The basic aspects of an adventure game are here; as Curtis the player travels to various locations, interact with the often strange and eccentric people in his life, and collects items and solves puzzles.
A Puzzle of Flesh's gameplay features a standard point-and-click interface, played from a third-person perspective: the cursor, when waved over an object or area that can be manipulated, will highlight, and clicking it will initiate a live-action clip that furthers the game along. Inventory is stored along the bottom of the screen and a simple click-and-drag command will cause inventory items to interact with other objects.
Due to the large amount of graphic violence and sexual content, A Puzzle of Flesh came with password-enabled parental controls that thoroughly edited out the game's offensive content.
A Puzzle of Flesh also has a large number of comedic Easter eggs, which the player can achieve on a point system, although, due to some of the complex key commands one must perform to enable them, most of them are impossible to access without outside help. These Easter eggs range from simple sight gags and messages to minigames and hidden videos.