Vampire Survivors is nominally set in rural Italy in 2021. Hordes of monsters summoned by the evil Bisconte Draculó (a villain inspired by Count Dracula) ravage the land, prompting the Belpaese family and other heroic survivors to take it upon themselves to hunt down and defeat Draculó. This quest takes them through monster-infested locales such as a cursed forest, a haunted library, an abandoned dairy plant, an ominous tower, and an otherworldly chapel, culminating in a battle against an Eldritch otherworldly being referred to as "The Directer". Despite the game's title, the characters do not fight any vampires in the story.