Mushihimesama is a vertically scrolling shooter that challenges players to navigate their character over a constantly moving landscape while scoring points by destroying enemies. The game's five stages each culminate in an intense "boss" battle. With its fast-paced gameplay and numerous enemies firing rapid succession of bullets, Mushihimesama is a quintessential example of the "bullet hell" style shooter genre.
Mushihimesama boasts three difficulty levels: original arcade, maniac, and ultra. Additionally, the PS2 version includes practice mode, allowing players to rehearse any stage or boss battle, as well as arrange mode. In arrange mode, players start with upgraded weapons and experience a modified scoring system.
The game's story revolves around a mysterious force that has appeared in the city, causing chaos and destruction. The player takes on the role of a protagonist tasked with defeating this force and saving the city. As they progress through the stages, they will encounter increasingly difficult enemies and bosses, testing their skills and reflexes.