The soundtrack for Vampire: The Masquerade—Bloodlines included plenty of licensed songs by the likes of Lacuna Coil, Chiasm, and the Genitorturers, as well as an original track by Ministry and Al Jourgensen, but its score composed by Rik Schaffer was also an essential part of its atmosphere. Fans were obviously concerned about whether he would be involved with the recently announced sequel.

Among them was game developer and streamer Outstar, who contacted Schaffer to ask if he was contributing to Bloodlines 2. He replied, "I contributed an hour of music to the OST and am the main composer. Been working on it for over a year."

Bloodlines' lead writer Brian Mitsoda has returned as well, working as a writer on the sequel alongside Cara Ellison and Chris Avellone.