Rampage Puzzle Attack is a puzzle game where players must clear the playfield of four different coloured block types: red, blue, green, and yellow. The gameplay involves changing the order of a line of blocks above the play field and dropping two at a time onto the blocks below.
The twist in Rampage Puzzle Attack comes from the Detoblock, a special block that appears on the field and must be dropped onto the corresponding colour to clear those blocks. Players can choose from various game modes, including Clear, where they must clean the playfield of all blocks, Puzzle, where they must clear all blocks within a set number of drops, Marathon, and Rescue Mode, where they must clear the blocks from the top of a cage containing monsters trapped in Rampage World Tour.
The game also features 2-player modes, including Rescue, Score, and Attack. In Rescue mode, players must free the monster before their opponent to win, while in Score mode, they must score the most points within a minute. The blocks cleared from one player's field appear on the opponent's screen in Attack mode.