Bedlam City is a fantastic setting book, packed with information and flavor. It is in many ways the antithesis of Freedom City. Its tone is relentlessly grim and thoroughly Iron Age, unafraid to tackle uncomfortable issues but with just enough spots of hope that players will want to fight that tide of depression. Its characters are not expys of traditional superheroes and villains, though they are often deconstructions. This is not a setting where the players will ask "why is my hero even needed?", though they may sometimes ask "what can my hero possibly do?".
As someone who loved the Rogue Isles of City of Villains and always wanted to play a hero there, to be one bright spot in the heart of the corruption, this setting really spoke to me. Corruption, apathy, and outright evil have permeated every part of the city, and it's all described in detail for your players to go up against. They will be fighting to save a city that, on some level, does not want to be saved. It is definitely a setting that stands on its own in spite of limiting itself to describing one city; it draws you in and makes you care, whether raising your hopes or kindling your anger.
The description of the city's infrastructure and the characters who make it work is the best I have ever seen. Everyone is a fully-realized character, with virtues and vices, and their presentation (laden with black humor) is perfect. You will love to hate most of them, but there are a few you will root for with all your heart, the aforementioned bright spots. The supernatural side of the city is also fantastically developed; Bedlam is a wonderful setting for magical heroes, a nexus of vile spirits, reality warpers, and astral travelers. It's also great for street-level vigilantes, with great detail on the vicious mob families, gangs, and drug dealers.
On the other hand, the super-powered characters are not generally ones I would be interested in. While the Westin Phipps everyman evil of many NPCs is powerful, the deconstruction and weird humor surrounding the supervillains lets them down in my opinion. Captain Condor (who looks more like a chicken) and Stabbo the Clown feel out of place next to the believable evils of crooked cops, vicious gangsters, and pedophile priests. Some work well, like Capricorn and the Nowhere Men, but Smashface the indestructible rapist baby-killer has no place in any campaign I can imagine playing.
In short, the strength of this book is an overwhelming aura of everyday, casual evil, with a sauce of supernatural wickedness that would haunt that sort of damned place and a light seasoning of people your players will want to save and see succeed. It looks racism, sadism, sexual crimes, and drugs straight in the eye and presents them unflinchingly. I may at some point run the entire city; until then, I will be forever taking bits, characters and institutions and the wonderfully evocative mood, to flavor my campaigns. This is well worth the purchase.