Vinny of Vinesauce and 'Roegame' both did playthroughs of each demo, while 'hotcyder' covered it in a video about 'wario-likes'. In 2019, the game would release four public demos, the most prominent coming out on that year's SAGE and leading to a large rise in its' notoriety.

Pizza Tower would have quite a few crossovers with different indie games as well as mods for other games, such as Rivals of Aether, Sonic Robo Blast Kart 2, DOOM 2 and Mega Man 8-bit Deathmatch, some made by Mcpig himself. On October 4th, 2018, the developer uploaded test footage of the cancelled 'Pizza Massacre' game on YouTube. Said chef later became the 'Peppino Spaghetti' character. It took ideas from a previously scrapped idea called 'Pizza Massacre', which was about a chef being transported to a nightmare world where he has to battle pizza creatures. On April 25th, 2018 this was expanded upon, with him also displaying some of the sprites and character designs made. On March 13th, 2018, a comic artist known as Mcpig uploaded initial sketches and ideas for 'The Leaning Tower of Pizza' to his 'weinerdontusedrugs ' page on Tumblr, explaining core mechanics and detailing his thought process. It follows Peppino, a severely depressed and mentally unstable Italian chef (and his fellow chef companion Gustavo) who's trying to stop his already failing Pizzeria from being completely run out of business by the antagonistic forces of the Tower.

It is known for having a 1990's cartoon art style resembling MS paint, a soundtrack full of 16-bit instrumentation and funk/hip-hop sampling, immensely over the top Boss Battles and NPCs, and featuring Mort the Chicken from the titular PS1 game. Pizza Tower is a 2023 Wario Land inspired high speed action-platformer by Indie developer Tour De Pizza on Steam.

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