Rosco McQueen Firefighter Extreme features 15 levels of third-person platforming action. Played from an over-the-shoulder perspective, players will guide Rosco through burning rooms filled with innocent hostages, power-ups, and secret items. It is advised that players move with extreme caution as there's a host of hazards including backdrafts, flame-overs, dangerous smoke, and electrical fires. There are 12 hazards in all, each taking hose precision and brainpower to overcome.

In addition to the various hazards, Rosco will use his trusty axe to dismantle his enemies and break down locked doors. While the fearless firefighter is rescuing hostages and hosing down the flames, he'll need to be on the lookout for any bombs. Those pesky A-Bots are bomb crazy; they're placing the destructive devices all over the place. Players are also required to keep an eye on the temperature. If a room gets too hot, the sirens will sound and the game will end.