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Fiona Belli has somehow found herself in a strange castle, which appears to be somewhere in Italy. She has just been involved in a car accident with her parents, but her memories of this accident are vague. When she awakens, she finds herself in some sort of large butcher's room. Noting that the cage that keeps her prisoner was left unlocked, she steps out but is startled by a large, fierce animal snarling and then running past her. She quickly begins searching for some answers and a way out of the castle. Along the way, she befriends the animal that initially frightened her, who is a white German Shepherd named Hewie, and who turns out to be a valuable ally. As Fiona's predicament gets more and more disturbing, she learns that she is the carrier of the Azoth, which is what the castle's residents are after.

The first enemy is Debilitas, a large, mentally disabled man. Debilitas chases Fiona around the castle and is stopped by Riccardo. Fiona meets Riccardo and Daniella and finds letters and memos given to her by a man named Lorenzo who wants her to escape the castle. Fiona and Hewie are chased by Debilitas to the chapel. The way in which the player ultimately eliminates Debilitas influences the outcome of the endings.

Soon after Fiona has rid herself of Debilitas, her new enemy, Daniella, is reintroduced to the game after her short appearance in the game's early scenes. Daniella becomes jealous that Fiona can smell, taste, touch or "experience pleasure". This foreshadows her later intimation, immediately before her boss battle, that she cannot engage in sexual intercourse. Daniella wields a large shard of broken glass (unless the player approaches Daniella while she is kneeling near a fire place which then replaces the glass with a hot poker; this deals twice as much damage).

After Fiona kills Daniella by impaling her with a large shard of glass broken from the ceiling, the third villain is reintroduced, Riccardo, who wields a revolver. For a majority of the game Riccardo keeps his face hidden under a hood. Riccardo reveals his face and his plot to Fiona after cornering her in the woods. He has the same face as Fiona's father, Ugo, and reveals that they are clones and that he is now the original. Riccardo murdered Ugo after attempting to kill him in the car crash as revenge for leaving the castle and marrying Ayla, Fiona's mother. He plans to use Fiona (by means of her womb and use of her Azoth) to help him be reborn so that he may live forever. Hewie rescues Fiona (unless the player's bond with Hewie is weak and results in one of the game's four endings) and assists in their escape from the tower in which Riccardo keeps Fiona imprisoned.

The final boss of the game is Lorenzo, who menaces Fiona in several different forms. The player first meets Lorenzo as an old, crippled man. He tells Fiona how Riccardo was always the problem child, and that he created both Riccardo and Ugo in attempts to find a body with an azoth he could use. Ugo had the Azoth but left the castle to marry Ayla. Now that he knows Fiona is finally his, he can take the azoth she inherited from Ugo. He rids himself of his wheelchair and crawls on the floor in order to chase Fiona. After crushing the elder Lorenzo in a machine, Fiona encounters a resurrected, youthful Lorenzo; azoth allows him mastery over his own aging process, as well as the ability to teleport. Fiona eventually, with the help of Hewie, causes Lorenzo to fall into a pit of lava. Immediately after defeating young Lorenzo, the castle begins to shake and collapse, and Lorenzo returns a final time as a flaming skeletal version of his former self. He chases Fiona, but finally dies as she and Hewie escape the castle.