Madness Miscreation is a scrolling shooting game. You are the hooded shooter going through an underground tunnel shooting enemies of various shapes and sizes. Everyone will be shooting at you with pistols, machine guns, semi-automatic weapons, and coming at you with spears and other polearms. The main character you're trying to shoot is the guy with the crescent moon head. The object is to kill everyone in the game as quickly as possible as your score is based off of speed. You can't die and you don't run out of ammo, so if you hone your aiming skills you can score very high in Madness Miscreation.