Blood+ Final Piece is a visual novel, based on the anime series Blood+.

The story follows along with parts of the anime via some cutscenes and mostly stills, which then present the players with action scenes requiring button presses, and/or different options for how to respond to other characters and advance the story in different ways. There are 4 animations and stories that have been made specifically for the game.

What happens in the game depends on what you choose, with the other characters responding to what you say or different things happening if you respond in time to the button presses. Failure to respond correctly or at the right time can cause a Game Over. The game also includes a sub-story mode which expands on the main story of the game, a gallery of stills from the game, a database, and an alarm mode which you can use to select a character from the game, to wake you up with their voice via the clock on your PSP.