An otome game (乙女ゲーム, otome gēmu, literally maiden game), is a story-based video game that is targeted towards women. Generally one of the goals, besides the main plot goal, is to develop a romantic relationship primarily between the female player character and one of several traditionally male characters.

Is Saya a monster?

As he contemplates suicide in the hospital, he meets Saya, who he sees as a beautiful young girl; however, in reality, she is a horrific extraterrestrial monster whose appearance drives people mad.

Is Saya no Uta sad?

The themes of the game itself are quite depressing. Due to Saya being an Eldritch Abomination and Fuminoris nightmarishly distorted senses, both of them are surrounded by people who they cannot or can barely tolerate interacting with. Both are completely alone in a hostile and alien world.