Super Real Mahjong Part IV is a strip mahjong game featuring three girls with five strip sequences each, plus 3 extra girls with one strip sequence each. Once again, the fourth game in the Super Real Mahjong series has redesigned the game tiles and from part IV on, all of the hand animations are completely removed from the game. Part IV also has greatly enhanced the quality of the animation and expanded its use in storytelling and strip sequences.

The gameplay is standard for this series. With every winning hand the opponent removes an article of clothing. With every loss she puts a piece of clothing back on. When the player clears all a girl's strip sequences, the next girl is introduced and the game continues. The girls have unlimited betting funds so each strip sequence must be won separately. If the player loses all of his funds then the game is over.

If the player defeats all three regular opponents then the bonus game begins. The bonus game features three extra girls with one strip sequence each. The difficulty is increased for the bonus game and once the bonus game starts there are no more continues.