The game plays similarly to a standard Pac-Man game with sound effects from Ms. Pac-Man. The game can be played cooperatively, with the first and second players controlling Pac-Man and Pikachu respectively. As with Pac-Man, the goal is to collect all the pellets in the level while avoiding enemies that patrol the level. They can take on the appearance of the traditional ghosts Blinky, Pinky, Inky, and Clyde, and two "Pokémon", a blue rabbit creature (which resembles the first enemy in Gamtec's Pocket Monster) and a green caterpillar resembling Caterpie. None of the enemies seem to follow any player-tracking system like most Pac-Man games and the enemies simply switch between tracking the player(s) or taking detours. Once the player reaches Stage 11, every stage thereafter uses a consistent enemy selection: Blinky > Rabbit > Pinky > Inky.

There are a total of eight worlds with four levels each, divided by timed bonus levels which give chances for extra points and lives. During these bonus stages, the player can tap the fire button to accelerate, which is also possible in main stages after collecting a Wing powerup. Other items include traditional Pac-Man fruit (which do not increase in value as the game progresses), poison that reverses the player's movement direction, and a Yin-Yang symbol that refills all the pellets on a stage.

Unlike regular Pac-Man titles, pellets eaten do not count towards the player's score until after the level is completed. If playing in two player, the player that eats the highest number of pellets takes all the points. For every board that is completed, the player will be shown a digitized photo of an Asian girl, out of fourteen available. Once all fourteen are shown in order, the game loops back to the first one.