Mikami consistently prioritizes creating a tense and immersive atmosphere in his games. He uses sound design, visual cues, and limited resources to build a sense of vulnerability and dread.

A hallmark of Mikami's survival horror games is the emphasis on resource management. Players must carefully conserve ammunition, health items, and other supplies to survive encounters.

Mikami's games are often known for their challenging gameplay. He aims to create a sense of tension and accomplishment by requiring players to think strategically and adapt to difficult situations.

While he often returns to his roots, Mikami demonstrates a willingness to experiment with new gameplay mechanics and perspectives. Resident Evil 4's over-the-shoulder camera is a prime example of this innovative spirit.