Quarantine Zone: The Last Check reframes the survival horror scenario by positioning the player as a methodical checkpoint inspector rather than a fighter. The core gameplay involves examining refugees one by one for zombie infection symptoms using progressively sophisticated tools—starting with visual observation and advancing to stethoscopes, reflex hammers, and portable X-rays. Based on symptom findings colour-coded as mild, moderate, or severe, players route individuals to safe zones, quarantine areas, research laboratories, or termination. The game constantly tests decision-making as it highlights inspection errors and mounting pressure.

Beyond inspections, the experience incorporates supplementary systems with uneven execution. Periodic raids task players with piloting a weaponised drone against approaching zombie hordes, offering fast-paced respite from the deliberate inspection rhythm. Resource management and base expansion provide long-term progression incentives. However, the laboratory minigame—requiring timed extraction of infected organs from subjects—suffers from unclear instructions and awkward controller translation from its original mouse-and-keyboard design. The title has migrated from a several-month Steam run to Xbox Game Pass, expanding access for players seeking unconventional horror-bureaucracy hybrids.