At its core Nervous Brickdown is a Arkanoid-clone and the first ten levels feature the familiar gameplay of using a horizontally moving paddle at the bottom and a ball to destroy bricks at the top of the screen. But each of the ten worlds (divided into 9 levels and one boss fight) feature a different type of gameplay. In the second stage the player needs to draw the paddle on the screen himself to knock the ball against ink blots. Depending on the form of the drawn paddle, the ball will bounce off differently. And to spice things up even more, the paddle isn't restricted to just horizontal movement anymore but can instead be freely moved around at the bottom of the screen. Other stages require the player to move through a haunted house and kill ghosts by blowing into the microphone or contain a laser beam which increases it's speed. By playing successfully through the levels, the player unlocks bonuses which range from extra lives to the ability to change the trajectory of the ball by blowing into the microphone. The game also features a multiplayer mode for two players in which the ball changes into the player's paddle color so it will only bounce off the paddle with the corresponding color.

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