Sekiro: Shadows Die Twice is an action-adventure game played from a third-person view. Compared to FromSoftware's own Souls series, the game features fewer role-playing elements, lacking character creation and the ability to level up a variety of stats, as well as having no multiplayer elements. It does, however, include gear upgrading, a skill tree, and limited ability customization. Rather than attacking to whittle an enemy's health points, combat in Sekiro revolves around using a katana to attack their posture and balance instead, which eventually leads to an opening that allows for a single killing blow.

The game also features stealth elements, allowing players to immediately eliminate some enemies if they can get in range undetected. In addition, the player character has the ability to use various tools to assist with combat and exploration, such as a grappling hook. If the player character dies, they have the option of being revived on the spot if they have resurrection power, which is restored by defeating enemies, instead of respawning at earlier checkpoints.