Similar to most other pinball games, and Extreme Pinball in particular, you play Psycho Pinball from a top-down perspective, seeing half of the table on the screen that then scrolls up or down to track the ball. The four tables are Psycho, Trick or Treat, The Abyss, and Wild West. In addition to having different settings and goals, they vary in difficulty level. What sets Psycho Pinball apart from others is the bonus games you can play if you get the ball in the right hole. These bonus games are played at the bottom of the screen, and give you extra points. The tables are linked in the sense that the ball can be gotten to travel between them.

Aside from fun bonus games, Psycho Pinball has all the trappings that will keep pinball fans hooked for a long time. The game features a three-ball multiball, a realistic tilt, and progressive game play targets with rewards. Up to four players can play on each table. Also included are twelve different surface types of varying friction like rubber and metal, over 200 sound effects, three difficulty levels with five speed options from Fogey to Psycho, and excellent animations. Good graphics, clearly stated goals, and plenty of on-line help will introduce newbies to the genre, while veterans will have fun with all-around solid gameplay and bonus games. Recommended!