In this game, the player controls Fujita Hiroyuki, a high-school student who seems to have more interest in romance than in his studies. In his school there are several pretty girls, and his goal is to be nice to one of them, make the right decisions when talking to her, and ultimately win her heart.

To Heart is a visual novel: the player reads text and looks at CG images, occasionally prompted to choose a response or an action out of several available ones. These decisions determine the outcome of the story. Each girl has her own "path" and ending, with various degrees of difficulty to attain.

The PC version of the game has explicit adult content. Subsequent console and handheld releases remove adult scenes and add voice acting to the game.

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