There are five fictional fighters competing: Dynamite Joe - The Miracle Fighter, Fernando Gomez - The South American Eagle, Kim Nang - The Korean Comet, King Jason - The Black King, and The Detroit Kid - The Invincible Black Panther.

Final Blow is a side-scrolling boxing game where the player moves left and right to control a screen sized boxer.

When the timing is right, the player can unleash a final blow punch which can sometimes KO the opponent in a single strike.

The Sega Genesis port adds two boxers: James "Buster" Douglas (who uses The Detroit Kid's graphics, slightly edited and palette swapped) and Ironhead.

In Japan, Game Machine listed Final Blow on their June 1, 1989 issue as being the third most-successful table arcade unit of the month.