Mushihime-sama Futari Black Label is a heavily altered version of Mushihime-sama Futari developed by Cave. The placement and shot patterns of many enemies have been changed, sometimes dramatically. As a result, the stages can feel very different from the original game in some places. The player characters' shot types have changed as well; rather than offering a choice between Normal and Abnormal shot types as in the original game, each character now has a single shot type that combines certain elements from each of the previous variations. In addition, the player characters' shot power is significantly increased, allowing for bosses to be killed more quickly and some of their more dangerous patterns to be avoided entirely. There are also some more minor, cosmetic changes: some of the stages have had their colors changed slightly, and the appearance of the golden score gems has been changed a bit.