The gameplay involves clearing blocks, known as Puyos, by combining four or more of the same color. This action creates Nuisance Puyos that fall onto the opponent's screen, blocking chains and combos they could create. To counter this, players can try to offset by clearing their own Puyos, limiting the number that would fall on their screen and increasing their Fever Meter.
When the Fever Meter fills up, players receive a set of prearranged Puyos with which they can create giant combos and send Nuisance Puyos to their opponent. The game features a two-player mode, as well as multiplayer modes for up to eight players on some versions, including the Xbox release.