Fred Flintstone discovers a treasure map during work, leading him on a quest to find the coveted treasure. To reach it, he must navigate through seven levels, some of which feature boss battles. These classic side-scrolling platform levels challenge Fred to jump over gaps and avoid enemies.
The game features traditional gameplay mechanics, where Fred uses his axes to stun and then kill enemies. Hitting an enemy when they're stunned allows Fred to use them as stepping stones, but they respawn if he returns to their starting location or at special power-up skulls. Additionally, Fred can collect power-ups that increase his points score or refresh his health.
Flintstones King Rock Treasure Island also introduces a unique mode of transportation - riding his pet dinosaur Dino. With this ability, Fred's movement and combat capabilities are enhanced, allowing him to throw axes straight and jump higher. However, Dino is lost if hit once, adding an extra layer of strategy to the game.