The Suffering centers on the story of Torque, a prisoner on death row for murdering his ex-wife and two children, a crime that he possesses no memory of committing. Shortly after he arrives in Abbot State Penitentiary on Carnate Island, off the coast of Maryland, an earthquake hits the island, resulting in the prison being attacked by supernatural threats from the island's past. After being freed, Torque attempts to fight his way to freedom while confronting his own personal demons, all while attempting to remember what really happened to his family. The game features three endings which depend on the players' gameplay choices throughout, each of which reveals a different version of the murder of Torque's family.