In the game the player takes on the role as designer of a university campus and must build and design a campus with dormitories and various educational rooms such as classrooms, lecture halls, and laboratories. They must also organize cultural and extracurricular activities as well as hiring staff such as professors and janitors.
The game is the sequel to Two Point Hospital and is also set in Two Point County. In addition, a few of the characters from Hospital re-appear in this game.
The game has the following tropes:
- An Entrepreneur Is You: The player needs to build and operate the campus in addition to taking care of the well-being of all students. Doing everything in the game costs money and the player must make sure that the university is operating profitably.
- Artificial Brilliance: Students in the game have procedurally generated personalities. They arrive on campus and form bonds with other students and they act in a way that reflects how they feel about the campus. How students feel determines whether they graduate, or fail and drop out of school.
- In-Universe Game Clock: One in-game year lasts around 20 minutes real-time with every in-game year ending with a graduation ceremony.
- Shout-Out
- Once again, the game's title is a reference to Twin Peaks.
