Apothecary of Ashes is a choice driven narrative visual novel that takes place over a seven day period. Players navigate a dark setting centered around a spreading plague and the psychological impact of survival, making daily decisions that directly affect the story's progression. Gameplay consists of reading text, managing narrative progression, and selecting one of three choices each day. These decisions track player choices across multiple moral axes, specifically balancing compassion versus pragmatism, truth versus deception, and mercy versus control. The game features branching paths and a total of four distinct endings based on the moral choices accumulated throughout the week.