Pestilence began in the Netherlands in 1986 as a thrash metal band. The lineup, consisting of guitarist/vocalist Patrick Mameli, guitarist Randy Meinhard, and drummer Marco Foddis, recorded two demos before gaining the attention of Roadrunner Records. After the first demo, bassist/vocalist Martin van Drunen joined the group.
Pestilence released their debut album, Malleus Maleficarum, in 1988, further refining their approach to thrash metal. Shortly thereafter, Meinhard left the band and Pestilence recruited a new guitar player by the name of Patrick Uterwijk. In 1989, they released their second album, Consuming Impulse, which marked a turn toward death metal; musically, things became heavier and more haunting, and vocally, van Drunen moved away from cleaner vocals in favour of a more acidic growl.
With the release of Consuming Impulse, Pestilence gained international attention, but before a follow-up was released, van Drunen departed to front Asphyx. So while recording their third album, 1991's Testimony of the Ancients, they enlisted bassist Tony Choy of Cynic and Mameli took over vocal duties. The new material was not as abrasive as the previous albums, but the band's musicianship had obviously grown and the album had the best production of the band's catalog to date. However, Tony Choy ended up going back to Florida to eventually play with Atheist, and Pestilence enlisted the talents of Jeroen Paul Thesseling.
Over the years, the members of Pestilence were getting into other forms of music, primarily jazz fusion, which they sought to pair with metal. The band's fourth and final Roadrunner album, Spheres, was released in 1993. Spheres mixed strong jazz fusion elements into their death metal style, and featured extensive use of guitar synths. Pestilence's popularity had grown with the release of each album, but unfortunately, so had tensions between the members. So the band unanimously decided to split up, feeling they had reached their creative peak.
In 1994, Roadrunner released one last Pestilence CD: a best-of called Mind Reflections, containing tracks from all four albums, plus the extremely rare song "Hatred Within" (originally released on the Teutonic Invasion Part II compilation) and six unreleased live tracks recorded at the Dynamo Open Air Festival in 1992.