Tokyo 23-ku: Seifuku Wars is a visual-novel style adventure game with light RPG elements set in an alternate-universe Tokyo where uniforms are actually battle suits which grant special powers. After a series of conflicts that ultimately result in the destruction of the capital, all uniforms are brought under the control the oppressive organization "Heaven". At the same time, Ryuji Kizaki, the leader of the Uniform Freedom Organization "HELP", has gone missing. The main character is trying to track down Kizaki in order to end the rule of Heaven and restore freedom.

The game plays out in a standard visual novel style, with the player choosing a location from a map and then reading through extended dialogue sequences which depict the story's events. Occasionally, there are card-based battles in which the player must defeat the opponent by selecting the proper alignment of attacks to counter the enemy's type.