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The game begins during the final scene of the film, with the mansion of Tony Montana (voiced by André Sogliuzzo) under attack from assassins sent by Alejandro Sosa (Robert Davi). Unlike in the film, however, Montana is able to evade Sosa's men and escape the grounds, just as the DEA and Miami-Dade arrive. Sosa is informed by his men that Montana's mansion has been seized by the police, his drug empire reduced to nothing, and that Montana himself is missing. Meanwhile, hiding in a safehouse in the Miami glades, Montana laments the deaths of his friend Manny and sister Gina, chastises himself for not listening to the advice of others due to his bull-headedness, determines to quit cocaine, and vows revenge on Sosa.

Three months later, Montana returns to Miami. All of his assets have been frozen, and the districts of Miami he used to dominate have been divided among other drug cartels. His first act is to ask George Sheffield (James Woods) to become his lawyer again. Sheffield reluctantly agrees, but at higher wages than before. As Montana has no real power anymore, he has little choice. He next travels to see his old friend and contact Felix (Carlos Ferro), who tells him Sosa is working with Gaspar Gomez (Cheech Marin) in an effort to take over all of Montana's old turf. He also warns Montana there are very few dealers who can be trusted anymore, as most report back to Sosa. Montana says he needs to make some small deals so he can make enough money to buy his mansion back from the Vice Squad, and begin to rebuild his empire. Felix advises him to speak to a bartender named Coco (Willa Holland). She puts him in touch with some dealers, as he slowly begins to re-establish his name, earning enough to re-purchase his mansion. He calls Felix, who tells him that he thinks Gaspar is smuggling cash. Montana steals one of Gaspar's trucks, carrying $50,000, and uses it to open a bank account. Reconnecting with his old banker, Jerry (Michael York), Montana uses the bank to launder his money as he sets out to reclaim control of Little Havana from the Diaz Brothers. As Montana's reputation increases, the brothers attempt to have him killed. He survives the assassination attempt, and one of the killers tells him the Diazes have murdered his mother. Killing them both in retaliation, he regains control of Little Havana.

Montana then gets a call from Pablo (Wilmer Valderrama), an associate of Sheffield's. He tells Montana they have information regarding the location of Montana's estranged wife, Elvira, and he arranges to meet. However, the meet is a set up. Montana escapes, and kills Pablo, realizing that Sheffield has turned against him. Meanwhile, he sets about taking control of Downtown from the Contreras cartel. Upon doing so, he is contacted by The Sandman (Steven Bauer), a cocaine producer from the Caribbean islands south of Miami. Sandman also wants Sosa out of the picture, and he invites Montana to come to see him. They agree that with Montana in Miami selling Sandman's product from the islands, they can run Sosa out of business. Montana then meets Venus (Cree Summer), Sandman's ex-girlfriend and a powerful influence on the islands herself. She tells him of the owner of a nearby casino, being run on a disused oil tanker, who is killing women and dumping their bodies overboard, and asks Montana if he can take care of it. The man turns out to be Nacho Contreras, formerly in control of Downtown's drug trade. Montana travels to the casino and kills Nacho.

He next sets about taking control of South Beach and North Beach, both of which are controlled by Gaspar Gomez. Upon doing so, he is contacted by The Sandman, who tells him he is going to war with the Colombian drug cartels. However, the Columbians get word of Sandman's plan and attack his plantation. Montana helps defend it, but Sandman tells him the Columbians have taken over his processing lab on the island of Tranquilandia, and are holding the workers hostage. Montana heads there, killing the Columbians and rescuing the hostages. Upon returning, The Sandman sells Montana his plantation, meaning Montana is now in charge of production and distribution, making him the most powerful drug lord in the vicinity and allowing him to finally go after Sosa, who is in Bolivia.

At his mansion, Sosa is hosting a meeting with Sheffield and Gomez in which they are discussing how best to get rid of Montana. From outside, they hear an explosion, as Montana attacks the house. Fighting his way through the grounds, he kills Sosa's security people, before shooting and killing Sheffield. Heading further into the estate, he kills Gomez. Eventually, he confronts Sosa, who tells Montana he warned him not to betray him, but Montana did, referring to the planned assassination of a journalist which Montana refused to carry out because there were children in the journalist's car. Sosa says that in their business, sometimes children have to be killed. Montana then kills him. As he leaves the mansion, Montana finds one of Sosa's men still alive. The survivor begs for his life, and Montana offers him a job.

The game ends with Sosa's surviving henchman working as Montana's butler, as Montana and Venus watch television in a Jacuzzi. Feeling good about his life, Montana declares he finally has what he always felt was coming to him: "the world."