In an appearance at the US District Court in New York, Mr Combs was charged with sex trafficking, racketeering and transportation to engage in prostitution.
In an indictment that was unsealed at the same time, prosecutors alleged that he also engaged in kidnapping, forced labour, bribery and other crimes.
They described him as the head of a criminal enterprise that abused women, using threats of violence to force them into participating in drug-fuelled orgies with male prostitutes.
These "freak offs" were "elaborate and produced sex performances" and were highly organised parties, prosecutors said.
Mr Combs' associates allegedly booked hotel suites, recruited sex workers and distributed drugs including cocaine, methamphetamine and oxycodone to coerce partygoers into sex and keep them "obedient".
His staff allegedly arranged travel for the victims and organised the supply of intravenous fluids to help them recover from the parties, which sometimes lasted for days.
Prosecutors also alleged that Mr Combs taped the "freak offs" and would use the footage to pressure his victims into silence.
If convicted, the musician faces a sentence of 15 years up to life in prison.
Mr Combs' lawyer, Marc Agnifilo, declared his client's innocence, and described the "freak offs" as consensual.
"Is it sex trafficking?" he asked. "Not if everybody wants to be there."
Mr Combs pleaded not guilty to the charges.
But he was denied bail after prosecutors argued that he posed "a significant risk" to the trial, reporting that he had "already tried to obstruct the government's investigation of this case, repeatedly contacting victims and witnesses and feeding them false narratives of events".
The judge cited the star's anger issues and history of substance abuse as reasons for keeping him detained until the trial.
"My concern is that this is a crime that happens behind closed doors," he said.
Mr Combs' lawyers have repeatedly appealed the decision, offering to place the star under the watch of a round-the-clock private security team.
However Judge Andrew L Carter Jr said that, even under those terms, Mr Combs could still use employees to contact witnesses.
He is being detained at Brooklyn's Metropolitan Detention Center until his trial, which is tentatively scheduled for 5 May 2025.