Mary Skelter Finale is a 3D dungeon-crawling role-playing game where players guide the Blood Maidens through a massive, ever-shifting tower called the Jail. Turn-based combat emphasizes strategic placement and the unique "Blood Maidens" mechanic, allowing characters to sacrifice health for powerful attacks. The Switch version adds handheld portability and supports local co-op. A Limited Edition was released for the platform, featuring extra physical collectibles such as an artbook and soundtrack.