This story sets the opening tone for the game. Erico uses her childhood as the topic for a speech competition which her friends, Kevin and Randy, promise her that she is guaranteed to win. After some yammering on about how wonderful and smart she is (they are all male at this point), a young green haired girl named Michel interrupts. In her hand she holds 4 personalized invitations to horror master Michael Reynolds' new, highly-exclusive horror theme park, Illbleed.

As a promotion for the grand opening of Illbleed, the first people to survive a trip to the park will be given $100,000,000, although the game frequently states the prize is only 1/100th this amount. A ridiculous amount of money by any standards, even if they say "survive". This prize is highly enticing to a group of high school students, who seem to have little regard for their personal health and safety. Everyone except Erico is into it, claiming that the contest will probably entail surviving nothing but a bunch of props, gimmicks and cheap scares. The three leave her behind with her ticket, and after several days out of contact with her friends, Erico decides to visit Illbleed to look for them.

It is at this point that the game actually begins. The most amusing bit of the entire situation is that Illbleed is exactly what they said it was to be, a park. The game consists of six levels, each taking place in a controlled environment filled with shabbily dressed crash test dummy monsters, amusement park workers, and other elements that destroy any hope that what is happening within the game can be considered supernatural.

The vast majority of the game consists of moving at a deliberate (sometimes glacial) pace while monitoring four EKG like indicators at the top of the screen. Each indicator corresponds to a different sense: Sight, Smell, Hearing and a nebulous "Sixth Sense". These senses can indicate the presence of an item, enemy or trap. Items range from restoratives, weapons and key items for getting past certain parts of the stage. Generally, however, your senses are just telling you something wants to hurt you. Nothing in the game kills you outright, for the traps are designed to either maim or scare you. Likewise, enemies can appear, much like traps, to send you to a confined battle zone that cannot escaped without defeating all the respective offenders, or summoning an escape ladder.

Each trap either increases or decreases one or more of your life stats: Stamina, Adrenaline, Bleeding, and Heart Rate. Scares might increase your heart rate and sap some adrenaline, or it might simply just slice you to ribbons reducing stamina and making you fire blood like the Hotel Bellagio fountains. These stats are all vitals, meaning that if any of them drops above or below the safe limit range, your Erico and her friends will meet an untimely end. All is not lost, for restoratives can be found or purchased at a campy gift shop called Bloody Mary's (keep in mind that everything is scaled to theme park prices). Restoratives can be used to either increase or decrease various stats, like nitroglycerin to reduce heart rate, coagulant to reduce blood loss, or a steak dinner to increase stamina. Conversely, you can also use items like porn to increase your heart rate in the case that it is too low.

More often than not the theme park traps will be directly blocking your path, making triggering them unavoidable. Times like these are best avoided by using an item that must be found in the first stage, the Horror Monitor. The Horror Monitor allows characters to mark potential traps, but it spends adrenaline in the process. If it turns out that there is a trap present, your adrenaline is returned to you and the trap is effectively defused. This should be used only when you are positive, as being wrong will result in the loss of adrenaline. For this reason, it is simply more beneficial to just take the damage and use restoratives later. The entire game becomes more about balancing vitals than brute force or puzzle solving like many other survival-horror titles.

Each stage concludes with a boss confrontation. Boss encounters are often multi-stage and the "horror" is almost always broken up with a humorous break in the forth wall. Players are often shown windows of someone working in a control room or gabbing on a phone about what they are going to be having for dinner. This sense of humor often seems in contrast to the murderous feel of the park itself.

Each stage also has a reward. These values are a $100,000,000 prize divided up based on the difficulty of the stage, and meeting certain criteria nets you more money. At the end of each stage a list of various criteria is shown. Things such as excessive bleeding or not finishing a stage fast enough results in a deduction from the cash prize. Additionally, in a small number of stages, your friends will be in trouble. Completing certain goals before a limited amount of time will allow you to rescue them. Rescued characters have different limits on their vitals and recovery rates, and can be used to complete different missions. The goals become increasingly difficult to meet, only further exacerbated by the length of the stages themselves. Stages vary between just over a half and hour to an hour and a half in length.

Illbleed is certainly not for everyone. The pacing of the game is slow and often times too poorly paced for the average gamer, especially those geared to more action oriented titles. The game feels more like a ride at Disneyland, whereby players are challenged to shoot animatronic ghoulies while being pulled on a rail. The story is fairly inconsequential, and the bite size stage-specific plots are cute, but they barely take more than a paragraph before you're sent further down the haunted house trail. If you are a fan of old slasher films or Mystery Science Theater, Illbleed is likely a good fit for you. The game definitely has a B-Movie feel from seemingly low production values, fountains of blood and cheap scares. These all work in favor of the game, and they never make it any less stressful to play. Illbleed has a certain charm that makes it easy to overlook having such glaring faults, and I would recommend it to anyone who owns a Sega Dreamcast.