out of five, saying "in the duo's own unusual way, Carter were something of a unique and thrilling prospect at its best, which the highlights of Damnations show."Trouser Press called it a "fully realised debut" and "mind-blowing in the most stimulating sense."
At the end of 1990, NME ranked it at number 29 in their list of the top 50 "Albums of the Year", whilst Sounds included it number 36 in their own list of the year's top 50 best albums. In 1992, NME ranked the album at number 19 in their list of the top 20 "Near-As-Dam-It Perfect Initial Efforts!"