There are two types of conflict in "Death by Scrabble": person against person, and person against the supernatural.

The person against person conflict is that of the narrator against his wife. On the most trivial level, they are competing against one another by playing a game. However, the narrator makes it clear from the first sentence that the conflict is more serious than this. He hates his wife and wants to kill her. His wife's feelings are not so clear, but the ending of the story strongly suggests that she feels much the same about him.

The conflict of the person against the supernatural emerges as the narrator begins to believe that the words he and his wife put down on the Scrabble board are having a mysterious effect on their environment. He believes that he can use these words to bring about the death of his wife, but finds that if there is a supernatural power at work, it is not on his side.

The main theme of this story is the corrosive and ultimately fatal effect of hatred, as the narrator is obsessed throughout the story by his hatred for his wife, and his desire for her death appears to bring about his own.