The book expands on game elements for the 5th edition, such as: It also includes detailed advice on running a horror themed campaign and a breakdown of the various types of horror in the genre. The Dungeon Master section includes an overview of safety tools for running a horror themed game such as 'things like the X-Card, trigger warnings, boundaries, and establishing clear lines of communication'. The book's marginalia is presented as correspondence between the vampire hunter Rudolph Van Richten, 'D&D's Van Helsing equivalent', and 'other heroes in Ravenloft like Ezmerelda d'Avenir and the Weathermay-Foxgrove Twins'. The book includes an overview of 39 Domains of Dread and a 20-page adventure called The House of Lament. Van Richten's Guide to Ravenloft is a 256-page campaign and adventure guide for using the Ravenloft setting in the 5th edition.
