Each region ranges in scenery from a city park to a frozen lake, and players can choose to play as either Sulley or Mike, with each monster having different moves and scare abilities.

The objective of the game is to successfully scare all the robot children (known as "Nerves") on the island and graduate from monster training with top honors.

The bronze medal is required to complete a level and can be obtained by scaring five Nerves; this also unlocks a short clip from the movie.

Obtaining the four bronze medals in each training ground unlocks a hidden item that may help the player reach previously unreachable areas.

The random Bag O' Calories increases health, while mailboxes provide tips and information to assist the player.