Moon Patrol is a side-scrolling game where the player must drive a moon buggy from one station on the Moon to another, all while avoiding crashing or getting destroyed by alien ships. The vehicle is constantly moving right and the player can speed up or slow down, jump, and shoot (simultaneously firing upwards and forwards.) There are 25 checkpoints along the way, each symbolized with a letter from A to Z and serving as a respawn point. Every five checkpoints mark a separate "stage" within the entire course; reaching the end of a stage under the par time grants a large score bonus.
The game features various dangers on the Moon, including rocks which can be shot or jumped over, pits that must be jumped, and UFOs which fire at the player or bombard the ground. Later in the game, stationary tanks and landmines are introduced, along with carnivorous plants that pop up out of pits. The player also encounters rocket cars that stalk the buggy from behind before rushing forward to ram it down.
As the player progresses through the game, they can attempt to complete the first course, known as the "Beginner Course", followed by the harder Champion Course.