The Coffin of Andy and Leyley is an adventure game presented from a top-down perspective, in which players, playing as sibling protagonists Andrew and Ashley Graves, explore the environment and solve puzzles to advance the narrative.

Upon learning there is no outbreak and they are deliberately being starved to death as part of an illegal organ harvesting operation, the siblings plan to escape; Andrew kills one of the two guards keeping them imprisoned, while Ashley sacrifices the soul of the other to the demon.

After the Graves family have an awkward dinner together, Ashley argues to Andrew that they should kill their parents in order to keep them from revealing that they survived, which would potentially incriminate them.

If the player pursues the corresponding narrative route, the demon's talisman causes Ashley and Andrew to see a potential future premonition of themselves entering an incestuous sexual relationship.

[8] Destructoid's Andrea Gonzalez gave The Coffin of Andy and Leyley a positive review, describing it as "a well-written exploration of a toxic sibling dynamic" and praising the overall tone of the narrative.

[4] The Mary Sue's Ana Valens praised the game's exploration of taboo subject matter, stating that it "has an important commentary to share about abuse, trauma, and dysfunctional family dynamics",[9] while also comparing the events of chapter 2 to the Folgers "Coming Home" advertisement.

She noted that over 7,000 Steam users positively reviewed The Coffin of Andy and Leyley, often leaving idiosyncratic comments jokingly endorsing the game's content.