The game is set in the United States following a cataclysmic event which caused destructive creatures to begin roaming the Earth.

The player controls Sam Porter Bridges (Norman Reedus), a courier tasked with delivering supplies to isolated colonies and reconnecting them via a wireless communications network.

Alongside Reedus, the game features actors Mads Mikkelsen, Léa Seydoux, Margaret Qualley, Troy Baker, Tommie Earl Jenkins, and Lindsay Wagner, in addition to the likenesses of film directors Guillermo del Toro and Nicolas Winding Refn, as supporting characters.

These merits are, in turn, used to level up the player's statistics, such as stability and weight capacity, and increase their standing with individual locations and characters (which can improve rewards).

[12] The game extensively uses licensed music, most often from the bands Silent Poets and Low Roar, to score and enhance specific set-pieces and moments of traversal.

[16][9][10][22] If they achieve a mental connection to a "Bridge Baby" (a "BB")—a premature child reflecting a state between life and death—it is possible for a person to sense the presence of a BT.

Depending on its severity, a condition known as "DOOMS" allows a person to naturally sense, see, or even control a BT, as well as granting a variety of powers, such as teleportation or travel to other people's Beaches.

Freelance courier Sam Porter Bridges (Norman Reedus) is transporting cargo to Central Knot City but is interrupted by Timefall and takes shelter.

[e] She tells him that over the past three years, she led an expedition across what is left of the continental United States, making contact with isolated cities and settlements and setting up terminals that would connect them to the Chiral Network: a system that facilitates instant communication and data transfer across vast distances through the Beach.

Following the instructions of Die-Hardman (Tommie Earl Jenkins), Bridget's personal aide and Director of BRIDGES, Sam begins his journey from the east to the west coast of North America.

Along the way, he delivers valuable cargo to various Knot Cities and settlements; helps research the Death Stranding with BRIDGES staff such as Mama and her twin sister Lockne (Margaret Qualley), Heartman (Nicolas Winding Refn/Darren Jacobs);[d] and thwarts deadly plots by terrorists and their leader, Higgs Monaghan (Troy Baker).

While connected to Lou, he occasionally experiences memories depicting Clifford Unger (Mads Mikkelsen) and his hospitalized wife and BB child.

Amelie is revealed as the true leader of Homo Demens, having conceived the Chiral Network to enable the Last Stranding, the end of life on Earth.

Although UCA law demands dying BBs are incinerated, Sam follows Deadman's advice and removes Lou from its pod in hopes of saving its life.

After a lengthy corporate conflict with Konami as a restricted subsidiary,[23][24] Kojima Productions closed in July 2015 and re-formed as an independent video game developer and studio in December.

[25][26] The same month, Hideo Kojima announced his partnership with Sony Interactive Entertainment, at the time led by Andrew House, to make a new PlayStation game.

[32] Kojima Productions' meeting room was recreated in the engine as a reference of accuracy and for the purpose of testing physically based lighting.

[35] In June, information came from Shawn Layden, president of Sony Interactive Entertainment America, affirming that Death Stranding was in fact in a playable alpha version, but he had not been able to categorize the game in a specific genre.

Several character names were revealed: Cliff (Mikkelsen), Fragile (Seydoux), Deadman (Del Toro), Die-Hardman (Jenkins), Higgs (Baker) and Amelie (Wagner).

Del Toro and Refn both received a "Special Appearance" credit, with Kojima later explaining that only their likenesses were used and their voice and motion capture were performed by other actors.

[49] During Gamescom that year, two more trailers were shown: the first showed one of the key elements of the video game, a BB (Bridge Baby), with the participation of the character "Deadman", portrayed by del Toro and Corti.

Furthermore, a 6-minute gameplay trailer was shown, which introduces in detail various game mechanics, such as the possibility of urinating and delivering packages to isolated delivery stations.

[58] The official soundtrack of the game, Death Stranding: Timefall, was released through RCA Records and Sony Interactive Entertainment on November 7, 2019, and features artists such as Chvrches, The Neighbourhood, Major Lazer, and Bring Me the Horizon.

[80][81] In June 2018, during the days following the E3 press conferences, Death Stranding reached the top ten in the most watched video game trailers on YouTube, with more than 4.5 million views.

[65] Publications noted a range of reactions from reviewers across the board, with the game being praised for its unique concepts, lasting appeal, graphics, voice acting, and soundtrack, but also being considered to be bloated, frustrating, and slow-paced.

[83][84][85][86] Russ Frushtick of Polygon described Death Stranding as "the most advanced walking simulator the world has ever seen", and as being "composed entirely of fetch quests", but that it was "pretty damn fun once it gets out of its own way".

[92] This made it the most successful debut for a new intellectual property in Japan for the eighth generation of video game consoles, overtaking previous record holder Judgment.

[107] The game was criticized for portraying asexuality as a "sexless" lifestyle choice,[108] rejection of emotional relationships, and responsible for the decline of birth rate.

In response, Kojima posted a series of photos on Twitter, cheekily depicting him punishing Reedus for confirming the game's existence.

[136][137] The sequel was teased with images revealed at numerous game expos featuring Elle Fanning, Shioli Kutsuna, and Léa Seydoux.