MX vs. ATV Alive is the fourth installment in the MX vs. ATV series and the sequel to MX vs ATV Reflex. Just like its predecessors, the game features several different racing modes. Players can use dirt bikes and ATVs for racing. Unlike MX vs. ATV Unleashed, no monster trucks, buggies or airplanes can be used.
The game features a multiplayer and single-player mode. Multiplayer can be played offline with two people split-screen, and online against multiple opponents through the internet. The game is divided into three skill levels: rookie, amateur, and pro, which determine the type of racing available. Amateur races are unlocked by obtaining a player level of 10, while pro races require a level of 25.
Single-player races feature several different racing courses on snow, sand or dirt. New courses can be unlocked by becoming a higher level driver, with the highest courses requiring a player level of 25. Before starting a race, players can customize their opponent's skill level, number of laps to complete, and vehicle used. Finishing races, finishing first place, making it to the podium, and completing racing goals all contribute to experience points that help players level up. By using the same vehicle for several races, vehicle experience is earned to level up that specific vehicle.
All vehicles and drivers can be customized. Dirt bikes can be modified with various graphic kits, handlebars, exhausts, tires, wheels, hubs, suspensions, chassis, brakes, and number plates. Drivers' appearances can be changed by selecting from three different gear sets or the appearance of professional drivers like Alex Martin, Ashley Fiolek, Chad Wienen, Dakota Tedder, Jeff Alessi, and PJ Larsen.