When not in battle, the player has the option of altering the weapon and armor attributes and effects with tools and super-tools, which are limited in number. Parasite Energy recharges during battle but the more players use it, the slower it refills. If the player chooses to attack, the battle briefly pauses and a dome/sphere symbolizing the range of the weapon appears, allowing the player to target an enemy within range. Upon each turn, the player may choose between attacking with their equipped weapon by pressing the attack button, using PE (Parasite Energy) for defense, assistance, or attack, using items, changing a weapon or armor, or escaping the battle. While waiting for her turn, the player character Aya can be moved around to dodge enemy attacks.

In battle, the game uses a pausable real-time combat system with an Active Time Bar (ATB) that sets the time that must be waited till the player can take their next action. Enemies materialize and attack players on the same screen that they move Aya around on, with no battle mode or screen being used. Upon the player walking over a 'hot spot', there's a chance of a random encounter. Movement in the ' world map' (which is a map of Manhattan) is limited to specific destinations. Parasite Eve is an action role-playing video game with survival horror elements. The original title was also followed by two video game sequels: Parasite Eve II in 1999 and The 3rd Birthday in 2010, and was re-released on the PlayStation Network in 2010. The video game adaptation was part of a resurgence of popularity in Japanese horror sparked by the original book, and was released alongside a film adaptation and two manga comics one based on the book, the other on the video game. Parasite Eve received positive reviews critics praised the graphics and gameplay, but found the overall game too linear and with little replay potential. Music for the title was composed by Yoko Shimomura who was widely acclaimed for her work to create an 'inorganic' and 'emotionless' soundtrack that saw two album releases. It was produced by Hironobu Sakaguchi and directed by Takashi Tokita. Parasite Eve was SquareSoft's first M-rated game, and the first major American and Japanese game development collaboration for the company. Players explore levels set in areas of New York while utilizing a pausable real-time combat system along with several role-playing game elements.

The story follows New York City police officer Aya Brea over a six-day span in 1997 as she attempts to stop the Eve, a woman who plans to destroy the human race through spontaneous human combustion. The game is a sequel to the novel Parasite Eve, written by Hideaki Sena it is also the first game in the Parasite Eve video game series. Parasite Eve is a 1998 action role-playing video game developed and published by Square.

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