Gameplay is similar to the previous Truxton. Truxton II has six huge areas, each with a boss at the end; the game "loops" these six areas forever. Lives are given out at 70000 points, then every 200000 points after; players start with three.

There are power-ups to increase ship speed, add a smartbomb to your stock, and change/strengthen your current weapon: red fires bombs in a small area around your ship, similar to the red weapon from Robo Aleste; blue is a homing laser, similar to the blue weapon from the original Truxton; while green fires wide-reaching salvos of green shots and more or less replaces the red weapon from Truxton.

“During the time of the grand battle known as Tatsujin, another battle was being fought in a remote area of the infinite universe, with similar stakes. The battle was known as Tatsujin Oh.”