Mikan lies on a bed inside a hospital room. Monokuma, wearing nurse clothing, appears with a huge syringe in his hand. He runs toward the bed, only to trip and jab the syringe into the floor beside it. The room promptly falls apart as the bed vibrates before flying away as a large, arm-shaped rocket pops out of the ground. Mikan is left straddling the rocket, and Monokuma's syringe is stuck in its side. The robotic bear injects the contents of his syringe (possibly adrenaline, hormones, or simply fuel) into the rocket as Mikan becomes increasingly ecstatic, ultimately entering an orgasmic-like state as the "refueling" is completed.
The rocket color changes from light brown to red, and it clenches its fist as it starts to launch. Monokuma hangs on the rocket with the giant syringe until the back of the rocket separates from the main body of the rocket.
When the rocket launches into space, Mikan closes her eyes and keeps holding to the rocket for dear life. She presumably dies from the lack of oxygen. After Mikan safely leaves the earth, Monokuma crashes to the ground below and becomes lodged face-first in the soil.
Mikan's execution has alternately been speculated to be death by lethal injection, with the events shown in-game being a hallucination or stylistic interpretation of the drugs' effects before she expires.
- The original Japanese title of the execution is almost identical in meaning to the English title, with its translation being "Pain Pain Go Away".
- Also, similar to how the English title has a childish tone to it, the specific phrase used in the Japanese title is written in childlike language. The word 飛んで行け tondeike (lit. "fly away") is a colloquial alteration of the more formal 出て行け deteike (lit. "go out and away") that is commonly used by young children.
- The execution's original Japanese subtitle reads 超高校級の保健委員罪木蜜柑処刑執行 chō kōkō kyū no hoken iin Tsumiki Mikan shokei-shikkō -meaning "Ultimate Nurse Mikan Tsumiki's Execution: Executed" as the English translation puts it.
- The execution track is used in Danganronpa 3: The End of Hope's Peak High School - Despair Arc #08 after Mikan is punished by Junko and Mikan seemingly faints.