The player controls Rick through eight different stages, each two-dimensional. New features include a difficulty setting and a password system for the English version, in which the Japanese version lacks a password feature.
Three months passed since the events of the first game. The Terror Mask appears to Rick and entices him to "go back to the house", telling him that Jennifer "doesn't have to die". Rick succeeds in rescuing Jennifer, and the House sinks into the bottom of the river.
In the western version, the design of the terror mask is skull-like, but in the Japanese version, the mask is white with black stripes over each eye, the mask loosely resembles a Japanese kabuki mask. In the western version, the Mask instructs Rick to "go back to the house" and does not specify where Jennifer is.
Upon reviewing the game for its Virtual Console release, Lucas Thomas of IGN noted that he was largely unimpressed with the game's lack of innovation, ultimately giving it a 5.5 out of 10. While he praised the game's continuation of its gory presentation, he wrote that "Splatterhouse 2 is even more violent and replete with even more disturbing images, the shock value is largely gone. We've seen it all before".