When you've turned on the game and the intro song starts, press 
to skip that if you like, and again on the title screen. Then you get to the Main Menu. The options here are (from left to right):
- New Game
- Load
- Versus
- Training
- Option
Pick one and press 
or 
.
Option Menu[edit]
There are three items here. The first one seems to be the Stereo / Mono setting. It defaults to left, which is stereo. The second item gives you a choice of having the lyrics displayed at the top of the screen. Left option is "on", right option is "off". Lastly, you can choose between system and cartridge RAM for your save file. If you're using a territory converter cart, you can only use the system RAM, but it only uses one or two blocks of memory, so no worries there. If your internal memory battery is dead, it should only cost you four dollars or so to replace it.
Training[edit]
This is useful if you haven't played this sort of game before, but if you've taken the time to track this game down, you're probably a fan of these sorts of games with little use for such basics. Course 1 is the bare basics, just the , 
, and buttons. Course 2 is a little tougher and uses 
also. Course 3 lets you press whatever you like with no guide.
Press or to pick a course, and then press or to start the music after the loading screen. An example will play on the top music line, and you repeat it on the bottom line. After you play, it will ask if you'd like to do it again. Left is "yes", right is "no". To exit the training menu, press . If you hear the phrase "Nakanaka ne?", that means "Simple, isn't it?"
New Game and Load[edit]
These are the one-player modes. Pick New Game if you've never played before and you'll start on Stage 1. If you choose Load, you can select which stage to play, assuming you've succeeded at the previous stage.
Versus Mode[edit]
First, you and your friend who you've coerced into playing this game can pick any of the characters. You both have to pick different characters, though. Then, you'll see some options. The first box lets you decide the difficulty. 1 is buttons-only, 2 is buttons and , and 3 is a more difficult version of 2. The next option box lets you decide which of the five songs you'd like to play. (These are not the same songs from the one-player mode.) The third option lets you pick between "friendly" and "fiercely competitive" modes. The fourth box just asks if you set the other options how you wanted them. The top answer is "yes" and starts the game. "No" is the bottom choice and lets you start over completely.
The "friendly" style lets you both take turns following the music line. Player one has the top line, player two has the bottom line. (There's no guide – just look at the line during your opponent's turn.) The score at the top of the screen doesn't always correspond to the Judgment screen (the one with scores at the end of the song), but it still declares the right winner.
"Fiercely competitive" mode, on the other hand, requires both players to be pressing buttons at the same time. At the end of each line, scores are given. Whoever has the lower score will lose part of his/her life bar at the top of the screen. How much is lost depends on the gap in scores. When one player runs out of life or when the song ends, a winner is declared. (There is a smaller bar underneath the life bar and sometimes you get a circular emblem with some English letters inside it.)