The player can upgrade the Camera's special functions and lenses using Spirit Orbs found throughout the game, and points earned from photographing ghosts. The Camera uses different types of film as 'ammunition', with the weakest type being unlimited. Mio's only weapon is the 'Camera Obscura', an antique camera that can photograph and dispel spirits.
Shortly into the game, Mio will obtain a flashlight, which can be aimed in different directions, although the flashlight will not work in all areas.
If Mio's health runs out, the game will end the player can replenish their HP using different healing items scattered throughout the game. Mio's health is shown as a bar in the lower right corner, although only during combat and/or in Finder mode.
For most of the game, the player controls Mio Amakura as she searches the Lost Village with (and sometimes, for) her twin sister, Mayu. Gameplay in Fatal Frame II has some changes and updates from its predecessor.