Kana: Little Sister focuses on storytelling, and falls into the subgenre of dating sims which are full of tragic events and meant to be emotionally moving for the player. It also falls into the subgenre of games, manga, and anime revolving around incestuous relationships. One playthrough of the game takes about 5 to 10 hours.
The story of Taka and his little sister Kana is told from Taka's perspective, starting when Kana is just about to start high school and then delving into the past to explore the relationship between the two siblings.
The game is a visual novel, displaying scenery and characters in the background while the characters' dialogue and Taka's narration are displayed as text. Music and sound effects are also used. The unhurried narration is intended to allow the player to identify with Taka (and Kana) as the story unfolds.
Over the course of the game, the player is presented with approximately 30 decision points which determine which path the storyline will follow and, ultimately, which ending the player will achieve.
Kana: Little Sister is an eroge and contains pornographic scenes. It is only sold in a few online stores. Because of its limited availability, the game is relatively unknown among American and European gamers.
The game was originally developed for Windows. A Mac OS version was subsequently published in 2001. In 2003, Panther Software announced plans to release an Xbox port, which was ultimately cancelled in May 2005 after multiple delays.
The original versions published by D.O. are now out of print. A revival Windows edition was released in 2004 under the title Kana…Okaeri‼ (加奈⋯おかえり！！—"Kana…Welcome Home!"). This new edition retains the original storyline, but features new character designs and is fully voiced.
Kana Todo (藤堂 加奈 Tōdō Kana): Taka's little sister. Because of renal insufficiency, she spends most of the time in the hospital. She does not have many friends, and is very dependent on her brother.
Yumi Kashima (鹿島 夕美 Kashima Yumi): a girl who attends the same school as Taka. Taka liked her until an incident occurred between them in the fifth grade, after which he started hating her with a passion. She, however, has always pursued him.
Miki Kondo (近藤 美樹 Kondō Miki): the hospital nurse who has taken care of Kana since she was a little girl. Yuta Ito (伊藤 勇太 Itō Yūta): one of Kana's classmates. When they first met, Yuta picked on her for her lack of school attendance and shy nature, but has now begun to develop an interest in her, and regrets his earlier actions. He now does his best to protect Kana from bullies at school, and seeks Taka's permission to go out with her. Kana still does not like him, though, and is shy and silent in his presence.
The endings are grouped into four categories: