The Last of Us Part II: Grounded Update introduces two new gameplay modes, Grounded and Permadeath, enhancing the challenge for players. This update also features a variety of new graphics, audio, and gameplay modifiers, including Mirror World, Slow Motion, and Infinite Ammo, among others. These additions aim to provide a fresh experience for both new and returning players, allowing for unique gameplay scenarios and increased replayability.

Alongside these modes and modifiers, the update implements several quality of life improvements such as displaying playtime in saves, options for film grain adjustment, and various aiming adjustments. Accessibility enhancements have also been included, particularly for the Ground Zero encounter and collectible tracking. Overall, this update enriches the gameplay experience, offering players more ways to engage with the familiar yet challenging world of The Last of Us.