The first entry in the Tetris: The Grand Master sub-series, this game plays similarly to other Tetris games, but rather than merely expecting the player to survive indefinitely, it challenges the player to attain the highest level and score they can in the shortest amount of time. The Grand Master series introduced several play mechanics to Tetris gameplay which can be seen today in its sequels and many other Tetris implementations.

The level, and therefore difficulty, increases every time a new piece falls onto the playing field and every time a line is cleared, for a maximum of 999. On levels whose lower two digits are 99 and on level 998, the level will only increase when a line is cleared. As the level increases, so too does the speed at which blocks fall, until eventually they reach the bottom of the playing field instantaneously, a state referred to as 20G. Once the pieces have hit 20G, the player has only a fraction of a second to maneuver them into the desired position before they are locked into place.

The ultimate goal of the game is to receive a high ranking, which is based entirely on score. The highest ranking of the game is Grand Master, which only occurs when a specified rank is reached within a determined time threshold. In the case that two players have achieved the exact same score, the high score table will award a higher place to the one who attained that score faster.