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"Run. Jump. Shoot. I can do this all day!"
This is a side-scrolling action game with story elements. Your job is to save the people in the underground world by destroying the bad guys. You can run and jump around. You can acquire multiple weapons and shoot things to collect power-up tokens and life. You can find additional life points, keys, and computer pass cards which give you access to additional levels.
Controllable by keyboard and gamepad, an additional program called DoConfig.exe allows the controls to be configured. There is also an HTML-based manual: load manual.html in your browser to view.
There is also a program called OrgView.exe in the same folder that plays all the music from the game in a Jukebox format.
Aeon Genesis has created a patch to convert Doukutsu Monogatari (Cave Story) into English. Otaku World has already applied the patch and created a self-extracting zip archive with the English version, available for download below. If you wish to apply the patch yourself, you must start with a clean installation of the Japanese version of Doukutsu Monogatari, then download and extract the patch files from Aeon Genesis. The patch archive contains two programs that apply the patches, converting both the game and the music player to English. Note that this process overwrites the Japanese version.
Note: there is apparently a Macintosh version available of Doukutsu Monogatari but I believe it is in Japanese.
Scott Sharkey, in his "Freeloader" column on 1up.com, wrote a review of Doukutsu Monogatari and liked it so much he wrote an "exceptionally useful Doukutsu Monogatari FAQ" which you may find most useful in playing the game.

Date: 2/6/2005
File: doukutsuinsten.exe (English version). Size: 1,207K
This is a self-extracting Windows zip file for Win98/ME/2000/XP only! Run Doukutsu.exe to play.
(Requires DirectX 7.0+)
(Original japanese version is also available: doukutsuinst.exe (Size: 1,188K).
Japanese version works well with the Multi-lingual Viewer)
There is also a Macintosh version available.

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