At the beginning of setup, all players draw map tiles and place them in real time following to a few simple rules (doors must connect to doors, for instance) to generate the map of the University. Then the group selects which Scenario to play, the players each pick a Character, and a Role Card is distributed to each player. There are two types of Role Card: the Cultist, which secretly describes how that player will betray the rest of the party and summon some sort of unspeakable abomination, and Academics, who are trying to complete the Scenario Goals before the Cultist can kill them. Academic role cards describe the particular way that character could go insane during the game.
On your turn, you first drawn an Event relevant to your location, Indoor or Outdoor, and then take two actions. Actions can be Move, Attack, Search, Use an Item, Steal, Trade, and doing any character or Scenario specific actions. Each player takes a turn in clockwise order, and then when it gets back around to the Start Player, instead of taking another turn, they move any monsters which may be on the board, and draw two University cards. University cards are all bad, but in different ways and to varying degrees. They could be an instantaneous one-time occurrence, or last for the round, or be Weather, which affects all Outdoor tiles and remains in play until it is replaced with a new Weather effect. The Start Player picks one to play and one to shuffle back into the deck without revealing it, and then passes the Start Player token to the player on their left, who begins the new round.
Events and University Cards have the chance to move the Star Chart forward. When the Star Chart gets to a particular number which only the Cultist knows for certain, they may reveal themselves, summoning a monster, or transforming themselves, or a number of other options, depending on which particular Cultist role card they have.
Play continues in that fashion until either the Cultist successfully kills all of the Academics, or the Academics complete all of their Scenario Goals.
Ability scores are of the form “a pair of colored dice.” The colors are Green (masterful), Blue (mediocre), and Red (miserable). They each have an assortment of faces on them, which are called Good, Bad, and Weird (in the final version they will be referred to by the August Derleth Elder Sign, the Yellow Sign, and the H.P. Lovecraft Elder Sign, respectively). Ability checks tell you what ability to use, what the difficulty is (Green for easy, Blue for moderate, and Red for difficult), and give a chart of possible outcomes based on the check result. To make an ability check, you take the dice for your ability into your hand, and then grab dice that are the color of the difficulty until you have five dice in hand. Roll them. You get a single reroll, which consists of you choosing all the dice that came up with a certain face (all the Weird results, or all the Bad results), and reroll those. Ability checks always have a beneficial result which occurs if you get three Good results, a result that is harmful to the individual character making the check if you get two Bad results, and a result that is strange and bad for the group as a whole if you get two Weird results.
Combat is done with opposed Brawn checks. The difficulty is determined by a random Combat card, which also determines the Weird result. Bad results decrease your own defense, Good results deal damage to your opponent.