Elevator Action EX is a Game Boy Color game where you play as Mike, Guy, or Sarah. Your goal is to collect secret documents, keys, and discs hidden behind doors marked with a white exclamation mark. Some doors have question marks which give you different weapons, while others have extra health bars.
The gameplay style remains the same as the original, but with some changes. You'll navigate through the building twice before facing all your opponents in one room. As you progress, each new level has tougher enemies than the last. The game starts with the same weapon for all three characters.