Described as an "open world role-playing game brimming with strange places and dark perils,"[2] Dread Delusion encourages player exploration and discovery over the use of combat and grinding.

The game features a character system that provides players with opportunities to resolve quests outside of combat,[3] under four attributes (Might, Guile, Wisdom, and Persona) which govern eight skills (Attack, Defence, Lockpick, Agility, Lore, Spellcast, Charm and Barter).

[4] Weapons, spells and quick-use items are managed in the inventory, where the player can also acquire or buy gear that improves their attack and defence skills.

The player is directed by the High Confessor to Jack Basalt, a former Navy Captain residing in Hallow Town, who became disgraced after abandoning his post to join Callose.

[8] An early access version of Dread Delusion was released onto Steam on 16 June 2022, following the involvement of independent publisher DreadXP in the development of the game.

[17] The release introduced several end-game content updates, including an ending to the game's main quest, the inclusion of a new region named the Underlands, and pilotable airships.

"[23] Writing for GamesHub, David Wildgoose stated the game was equally compelling and bewildering, noting that "throughout the surreal landscape were many locations and incidents that left me puzzled, but intrigued and keen to discover more", observing that I'm rarely sure whether its mysteriousness is the result of deliberate design or that some bits just aren't done yet.

[26] However, Alexander Chatziionnou of PC Gamer considered the game's final chapter to be of a lower quality, due to the "visually uninteresting" setting of the Underlands, describing it as "rigidly designed" and repetitive.

[29] Alexander Chatziionnou of PC Gamer praised the open-ended and immersive approach to quests, although found combat mechanics and movement to be "rudimentary" and "simplistic" in nature.

[27] Willa Rowe of Kotaku stated that the game's combat was "simple but not very fun", considering it to be "silly" lacking depth, and outmoded by other options including sneaking, lockpicking or charming the player's way out of encounters.

[30] In addition to the "clunky combat" which he considered could have been more "interesting and dangerous", Ian Boudreau of PCGamesN faulted the game's "unreliable" quest logs and bugs.