The sport of women's roller derby has made an enormous comeback, now with more than 30 leagues nationwide forming the Women's Flat Track Derby Association. Blood on the Flat Track focuses on the Rat City Rollergirls of Seattle, who formed their league from scratch in April of 2004. In the first season, the league started playing at a small rink in front of about 200 fans; they now sell out of 1,500 tickets monthly. This film follows the teams throughout its first two seasons and focuses on the women who comprise the league, their teams' struggle to win the championship bout and their relationships with each other.

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