The game starts off with Colonel Trautman asking Rambo whether or not he wants to leave the prison and start the mission. Players are given a choice, but cannot advance in the game unless "yes" is chosen. Players advance through the camp and talk to others, and when talking to Trautman again, he tells Rambo the mission. Rambo then drops into the forest and fights spiders and other forest creatures. Bosses include giant spiders and helicopters. The game is noted for its identical gameplay to Zelda II: The Adventure of Link, in that the player can kill enemies for experience points and the layouts are similar. In the Japanese version, the experience meter is replaced by an anger meter, however, it functions exactly the same.