The player controls a patient suffering from amnesia within the Blackwood Sanatorium in 1952 during the aftermath of a mine collapse, with the intent on reclaiming their memories.

Their travel to the cable cars off the mountain is met with Wendigos and police officers who are ordered to silence anyone present.

Once the team makes it to the cable cars, either the roommate or the protagonist is revealed to have eaten human flesh and become a Wendigo.

If the roommate becomes the Wendigo and the protagonist made it off the mountain, they are shown being interrogated by a police officer, who intimidates them to be quiet of the events that happened.

[4] The game acts as a prequel to 2015's Until Dawn, set inside the Blackwood Sanatorium, 63 years prior to the events of the original.

In order to subconsciously draw players into the story, Supermassive Games employed elements of psychological horror, which included them rendering three-dimensional binaural audio to supplement the visuals.