Giana Sisters: Twisted Dreams is a blistering hardcore platformer with contrasting worlds. Warp Giana’s vivid dreams to alter your abilities and destroy the twisted creatures lurking within. Giana Sisters: Twisted Dreams combines the challenge of retro era platforming with graphics that pack a visual punch and tight controls. Fluidly morph between two dynamically different dream worlds to solve puzzles and combat grueling enemies. Players will have to intertwine sweet Giana's twirling jump attack with Punk Giana's hammering dash attack to survive the dualling dimensions.

Maria is abducted to the Dream World, where a giant dragon holds her prisoner. It is up to her sister, Giana, who has become a teenager in the time since the last entry in the series, to enter the Dream World and rescue her. Because she is in a stage of her life that is all about transformation, she has learned how to manipulate her dreams. She must use this newly developed ability to jump between dreams and transform herself into a "Cute" and "Punk" persona in order to deal with her inner conflict and fear while she searches for her sister. As in the past, Giana can pick up crystals for points and discover secrets.