The follow-up to Puyo Puyo is a falling block game where the goal is to combine four or more blocks of the same color, which then disappear. The remaining Puyos will then fall down and can produce combos that can cause special blocks to appear on the enemy's field.
The story follows Arle as she battles against computer enemies in a quest for victory. Players can choose from various modes, including single-player mode with increasing difficulty levels, versus player mode, four-player mode (available only on the Sega Game Gear), and an endless mode.
Gameplay involves matching blocks of the same color to clear them from the screen. Combining blocks creates combos that can trigger special effects, such as the appearance of Nuisance Puyos, which must be eliminated by clearing adjacent blocks.