Katawa Shoujo is a visual novel about a boy called Hisao Nakai who has to go to a school for handicapped children after he suffers from a hearth attack and is diagnosed with arrhythmia. The goal of the game is to read the story and occasionally pick between a number of options that branch the story out. It has to be noted that a secondary objective throughout the game is to try and keep Hisao alive as he struggles with his weak heart.
The game was made on the Ren'Py visual novel engine and uses a variety of sprites and backgrounds, as well as some animations to support the story.
The game caused controversy due to its name, as the term "Katawa" is considered an archaic derogatory term in Japan. "Katawa Shoujo" translates into "Disability Girl" in English, but a more literal translation of "katawa" from Japanese is "cripple".
Not the only Four Leaf Studios game
Despite being founded to create Katawa Shoujo, this is actually the team's third game. Prior to the release of Katawa Shoujo, 4LS produced two other short visual novels: The Answer, and pXt.