Yoshi for the NES is a Tetris-inspired action puzzle in which your job is to maneuver Mario horizontally along the bottom of the screen, shuffling four trays and catching characters and egg shells that fall from the top of the screen. The characters include creatures from the Mario universe, such as Piranha Plant, Little Goomba, Bloober, and Boo Buddy. When you match two characters of the same type, they disappear from the screen. If you stack too many characters that don't match, they begin to clutter the screen, eventually rising to the top line. Once a stack grows above the top line, the game is over.

To score bonus points, you should match up the top and bottom parts of the eggs, effectively hatching Yoshi out of each newly formed egg. Any character caught between the two properly matched egg halves will be removed from the screen.

In the two-player, split-screen mode, Luigi joins in on the action. Here you must clear all the characters on your trays before your opponent does.