The first stage of play involves exploring the locale by adding randomly chosen tiles to the board. The characters encounter challenges in most turns, and use dice in combination with their traits to determine the outcomes. They may gain or lose items or trait points, trigger alterations to the board, kill or loose monsters, or trigger game-wide events.
At some randomly-determined point, an event triggers the second stage of play. One of fifty horror scenarios begins, setting one of the players against the others in a struggle to complete some goal.
Because of the wide variety of characters, board configurations, and scenarios, the game is different every time.