Gradius V was largely developed under contract by Treasure, who had previously worked on Radiant Silvergun and Ikaruga.

The game takes place as a 2D scrolling shooter with the Vic Viper contending with formations of enemies, both stationary and moving, that fire bullets.

[2] In Gradius V, the hit box (the pixels which must be touched by an object to destroy the ship) has been reduced in size to allow players to get through small areas more easily.

[9] Finally, players have the option to view the highest local scores, save or load game data using a PlayStation 2 memory card, or to adjust the game's settings, including stereo or monoural sound, difficulty, number of lives available, the number of points required to earn extra lives, the ability to restart from a checkpoint or immediately after being destroyed, or button configuration.

[8] The cursor cycles through the following power-ups in order: "Speed Up", "Missile", "Double", "Laser", "Multiple", and "Shield".

[11] A new feature in Gradius V gives players the ability to control their "Multiples" with the push of a button, depending on which weaponry was selected before starting the game.

By pressing a button, players can freeze their Multiples in place, cause them to rotate around the Vic Viper, control the direction of their fire, or spread them out above and below the ship.

[4][11] In the year 8010, the planet Gradius is once again invaded by the alien Bacterians, who assemble a large-scale assault force to destroy its enemies.

[14] In an interview with the game's producer Yasushi Takano on the promotional DVD, Gradius Breakdown, Takano said that he felt the traditional Gradius formula had become stagnant and expressed a desire for a new direction for the series to remain relevant,[15] he also admitted that some of their early work was not as impressive as it would later become.

Plans were also made to produce a counterpart for video arcades alongside the console version, but it was canceled because of time constraints.

[15] On April 9, 2004, Konami announced a DVD called OPTIONS was being offered to pre-ordering customers in Japan — containing interviews with the developers, art galleries and a number of videos demonstrating the inner workings of the game's levels.

[17] For the North American release of the game, Konami produced a DVD called Gradius Breakdown as a pre-order incentive.

[22] Konami also held an online high score ranking competition in the United States and the winners received a director's cut version of the Gradius Breakdown DVD that included additional pieces of concept art and videos of the later levels.

[26] Positive response tends to focus on the intricate level design, graphical excellence, and "old school" appeal of the shoot 'em up genre.