Gameplay in The Stretchers alternates between driving an ambulance around an overworld map made up of two large islands, and the player(s) engaging with individual levels & missions located around the overworld.
The driving portions of the game are reminiscent of Crazy Taxi - the driving physics are loose, there is no penalty for driving through walls or road signs (in fact, there are in-game achievements that encourage you to do so), and eventually the ability to boost and deploy glider wings is unlocked. The environment itself is littered with boost ramps, billboards to destroy, and hoops to jump through, further encouraging the player to drive recklessly, which ties into the comedic tone of the game.
The individual levels involve the paramedic characters rescuing Dizzies (the locals who have been incapacitated by the villain of the game) by transporting them to the ambulance and driving them back to the hospital. There are always two characters on-screen; if playing solo, the player controls both avatars, in co-op, it is one avatar per player. The characters have the ability to grab objects directly, or retrieve stretchers from their backpacks to load objects and Dizzies onto. This is always faster than just dragging objects directly, but requires cooperation from the 2 characters to navigate the stretcher through the level's obstacles, as one character is holding onto each end of the stretcher. Typical obstacles range from buzzsaws, wrecking balls, and sprinklers to pigs that will charge at the players and knock them down.