The gameplay is very similar to that of the majority of other games developed using RPG Maker and similar programs. So, from an aerial perspective you will control Aki, the protagonist, while you explore different rooms, speak with people, and above all, try to survive.
The story behind Misao is its strongest point. It's a terrifying story with no limits, where you'll find extreme violence, murder, insults, and many other elements not appropriate for players under 18 years of age. Additionally, those who have played 'Mad Father' in the past will run into some references to that game.
Misao is a shocking game, one of those that leaves you with a bad feeling after playing, but its quality is undeniable. It's not very impressive graphically, nor is the story very long, but it's well worth your time to take a look at this excellent horror game.