Pachinko UFO is a simulator of the popular Japanese gambling pastime of pachinko with added computerised action elements. The main screen resembles a typical pachinko unit with pins for balls to bounce on, spinners for balls to put in motion, and baskets for them to land in. The baskets open and close, and so does the big feature in the middle of the screen, an airplane or spaceship with an integrated fruit-machine like counter. When a score specified by the counters is reached, the game changes to a shooter sequence, where the pachinko balls must be used to shoot down aliens. After that, the game continues to the next table.

The control mechanism is similar to golf games, in that the longer you press the button, the more power is given to the ball ejection mechanism. This makes for an experience unlike a real pachinko machine, where the perfect power of the ejector is reached by setting a dial at the right angle, after which it can be locked at that angle. In Pachinko UFO, you must hit a perfect timing instead.