Quote Originally Posted by Kraco
I haven't read books, and I don't feel like I'm missing anything essential. Type-Moon doesn't do half-assed work like that. I expect a ton more information does exist, like is Type-Moon's way, but you don't need it to watch this. Just be ready to think a little as this isn't a shounen show, and certain chronological nonlinearity may exist from episode to episode (but this is no Suzumiya Haruhi).

This is a masterpiece of anime making and there's absolutely no reason not to watch it unless you don't like horror and violence.
Playing the Tsukihime visual novel or watching the anime (Shingetsutan Tsukihime) also helps a lot. They didn't really explain how the Mystic Eyes of Death Perception worked until episode 4, and even then it was a rather brief explanation.

I'd be a bit lost in the earlier episodes without some background info.