A former bastion of humanity, Stratholme is now a place of despair and death after being torn apart by Arthas in a crusade against the plague and Mal'Ganis. In WotLK, Blizzard added another dungeon, The Culling of Stratholme, to the Caverns of Time to let players see how Stratholme came to be.

Stratholme is divided by several gates that ultimately make for two sides. One is commonly referred to as the "Live" or "Scarlet" side (main gate zone in), which the Scarlet Crusade has taken over; the other is the "Dead" side (service gate zone in), famous for its end boss which drops the much coveted and rare mount Deathcharger's Reins. Though at one point players could continue from the "Live" side into the "Dead" side, but the dividing gate is now locked into place, creating two separate instances.