The three protagonists abducted by Zero and are trapped in a facility along with six other participants and are divided into three teams. The story primarily follows three people: a nurse named Diana, a firefighter named Carlos, and a boy with a spherical helmet named Q.

The gameplay is a mix of escape-the-room and puzzle. The story also contains major science-fiction elements, preventing it from being a realistic murder mystery. There are still slight elements of humor and comedy to fill in the gaps when the atmosphere isn't so dark, although there is a lesser focus compared to the previous two entries to focus on the more emotional and serious aspects of the story. The game's genre is a mix of psychological horror, mystery, suspense and thriller. All versions of the game feature English and Japanese dual audio. The only known changes are the addition of a new lighting engine and a few re-done textures. A port to the PlayStation 4 was released on August 18, 2017. The 3DS and Vita versions are digital download only for Europeans, with the only exception being the New Zealand 3DS digital copy, because it does not exist.

It was released for the Nintendo 3DS, PlayStation Vita / PlayStation TV, and PC on Steam in June 2016. It is developed by Spike Chunsoft and published by Aksys Games in North America and Europe. It is the sequel (and chronologically, a prequel) to Zero Escape: Virtue's Last Reward. Zero Escape: Zero Time Dilemma, often abbreviated as ZTD, is the third and final installment of the Zero Escape trilogy.

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