When the mod is installed, it changes the entire beginning of the game so is best with a new game, but can also be played with any savedgame. Instead of starting on the Imperial Prison Ship, characters start on a ship that was recently marooned in a storm, on a very strange island. Also on the ship are a young Mog child and a baby green dragon.
Misty Isle has mostly a more "gentle" flavor and landscape than the main game, being made up of cool lakeside forests and gentle snowy regions.