The major difference in the gameplay is that the game is quest-driven. Once an ambition has been completed, the play will unlock new ambitions for future playthroughs as well as unlocking freeplay for that specific kingdom. The storyline of the game is to build a successful kingdom by fulfilling the player's 'Kingdom Ambition,' which the player chooses at the start of the game.
The Sims Medieval is a life-simulation game with action-adventure elements.