Really bad. Exceptionally terrible; as terrible as balls, so to speak.
Person A: "Fuck! I think my car got towed."
Person B: "Seriously? Shit dude, that is balls terrible."
Used to indicate an unusually high degree of intensity. See gangbusters.
Whoa, have you looked outside? It's raining like a motherfucker.
Let's stop at a gas station; I gotta piss like a motherfucker.
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