Lady killer is an adult, puzzle game featuring eight sexy women. The objective of the game is to dive and leap through the surface of the play area to reveal the image of the girl underneath.

At the start of each level the player gets to select which girl he wants to reveal. Her image is then shown and is then covered by the game board. Then the level begins. The player must move to avoid the enemies while attempting to flip the tiles on the board by diving and surfacing through them. Flipped tiles often reveal power-ups to help the player. The player is killed any time he touches or is shot by an enemy, but the player can kill enemies by flipping a tile that the enemy is standing on. Enemies will re-spawn until the level is completed. The level is completed once all of the tiles have been removed.

Each girl features five states of undress and four stages. During gameplay, the girl's silhouette remains visible through the surface of the game play area and while her state of dress changes between stages, her pose and silhouette will remain the same. Each girl also has a special stage featuring a mini-game of a sliding tile game or a number selecting game. After completing the final stage for each girl, the player is shown an erotic scene for that girl and the player must wiggle the joystick left and right to advance the scene.

The game is over when the player has lost all of his lives. Upon continuing the player restarts the level he is currently on.