Like its predecessors, Sangokushi VII is a grand strategy game set in the Three Kingdoms period in the history of China. The game offers various scenarios based on historical events that occurred in the late 2nd and 3rd centuries AD, beginning with the fall of the Han Dynasty. China is split into several states, and the leaders of each one try to conquer the others and become the sole leader of the Middle Country.

The seventh game of the series contains some changes, such as 3D graphics and the ability to play as any one of the main historical characters. Similarly to the previous games, the game focuses on governing a nation, managing its economy, diplomacy, as well as military planning and preparation. Turn-based tactical battles occur when one nation invades another.