I just installed this and it won't go past the initial auto-save notification screen with the spinning tape?
It doesn't freeze or anything (the tape keeps spinning), it just won't go any further.
Tried the '-gl' launch option with no luck. Overlays are also disabled.
Am I screwed?
Running a hi-spec pc with Windows 10.
Any help would be much appreciated.

Now I know this topic is old - but I ran into this exact problem so I'm leaving my solution here in case some one else experiences the same problem:

Turns out the game doesn't launch when you limit the frames in the GPU driver settings. For instance, in the nvidia settings, there is the option "max frames" that I usually set to save energy and improve the life span of my hardware.

As soon as I added a separate profile for the HotlineMiamiGL.exe and disabled max frames, the game launched just fine. Re-enabling the frame limit stops the game from launching again - so it's definitely one possible cause for the problem.

I've also disabled XBOX Live since on a steam thread overlays were cited as a potential problem cause. I don't know if that had any effect, however.