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The Death Stranding led to supernatural beings – notably beached things (BTs) – "stranding" on Earth from another place. Individuals killed by BTs can cause explosions of varying sizes called voidouts, leaving behind large craters in the landscape where they died. Accompanying these beings was an otherworldly precipitation known as timefall, a rain that rapidly grows and decays organic matter.
When these entities crossed over, a bridge was formed between Earth and "the other side". This place is described as an "upside-down realm" submerged in water, and shown to have otherworldly creatures and ocean life from Earth swimming through it. Black tendrils can be seen vanishing into the sky on both sides.
- Higgs claims to understand the truth of the Death Stranding, stating that it's hard for people to form connections when they are unable to shake hands.
- The namesake concept of the Death Stranding, cetacean stranding, is the phenomenon of cetaceans stranding themselves ashore. The phenomenon is more encompassing in Death Stranding than it is in reality, however; several other forms of marine life are seen stranded on a beach alongside cetaceans, including crustaceans and fish.