The adventure concerns the lichVecna and his disembodied hand and eye—both powerful magical artifacts. The arch-lich Vecna and his cult are plotting to change Oerth forever. The adventure starts with a scene in which the players play the City of Greyhawk's great Circle of Eight wizards. Vecna has ascended to demigod status, and serves as the ultimate foe for the adventurers in the module. Assuming the players are successful in defeating Vecna, he is transported to and imprisoned within the Ravenloft campaign setting.
Allen Varney briefly reviewed Vecna Lives! for Dragon magazine #175 (November 1991). According to Varney, this adventure is "yet another way to scare players". He felt that after the first scene, the rest of the adventure is "more routine", but advised that the heroes "have many chances to mess this one up big-time, and that will transform your campaign in ways you may not want. For fans of high-level AD&D adventures, though, this is definitely worth a look."