Earthworm Jim is played from a side-view perspective across a sequence of highly varied stages. The main objective is to reach the end of each level while defeating enemies, avoiding hazards, and surviving environmental challenges. Jim can run, jump, fire his blaster, and use his head as a whip to attack enemies or interact with the terrain.

Levels include conventional platforming, swimming, vehicle-based sections, and chase sequences. The game uses a limited number of lives and continues, while each stage ends with a boss or a distinctive set piece. Progress depends on learning enemy patterns, timing jumps, and adapting to each level's special mechanics.

Learn the timing of Jim's whip and blaster rather than attacking continuously. Use the whip to control enemies at close range and to reach or activate objects from a safer distance.

Explore cautiously, especially in unfamiliar stages. Vehicle and swimming sections use different movement rules, so prioritize survival over speed. Save lives for boss encounters by avoiding unnecessary damage and studying each boss's attack pattern before committing to an attack.