Melty Blood: Act Cadenza is a fighting game released for PlayStation 2, set a year after Tsukihime and days after Kagetsu Tohya. Players control various characters as they engage in battles following a series of murders in Misaki Town. The story centers on Shiki Tohno's encounter with Sion Eltnam Atlasia, who seeks to find the True Ancestor to discover a cure for vampirism.
Melty Blood follows one year after Tsukihime and some days after of Kagetsu Tohya. In the beginning of August 2001, Shiki Tohno hears of a new series of murders in Misaki Town, similar to the ones that took place Tsukihime, in the last weeks of October 1999. Whilst searching for the murderer he meets Sion Eltnam Atlasia who initiates a fight with him, attempting to capture him. After the fight she reveals that her reason for trying to capture him is to get in contact with the `True Ancestor` (referring to Arcueid) so that she may acquire information on the `cure for vampirism`. Shiki then decides to help her with this task.