LISA: The First is the first game in what is known as the LISA trilogy, all of which take place in the same world and deal with heavy themes such as physical and psychological abuse, mental illness, and the depths of human depravity. The First centers on a character named Lisa Armstrong and the adventure she goes on to escape the terrible things that have been happening to her. The adventure then starts resembling the one Madotsuki went on in Yume Nikki as Lisa finds herself in places that symbolize various parts of her life.

Spikestuff in this run opts to get both endings in the game — the normal ending and the true ending — and does so in record time.

Caution: Some sequences in this game may be disturbing and triggering to some people. Viewer discretion is highly advised.