The game is a crossover between the Puyo Puyo and Tetris. The game can be played solely in one of them or can be alternated periodically. There is also a special mode where the player plays both at the same time with Puyos and Tetriminos in the same playspace following both games rules. There's a cast of playable characters with the Puyo Puyo characters coming from the past games and the Tetris characters being all new. The game's story mode has the player interact with the entire cast in their crazy adventures though it typically has Puyo Puyo characters play Puyo Puyo and the Tetris characters play Tetris. In multiplayer, the game type can be different between the players in the basic mode and puzzle modes.
Amitie and Arle both find themselves in Ringo's world after popping puyos. They later discover that there are also tetrimonos, or Tetris pieces coming from the sky. They then go on a quest to turn it back to normal.