Regularly, the investigators confront the cosmic horror on that blue planet they call "Earth." They leave its confines behind and travel to the Moon, to distant planets, and to the heart of the universe, where they can listen to the mad flute playing of the servants of Azathoth. It is about the final apotheosis – the birth of a new Great Old One – and the investigators are to serve as midwives.

A background chapter in Cthulhu: Extraterrana Cthulhiana deals with traveling beyond Earth and various more or less noteworthy destinations. Five very different scenarios can be played separately or as a campaign.