Unlike most colony sims, Going Medieval features a full 3D voxel system, allowing you to build multi-story castles, complex underground cellars for food preservation, and intricate defensive fortifications.

You manage settlers' needs, such as hunger, mood, and sleep, while assigning them roles like research, farming, and animal handling.

The game includes periodic raids from bandits and rival factions. While building defenses is rewarding, some critics find the actual combat mechanics "messy" or "boring" compared to the building aspects.

Reviewers frequently describe the game as "," noting its deep voxel-based building system as its standout feature.