It was originally released for Windows and was later ported to Linux, OS X, Android, iOS, and the Nintendo Switch.

The game features relatively few gameplay mechanics, with the player controlling the two doctors, exploring the narrative, and solving puzzles as they try to reconstruct the dying man's memories in order to fulfill his wish.

The game was updated later to include free downloadable content called "minisodes" to give more context to the main characters.

[1] To the Moon is built on the RPG Maker XP engine, which is used to create 16-bit 2D role-playing games in the style of Suikoden 1 and 2.

As the game is mostly story-driven, the gameplay focuses on puzzle solving, interpreting information from the subject's (Johnny's) life, and finding ways to get deeper into his memories.

Occasionally, the player will have to explore Johnny's house and the surrounding area for certain clues, if they cannot gather enough energy from a certain memory, or don't know how to proceed to a further one.

At this point, the player can begin manipulating the memories, by changing around characters, objects, and events, to make Johnny believe he had achieved his dream of going to the Moon.

Sigmund Corp. employees Dr. Eva Rosalene and Dr. Neil Watts are contracted with fulfilling the wish of the dying Johnny Wyles.

With each leap to an important moment in Johnny's memories, they learn more about him, largely revolving around his somewhat unhappy marriage to his teenage sweetheart, River.

The doctors later uncover medical records explaining that Johnny once received a large dose of beta blockers as a child despite not having a heart condition, causing significant memory loss.

The two agreed to meet at the same place the following year, with Johnny promising that should he forget or get lost, the two would "regroup on the Moon", finally explaining the motivation behind his last wish.

As a result, Johnny never meets River in school and would spend his entire youth working on becoming an astronaut to fulfill his promise to her.

Rosalene and Watts, now back in the real world, look to Johnny's grave, placed adjacent to River's, behind their home.

[7] The game was localized in Chinese, German, Italian, Spanish, French, Polish, Russian, Brazilian Portuguese, Vietnamese, Dutch, Korean, and Turkish.

[8] The score of the game was composed by Gao, with a theme song titled "Everything's Alright" being written and performed by Laura Shigihara.

A downloadable minisode was released on December 31, 2013, which centers on Dr. Rosalene and Dr. Watts during a holiday party at their local Sigmund Corp.

While not a direct continuation of the story, it serves as a bridge between To the Moon and Finding Paradise, a sequel which was released in December 2017.