The game features three separate tables:
- "Wandering", a fairly open playfield with a large clock that counts down as you destroy zombies.
- "Movement" takes place in a secret laboratory filled with large loops and hideous experiments.
- "Cemetery", the final board, has a worm-like creature that spits out zombies, as well as a monstrous zombie who tears through the floor.
The goal for each table is roughly the same — destroy the hordes of zombies wandering around the playfield to enable various features, then activate them to confront the two Bosses of each table. "Free Play" allows the player to choose a table to play, while "Challenge" goes through all three boards in a distilled adaptation of the first two House of the Dead games. Digitized voices and video clips add to the immersion, and it even allows saving games in progress either to the cartridge or via a password.
As a pinball game, The Pinball of the Dead is rather sketchy, with floaty physics and some obviously canned ball physics; a bigger problem is the lack of depth, as the game is not too taxing, and all of tis gameplay elements are revealed after a few plays. As an action game, however, it's a campy way to revisit the House of the Dead universe with a fast and uncomplicated diversion.
The Pinball of the Dead demonstrates the following tropes:
- Abandoned Laboratory: "Movement" is set in a desolate laboratory filled with rusty implements.
- Attack Its Weak Point: All of the bosses are defeated by repeatedly hitting their one weak point.
- Boss Room: All of the Boss Battles take place in a single-screen playfield separate from the main table.
- Chainsaw Good: Strength, one of the bosses in "Movement", wields a chainsaw.
- David Versus Goliath: Ricky, the giant zombie monster of "Cemetery".
- Dual Boss: Judgement from "Wandering" is composed of a small imp, Zeal, and Kuarl, a giant suit of armor.
- Final Boss: The Emperor, the last boss of "Cemetery".
- Flunky Boss: Hierophant, from the "Wandering" table, who periodically rattles the screen and causes groups of Mofish to fall onto the table.
- Headless Horseman: Kuarl, the suit of armor half of Judgement.
- Humanoid Abomination: Anything vaguely humanoid in this game qualifies as this.
- Night of the Living Mooks
- Oddly Named Sequel 2: Electric Boogaloo
- Playing with Fire: Tower from "Movement", and the Magician from "Cemetery".
- Sand Worm: Tower, one of the bosses from "Movement", which consists of two reddish snakes controlled by a larger blue snake.
- Skill Shot: Press a button at the right time to shoot a zombie with a moving onscreen crosshair.
- Tarot Motifs/Theme Naming: The bosses are named after Tarot cards.
- Title of the Dead
- Womb Level: The "Cemetery" level looks as if it's made largely out of muscle and flesh.
- Zombie Gait