Rhythm Heaven Fever features various levels with their own set of rules, requiring the player to play in time to the rhythm in order to clear them. These levels range from stabbing peas with a fork, to attacking evil spirits with a sword, and playing badminton in midair. The game is played by either tapping the A button, or squeezing the A and B buttons together. At the end of each level, players are ranked on their performance, with at least an 'OK' rank required to clear the level and progress onto the next. Each set of levels culminates in a Remix stage, which combines all of the gameplay elements of the previous levels in one stage.