The game's premise is based on the Lewis Carroll novels Alice's Adventures in Wonderland (1865) and Through the Looking-Glass (1871) but presents a gloomy, cruel and violent version of the setting.

After several years of treatment in a psychiatric clinic, the emotionally traumatized Alice makes a mental retreat to Wonderland, which has been disfigured by her injured psyche.

Along with the basic actions of walking and jogging, Alice can jump, cling to ledges, climb and swing on ropes, swim in water, and glide over columns of steam by using her inflated dress as a makeshift parachute.

Because the game takes place within Alice's imagination, the health mechanic is represented as "sanity", which is displayed as a red bar on the left-hand side of the screen.

She learns from nearby village inhabitants that the Queen of Hearts has put Wonderland in decline and despondency, and that the White Rabbit has promised a champion in Alice.

After aiding the Mock Turtle in retrieving his stolen shell from the Duchess, Alice catches up to the White Rabbit, who takes her in the direction of the Caterpillar before he is crushed by the normal-sized Hatter's foot.

In her search for the remaining pieces of the Eye Staff, Alice defeats the Red King in the chess-themed Looking-Glass Land, as well as the Hatter's minions Tweedledum and Tweedledee.

[7] McGee's dark and lustrous image of Alice's Adventures in Wonderland was primarily inspired by the Crystal Method track "Trip Like I Do", in which he heard the word "wonder".

Many of the early experiments with evolving the material of the novel – which included manga, futuristic, cartoon and sexual interpretations – strayed from McGee's intended direction.

Sketches of Alice, the Cheshire Cat and the Hatter by Terry Smith and Norm Felchle played a decisive role in establishing the game's visual style and served as a foundation for subsequent concept art.

[9] McGee sought to omit shortcomings in products that he had previously designed, such as recreating reality instead of creating a fantastic world, reusing traditional weapons, and unremarkable characters.

In the final product, the player can press a button to summon the Cheshire Cat at any time, though he merely provides cryptic advice on the current situation and does nothing to aid Alice if she is being attacked.

An Alice port for the then-unreleased PlayStation 2 was also in development but was later cancelled, which caused Rogue Entertainment to shut down, another decision which angered American McGee and resulted him leaving EA in frustration.

[9] The game's box art was altered after release to show Alice holding the Ice Wand instead of the Vorpal Blade and to reduce the skeletal character of the Cheshire Cat's anatomy.

However, in a 2009 interview, McGee expressed regret for his decision and said that the violence in the game did not warrant an M-rating; he felt that consumers should buy products responsibly after referring to the recommendations of the ESRB.

[21] All of the music created for the official American McGee's Alice soundtrack was written and performed by Chris Vrenna with the help of guitarist Mark Blasquez and singer Jessicka.

The Pale Realm theme, as well as the track "I'm Not Edible", features the melody of the chorus of a popular children's song, "My Grandfather's Clock".

It features all twenty original compositions by former Nine Inch Nails live drummer and studio collaborator Chris Vrenna with vocals done by Jessicka Addams of Jack Off Jill and Scarling.

[27] In 2006, Muckle Mannequins created life-sized statues of Alice and the Cheshire Cat on stands with variants for video game stores for international promotion from its success.

[28] For costume ware American McGee's company Mysterious released a replica of the Omega Necklace worn by Alice throughout the game.

Many levels depict a world of chaos and wonder, some reminiscent of the inside of an asylum or a madhouse, visually linking Wonderland to Alice's reality.

[53] Blake Fischer reviewed the PC version of the game for Next Generation, rating it four stars out of five, and stated that "Alice is an incredibly beautiful and well-designed shooter.

Later, Miramax head Bob Weinstein was shown the game's trailer, after which he immediately (and without waiting for the opinion of the board of directors) supported the production of a film adaptation.

[54] On July 5, 2000, FGN Online published an exclusive piece claiming that EA had signed an agreement with Miramax to create a film based on the game.

[66] On February 8, 2006, Scott Faye, who had become a producer of the project, announced that filming would begin in the summer of 2006, with a budget of $40 to $50 million and a tentative 2007 release date.

[69][70][71] With the success of earning the funds to produce Alice: Otherlands, McGee stated his desire to continue to work on the possibility of adapting the series into a feature film on Kickstarter.

[73] On April 16, 2014, he assured fans that the film is still in production and is currently working with a producer in Hollywood who they have licensed the rights from, but has run into a few difficulties along the way.

He was speaking with potential investors and financiers to gather the $400,000 (~$502,755 in 2023) required[75] but on January 8, 2015, McGee stated that negotiations for the feature film had gone on a hiatus.

[76] On January 31, 2022, it was announced that Radar Pictures – in partnership with Abandon Entertainment – was developing a television adaptation of American McGee's Alice written and co-produced by David Hayter.

In it, Alice is in therapy after a relapse nine months after the events of the first game, and she appears to hallucinate an image of the Cheshire Cat in place of her doctor.