The goal is to place pieces of different shapes made up of four tiles in a ten-by-twenty well, organizing them into complete rows, which then clear. As rows are cleared, the pace of the game increases and the background changes. The game ends if the stack of pieces reaches the top of the well.
The game is very similar to Nintendo's own NES version of the game, featuring the same endless and set-clear modes. The game also features a two-player versus mode that can be played with two Game Boys, two copies of Tetris, and a Game Boy link cable. Clearing rows in this mode will cause the other player's stack to rise. The first player whose stack reaches the top loses.
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