It's a little fucked up, yeah, but Accordion, Bistro, Fancy Clown and All Caps are all among the best hip-hop tracks ever and there's literally nothing else out there like any of it. Believe me, I've heard a lot of abstract hip-hop, and never has a hip-hop album come so close to feeling like a dream. Especially the first time you hear the album, it's almost impossible to process what's happening. It's not so much that there aren't any hooks or great melodies (there are loads of them, and you find more as you listen further), but the way the songs are structured prevents you from ever getting a proper rhythm. At first, this is kind of frustrating, because your expectations always go back to intro-verse-chorus-verse-chorus-NEXT SONG-intro-verse-etc. but Madvillainy doesn't give you that. You can't tell where the next song even starts, most of the time.
Best way to listen to Madvillainy is in the dark, with headphones, just like most good music. It's an adventure, something really special and exciting that smashes convention. MF Doom is easily one of the best pure MCs around, because he throws around these dense volleys of wordplay and metaphor without breaking a sweat. He always sounds like he's in his element, no matter how complex the ideas. Seriously, break out the lyric sheet and be amazed by some of that shit. I find a great new use of language each time I hear it, even after 30+ listens.
Easy 5/5 for me, and probably my...4th favorite hip-hop album ever. If I ever made a hip-hop album, I would not necessarily want it to sound like Madvillainy, but I would want it to be just as brave and creative. It, to me, is every bit as innovative as Endtroducing, only it has the added bonus of great lyrics.