The story follows Ren and Stimpy as they try to escape from their evil nemesis, Powdered Toast Man. They navigate through various levels, fighting off enemies and avoiding obstacles to reach the end of each stage.
The gameplay remains largely the same as its SNES counterpart, with players controlling either Ren or Stimpy through side-scrolling platform levels. However, due to technical constraints on the Game Boy, some changes have been made. The order of the levels has been rearranged, and certain sections of some levels are missing.