George Foreman's KO Boxing is a reworking of the Master System title James 'Buster' Douglas Knockout Boxing , where players take on the role of George Foreman to win the championship title belt. The game follows a similar storyline as other versions, with players facing different opponents in a series of boxing matches.
The gameplay is action-packed, with players able to move left or right in the ring to avoid punches. Other moves include blocking and striking, which can be varied into jabs and crosses. Matches can last up to ten rounds, with no regular or technical knock-out occurring determining the winner. The game features a unique system where super punches need to be charged and unleashed when near an opponent, sending them straight to the back of the ring.
Each match awards skill points that can be distributed over three characteristics, improving the player's boxer. Additionally, the game supports matches for two players. At the start of the game, a slow or fast speed option is available, allowing players to choose their gameplay pace.