Secret 1: Crack in the wall near the start
At the start of the level, there is a crack on the wall to the right of the Sewer exit. Blow it up and grab the Freezethrower to get the secret. This also allows access to the ledges on the street.
Secret 2: Under the knife
The room where the blue key is holds the second secret. On the counter on the wall opposite the key, you will see a knife on a counter. Search on the counter there, and a room will be revealed with an Atomic health. Go in to get the health to get the second secret of this level.
Secret 3: Behind the painting
In the building you get to by jumping toward the East Town Towers then through the window, go up the stair and use the painting with the trees for a secret and Devastator ammo.
The following hidden compartments are not counted as secrets:
- Next to the Red Key is a cabinet with RPG ammo and Devastator ammo.
Using the "Jump-Duck-Jump" glitch on certain spots along the bottoms of the buildings allows the player to reach the tops earlier than intended. Retaining the Jetpack from previous levels also allows for massive sequence skips on this level.
See the Speedrunning page for more information.
- "East Town Towers" is a reference to id Software, makers of Doom & Quake (and other games). At the time, id Software was in an office tower in Mesquite TX named "Town East Towers". The "East Town Towers" building in this level also resembles the real life building.
- When Duke says "I ain't afraid of no Quake" after triggering the earthquake in this level; it was a reference to the 1st release in the Quake Series at the time. Duke 1.3D came out on January 29, 1996; five months before the 1st Quake was released in June 22, 1996.
- Visible when using noclip - at the level exit, head outside through the window and look around for the message "YOU'RE NOT SUPPOSED TO BE HERE... EITHER -- LEVELORD"
- A hidden message on the wall of the lobby in the abortion clinic reads, "Under the knife." This is a clue for discovering the secret in the next room.