The Dark Pictures Anthology: Man of Medan is a horror themed video game played from a
third-person perspective in which single or multiple players assume control of five different characters that become trapped on board a ghost ship.
[2] Players are required to make decisions based on their character's "head" or their "heart", or can choose for them to do nothing, while selecting between different options when interacting with other characters. The selection of options are stylised as a compass, which is both representative of the characters' "moral compass" and reflective of the game's nautical themes. The narrative changes and adapts to the choices that the players make, thus making it possible for players to keep all playable characters alive or to have some (or all) of them die. Choices also affect the characters' personality traits (which affects subsequent cutscenes and dialogue options), as well as their relationships with each other. The game can be played multiple times, as there are
multiple endings and multiple scenarios based on the decisions that the players make. Action sequences mainly feature
quick time events, most of which, if missed, can lead to dire consequences for the characters. As players explore the ghost ship, they can find different
"Dark Pictures" that gives them
premonitions of what may happen in the future.
[3] Players can also uncover the mystery surrounding the tragedy that occurred on the ship in the past, which can help save their character's lives in the present.