Splatterhouse is a sidescrolling beat ’em up video game in which the player controls Rick, a parapsychology student who is trapped inside West Mansion. After his resurrection by the Terror Mask, Rick makes his way through the mansion, fighting off hordes of creatures in a vain attempt to save his girlfriend Jennifer from a grisly fate. Players of this game will also recognize a number of western horror film influences, such as Friday the 13th and Evil Dead 2.

Similar to many sidescrolling beat ’em up games, Rick can only move in a two-dimensional environment. The playing field does not feature a three-dimensional area, a feature that was added later in the series with Splatterhouse 3. He has the ability to jump and can punch and kick. Rick also has a Special Attack, where he will perform a drop kick that sends him skidding along the ground, damaging any enemies he hits. Rick can also perform a low kick, low punch, and jumping attacks, as well as pick up and use various weapons placed in the levels.

All of the levels consist of walking left to right, with occasional auto-scrolling segments. However, alternative pathways through sections of the house are possible by falling down through holes or jumping up onto ladders. In this way, branching gameplay is possible, if only prevalent in the middle levels. Levels culminate in boss fights that take place in a single room. Unlike traditional side-scrolling fighters, boss fights have varying objectives and styles. Unlike most arcade games in the genre, Splatterhouse sends players back to checkpoints after losing lives or reaching game over, discouraging “credit feeding” as a method of overcoming the various challenges.