There are eight main plot lines that the player will have the chance to experience, one for each of the heroines. Gameplay pauses at these points, and depending on which choice the player makes, the plot will progress in a specific direction. The time between these points is variable and can occur anywhere from a minute to much longer. Every so often the player will come to a 'decision point', where he or she is given the chance to choose from multiple options. The gameplay in To Heart requires little player interaction as much of the game's duration is spent reading the text that appears on the screen, which represents either dialogue between various characters or the inner thoughts of the protagonist.

To Heart was adapted into a thirteen-episode TV anime series by Oriental Light and Magic aired between April and July 1999, and a second anime, To Heart: Remember My Memories, aired between October and December 2004. The PlayStation version had the adult scenes removed.

It was later ported to the PlayStation and given voice acting. 5 /5To Heart is a Japanese adult visual novel developed by Leaf and released on for the PC.

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