The game is a story-driven first-person shooter with stealth elements, set in two environments: the Metro and the surface. In the Metro, Artyom must fight against mutants and other enemies while managing scarce bullets as the currency of the Metro. Stealth is often encouraged, and players can choose between lethal or non-lethal takedowns. The game features a variety of stations, each with its own challenges and hostiles.
Exploring the surface is a perilous task that requires Artyom to wear a gas mask to survive. Scavenging for gas mask filters becomes crucial as the player must find new masks before they crack and break. The surface is filled with toxic hazards, mutants, and deadly traps, making every step a challenge.