The player takes the role of an assassin and uses attacks, dodges and stealth to pursue targets.

[2][3] The gameplay experience of Tokyo 42 can be likened to that of a shoot 'em up game; The player must be aware of their surroundings as it is likely that enemy bullets will be coming in from multiple directions.

The main premise of the story is that the player plays as an inhabitant of an ultra futuristic version of the Japanese city Tokyo who is framed for murder.

The player escapes a police chase in the tutorial and is now officially a wanted criminal on the run.

The game is consistently praised for its highly stylized isometric visuals depicting future Tokyo.