The game has two modes, Vs. Mode and Practice. In Vs. Mode, the two players share the system and take turns after holding A to inflate the Wario balloon. The player who pops the balloon loses. The A button can only be held down for a few seconds, and the air pump on the right shows how much time is left to hold A. Once the balloon is extremely large and about to pop, the background will change from yellow and pink to purple and pink, and the music will become more tense. Practice mode is identical to Vs. Mode, but the player plays against a CPU instead in this mode.
The card's instructions are as follows:
"Choose an opponent to duel. Players in the duel will bet all their In-Play cards. The winner takes all the In-Play cards."
In the game, the main menu has these instructions:
"A : Hold the A Button to blow up the Wario balloon"