1. The styles are very different. While in the manga the characters design is soft and clean, in the anime the chief animation director based the character design used in the anime on Noizi Ito's original concept.
2. In the manga Teshigawara often hangs around Kazami, not Mochizuki. Also, many of the actions given to Akazawa in the anime were his in the manga (such as shaking Kouichi's hand at the hospital). Also, in the manga Kazami doesn't die and doesn't turn out to be insane.
3. Akazawa is less friendly and more actively hostile toward Mei, and for different reasons. She tried to kill Mei, stabbing her left eye, but due to her own paranoia, rather than to avenge Sugiura. A moment later, a cupboard fell on her, and she was rescued by Tatsuji Chibiki afterward. Even if she doesn't die, she cuts her hair shortly.
4. Katsumi Matsunaga never met the group, but only Tomoka Inose. Kouichi, Mochizuki, and Teshigawara found out where is the tape from his conversation with Tomoka. Mei is not present at this meeting and does not help search for the tape when Kouichi tells her about it. They never went to the beach.
5. In the manga, Maejima, Sugiura, Yonemura, Nakao died in the fire at the inn. Yumi Ogura is not present (or at least not named) in this adaption.
6. In the manga, the relationship between Reiko and her eldest sister, Ritsuko, is more pronounced and also closer than in the anime. In the first chapter of Another 0, she is seen standing at her memento and talking to her.
7. In the manga, Teshigawara's feelings for Akazawa are more pronounced than in the anime. For example, when Akazawa cut her hair shorter, Teshigawara made her a compliment and then blushed.
8. Ikuo Takabayashi never appeared in the manga, he is only mentioned. Also, Aya Ayano and Makoto Ouji are anime-only characters. They never appeared in the manga.
9. Akazawa never met Kouichi a year and half ago.
10. In the manga, Mei's past is more detailed. Mei said that when she was a child, she caught her "mother" crying, asking why. Also, she wanted to donate one of her kidney to Misaki, but she couldn't because the rules said that children below 15 years of age are not allowed to, so instead the donor was Mitsuyo. This information was never revealed in the anime.
11. Mei never mentions having a vacation house near the beach in the manga; in fact, the beach is never visited.
12. Reiko's past revealed in Another 0, it isn't revealed in the anime.
13. Takeru Mizuno went in the class trip in the manga.
14. In the manga, it wasn't Wakui who suddenly fell sick during dinner, but Kouichi. When Akazawa and Mei were arguing. Akazawa blamed Mei and Kouichi for all that had happened. When Kouichi tried to protect Mei, he suddenly collapsed. Takeru helped Kouichi to his room at the Inn, showing he'd forgiven Kouichi for his role in his sister's death.
15. Ogura briefly appears only in Chapter 12 of manga and talks with Mei much to Kouichi's surprise. Ogura didn't attend the trip and her role in anime in which she tried to kill Mei isn't present. Ogura survives the curse in the manga.
16. When Mei tries to reason with Kouichi after the latter confronted her about having to kill Reiko, Mei doesn't allude to wanting to avoid hurting Kouichi's feelings when stating why she didn't reveal who the extra one was, just that she thought there was no use for sharing that information with the rest of the class without knowing how to properly deal with the extra one, and that after hearing the tape, she decided to take matters into her own hands.
17. Neither Keiko nor Kensaku appear in the manga. In Keiko's absence, the fire at the inn was started by a lightning strike, which did not shatter any windows.
18. The moment where Mei uncovers her vandalized painting of Yukiyo during the art club scene was omitted from the manga.
19. Atsushi Ogura, Yumi's older brother, doesn't die from having a runaway construction vehicle crash into his house. In fact, he's never mentioned in the manga. His role in the story was instead given to Kazuma Akazawa, Izumi's older brother, who died by suicide.
20. During the dinner confrontation scene at Sakitani Kinenkan, Izumi acknowledges her mistake of not informing Kouichi about the class situation ahead of time, unlike in the anime.