In the opening cinematic, Sylvanas shatters the Helm of Dominion, breaching the veil between the material realm and the Shadowlands, an ancient dimension where the dead coalesces for judgment. Sylvanas' actions have upset the natural balance between life and death, and it's on players to enter the Shadowlands itself and repair the cycle before it is too late.
After being deposed as Warchief of the Horde in Battle for Azeroth, Sylvanas Windrunner travels to Icecrown Citadel in the Scourge-infested wastes of Northrend, and confronts the reigning Lich King, Bolvar Fordragon. Taking the Lich King's Helm of Domination from him, she tears it in two, shattering the veil between realities and opening a portal to the Shadowlands, Azeroth's afterlife. The Shadowlands have become warped in function during recent times. The Maw, a place in the afterlife reserved for the most sinful souls, is now absorbing all souls.
The Shadowlands are accessible upon death, where the player-character can roam, and can only be seen by other spirits. The Spirit of Tony Two-Tusk describes the Shadowlands as all grey and dark, swirling clouds. While Uuna was in the Shadowlands, she described it as dark and she was unable to see anything, though she could hear people interacting with her in the physical world. From within the Shadowlands, she could see the light of the naaru A'dal who was in the physical world, but it was so bright that it scared her. The moonlight at Lake Falathim allowed her to see a friend in the physical world.