Parasite Eve received positive reviews critics praised the graphics and gameplay, but found the overall game too linear and with little replay potential. The video game adaptation was part of a resurgence of popularity in Japanese horror sparked by the original book, and was released alongside a film adaptation and two manga comics one based on the book, the other on the video game. The original title was also followed by two video game sequels: Parasite Eve II in 1999 and The 3rd Birthday in 2010, and was re-released on the PlayStation Network in 2010. The first two games, Parasite Eve and Parasite Eve II, had shipped over 3 million copies worldwide by 2010. Parasite Eve is an action role-playing video game with survival horror elements. Movement in the ' world map' (which is a map of Manhattan) is limited to specific destinations. Upon the player walking over a 'hot spot', there's a chance of a random encounter. Enemies materialize and attack players on the same screen that they move Aya around on, with no battle mode or screen being used. In battle, the game uses a pausable real-time combat system with an Active Time Bar (ATB) that sets the time that must be waited till the player can take their next action. While waiting for her turn, the player character Aya can be moved around to dodge enemy attacks. Upon each turn, the player may choose between attacking with their equipped weapon by pressing the attack button, using PE (Parasite Energy) for defense, assistance, or attack, using items, changing a weapon or armor, or escaping the battle. If the player chooses to attack, the battle briefly pauses and a dome/sphere symbolizing the range of the weapon appears, allowing the player to target an enemy within range. Parasite Energy recharges during battle but the more players use it, the slower it refills. When not in battle, the player has the option of altering the weapon and armor attributes and effects with tools and super-tools, which are limited in number. The player selects the 'tune-up' option, choosing the weapon that will be altered and the weapon from which the attributes or effect will be taken.

Weapons have many different properties, including special effects like 'acid', which causes enemies to continuously take damage.

One of the principal RPG elements of the game is that experience-based levels are present.

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