Variations of the game include the use of the foot -'footies' or 'Devils' touch'; a semi-contact rule popularised at Coopers Technology College.

In 1992, Highgate Wood School in Haringey installed special Patball walls made from plywood in order to satisfy the popularity of the game.

St John's Beaumont School has pat ball courts painted on a playground wall.

Only the players' hands may hit the ball and different shots and skills are employed to avoid the opponent being able to return the shot, at which point the opposing player is out or loses a life depending on the game version being played.

If the ball double bounced, was missed or went out of court, the player was out and demoted to the bottom square.

For example, some players would not allow the shooting technique of hitting the ball onto the wall without a bounce - but others could eliminate that rule so that the shooting player can hit the ball right before the bounce occurs.

In any instance where the ball goes in a wild direction due to an odd surface, named "curbs" or a "dodgy bounce", a re-throw takes place.

Patball uses a jargon language within the game, with a fairly large number of terms and usages.