Because of this highly simplified control scheme, characters can only move left and right between scenes while up and down are used to interact with objects in the environment and the player's inventory, respectively.

The game deals with mature themes such as depression, suicide, murder and cancer, but also provides moments of humor.

One night, Susan decides to take her own life, but this leads her to a strange place in death where she encounters the Queen of Maggots, who grants her immortality and gives her the task of ridding the world of five psychopaths referred to as the "parasites".

Whilst summoning the cats, she receives a complaint from a neighbour who threatens to call pest control.

He stumbled upon a suicide forum online, in which a troll called the "Eye of Adam" lured people to kill themselves.

Susan reveals her hatred for flowers; ten years ago, she was young mother to Zoe, married to a taxi driver named Eric.

She tries to break things off with a man who attempts to pursue her despite her being married by repeatedly sending her flowers, which she hides in Zoe's room.

Eric returns home, informing Susan of a terrorist attack happening earlier that day, nearly killing him.

Whilst Eric and Susan argue, Zoe has an allergic reaction to the pollen from the flowers, eventually killing her.

[4] Kevin VanOrd of GameSpot gave the game a very positive review, and concluded it by saying, "If you seek horror, The Cat Lady may sometimes freak you out, though probably not outright scare you.