Touhou Spell Bubble is a chaotic mashup of Puzzle Bobble and the Tōhō (Touhou) series . At its core, it keeps Puzzle Bobble 's core gameplay; the top of the screen is filled with bubbles of various colours, and players shoot coloured balls from their cannon at the bottom of the screen in order to create combos and clear the screen. Layered on top of this is a rhythm game element, with players rewarded for shooting bubbles to the beat of the music.
The gameplay is fast-paced and chaotic, requiring quick reflexes and strategy to succeed. Players must think ahead and plan their shots carefully to create combinations and clear the screen before time runs out.