The game features six levels, but the levels differ between the Japanese and North American versions. The Japanese version follows this order: City, Park, Alley, Town, Cemetery, Street. However, the North American version replaces a few levels and follows this order: Town, City, Alley, Park, Cemetery, Street.
The player starts out controlling Dr. Jekyll on his way to the church, walking to the right. As he takes damage from the various enemies and obstacles, his Life Meter decreases and his Anger Meter increases. If his Life Meter is fully depleted, Dr. Jekyll dies and the game is over. If his Anger Meter completely fills, however, he transforms into Mr. Hyde. Day turns to night and monsters appear. At this point, the level is mirrored horizontally and Mr. Hyde walks from right to left with the screen autoscrolling. Mr. Hyde must kill as many monsters as he can as fast as he can in order to turn back into Dr. Jekyll.
If at any point Mr. Hyde reaches Dr. Jekyll's location, a bolt of lightning strikes him, killing him instantly. Therefore, the objective of the game is to advance as far as possible as Dr. Jekyll and to transform back as soon as possible as Mr. Hyde.