The game introduces the Shrine Maiden Reimu Hakurei, who frantically attempts to persuade a bouncing Yin-Yang Orb to hit various on-screen targets, "cards" and "bosses" alike. Reimu can knock and maneuver the Yin-Yang orb around by whacking it with her gohei, slide-tackling it, and firing shots at it. Enemies will be trying to hinder your progress by firing at you, but you can cancel out their shots with your own, or even deflect them by swinging your gohei. Only the Yin-Yang orb can damage the enemies, however, so simply firing your shots at enemies will have no effect. As a last resort, Reimu can use a "bomb", once per life, to hit all cards on the screen. There is no guarantee that any given card will be hit, and will often fail to damage a boss. The game consists of several stages of increasing difficulty, with a boss fight occurring every five stages. To complete a stage, the player should clear all cards or defeat the boss. Reimu will lose a life whenever she is hit by an enemy projectile or the yin-yang orb. There are two selectable paths in the game: the Hell path and the Makai path. Each route features unique stages, bosses, and endings.

The strength of the seal that keeps demons and other evil creatures from entering the Eastern Country via the Hakurei Shrine, which also serves as an entrance to the “outside world” as you and I know it – has been diminishing. Reimu decides to go in of her own volition to see whether the cause is in there, and needs beaten up. (It does. )