The main objective of the game is to flee the house while evading the looming menace in just five (or six, if the picture puzzle is finished). By picking the lock on the front door, repairing the automobile in the garage, or picking the lock on the vault door in the drain tunnel, the player can leave the room. They're all different in what they need.

The gamer has a choice of five different levels of difficulty: Practice in an environment without grandparents; try easy, normal, hard, and extreme. Multiple locks came at the front door with Granny increasing faster and the floor beginning to crack at each problem, which was conveyed from Practice. Additional settings include Nightmare (which modifies the game's texture), Extra Key, and Darker. Rats appear all around the home in Nightmare to warn Granny, while Extra Locks and Darker are compelled to activate in Extreme.

Grandma prowls the house in search of players, taking advantage of any noises they make and setting bear traps to obstruct their passage. If the player is discovered, Granny will make them comatose, terminating the day and beginning the next and returning them to the master bedroom. Other environmental dangers that might knock out the player include Granny's spiders and falling from the attic, among others that can be found throughout the game. One of the five "game over" cutscenes will play if the player is captured on the final day of the game, and they are then taken back to the title screen. The player has a multitude of options to defend themselves from Granny, including employing various traps and weapons that may be found everywhere about the house, such shotguns or pepper spray, to render her momentarily blind or comatose.

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