Released in December of 1991, Double Dragon II on the Game Boy is a completely different game than all other versions of Double Dragon II: The Revenge. Rather than porting the arcade game to the Game Boy, as with Double Dragon and Double Dragon III: The Sacred Stones, Technos chose to adapt the Japanese brawler Nekketsu Kouha Kunio-Kun: Bangai Rountouhen (a game in the same franchise as Renegade and River City Ransom) into a Double Dragon game.
In this version of the game, players control Billy Lee, being hunted by the Scorpions (a gang; Billy has been framed for killing one of their members). After fighting various members of the Scorpions, Billy faces off against the real murderer, Anderson. Featuring cooperative play through a Game Boy Link Cable, a second player can play as Jimmy Lee.
The gameplay is similar to the Game Boy version of Double Dragon. Players can punch, kick, and kneel (by pressing both the punch and kick buttons simultaneously). After kneeling down, the character can perform a special jump uppercut by hitting either of the buttons. Additionally, players can grab enemies and then throw them. Unlike other versions of Double Dragon II, the Game Boy game has a total of eleven levels spanning across three stages (although the eleventh level is only available on Normal or Hard; not Easy).