Touch the Dead is an ugly game - and I don't mean because you are fighting a near limitless horde of zombies and other undead abominations. If the DS has any failings, it is that its 3D capabilities aren't the best. Still, some developers have managed to really push the system's limits while others, like Touch the Dead, simply do an okay job.
Touch the Dead's environments are bland and sterile. Zombies fare a little better, though it becomes really hard to tell what you are shooting at - especially later on when every shot counts. When you do hit a spot you are treated to a body part flying off, though sometimes the animations can be deceiving. When hit with a near head shot, the zombie's head jerks back. Given the grainy quality of the visuals, it looks like you scored a headshot and the head grew back, only that's not what is really happening, turning your glee into panic.
Nothing stands out about sound. You have gunfire noises, groans of zombies and appropriate music. While you are likely to hear these every so often, it is easy to tune it all out during the game.