The Hunter arrives in Yharnam seeking "Paleblood" and receives a blood transfusion. After the procedure, they awaken during a night of the Hunt, when Yharnam's citizens and Hunters kill those transformed by the plague. Trapped in the Hunter's Dream, the Hunter is guided to the Healing Church's grand cathedral, where a vision points them toward Byrgenwerth.
At Byrgenwerth, the Hunter defeats Rom, a spider-like being whose death reveals the blood moon and the influence of the Great Ones. The Hunter then encounters signs of Queen Yharnam, her child Mergo, and the Nightmare of Mensis. In the hidden village of Yahar'gul, the Hunter defeats the One Reborn and enters the Nightmare of Mensis. There, they kill Micolash, leader of the School of Mensis, and Mergo's Wet Nurse, ending the nightmare.
Afterwards, the Hunter returns to the Hunter's Dream, where Gehrman offers to release them.
If the Hunter accepts, Gehrman kills them, and they awaken in Yharnam at sunrise.
If the Hunter refuses, they defeat Gehrman, but the Dream's master, the Moon Presence, binds them to the Hunter's Dream as his replacement.
If the Hunter has consumed three umbilical cords associated with the Great Ones before refusing, they resist the Moon Presence, kill it, and are reborn as an infant Great One.
