To the Moon follows two scientists, Dr. Eva Rosalene and Dr. Neil Watts, as they alter the memories of those in need. This unique technology allows them to change people's lives by erasing mistakes and guilt, and fulfilling unrealized potential.
The game tells the story of Johnny, an elderly man who is nearing death. His life wish was to visit the moon, but he never got the chance. As his memories begin to fade, Eva and Neil enter his mind to weave new experiences and make him remember a life he never lived. They must navigate through Johnny's past to create a new reality for him.
The gameplay is largely driven by conversation and exploration, with some puzzle elements thrown in. Players control Eva and Neil as they travel back through Johnny's memories, collecting orbs that become part of a memento. By solving small puzzles, they unlock access to earlier life periods and reveal the cause-and-effect relationships between events.
Throughout the game, players are free to explore and examine objects, but their input is limited. Characters not remembered by the patient appear as vague outlines. As the game progresses, additional gameplay options become available, including horseback riding and action sequences. The doctors have access to a menu screen with notes, items, and character information.