Pick 'n Pile is a Tetris-style puzzle game. On each level there are a variety of symbols arranged in columns on the screen. By moving the symbols around, you need to create columns which contain identical symbols; once all the symbols in a column are the same, that column disappears. Your goal is to earn points and complete the levels by making all of the symbols on the screen disappear. Occasionally, you may become stuck with a symbol that doesn't match anything onscreen; when this happens, you can call for an additional symbol to drop onto the screen. However, as the symbol which appears is random you may need to create quite a few symbols before the one you need appears. Each level has a time limit in which it needs to be completed; run out of time and you lose a life; lose all lives and the game is over.

In addition to the regular symbols, there are also some special objects on the screen which may help or hinder your progress. These include bombs which destroy several symbols at once, blocks which may get in the way or be arranged to help out, death heads which diminish time more quickly, and flower pots which can't be moved.