Play begins in the top half of the cabinet, which features a conventional CRT display that depicts a modified game of Pac-Man. The maze features no power pellets, one warp tunnel to the sides, and two tunnels out of the bottom of the maze. If the player exits one of these bottom tunnels, play transitions to the bottom of the cabinet with a small pinball table. Accomplishing various tasks on this table will spawn power pellets and bonus items in the maze above, as well as incrementally increase the speed of Baby Pac-Man. Once the player drains a ball, play resumes in the top half of the cabinet with the tunnels to the pinball section closed until all of the pellets of the maze are consumed.
Baby Pac-Man was developed by Midway without permission by Namco. It shares this trait with Pac-Man Plus, Professor Pac-Man, and Jr. Pac-Man (Ms. Pac-Man purportedly had the approval of Namco).