Wrestle War puts the player in the role of a rookie pro-wrestler, Bruce Blade, who has to go through a series of bouts to win the championship. The "Sega Wrestling Alliance" wrestling promotion in which the wrestlers compete is fictional. There are no real-life wrestlers or any licensed tournament used in the game; however, many of the characters bear a strong resemblance to popular wrestlers or movie characters.

The ring is done in pseudo 3D. The graphics are sprites, but the wrestlers can move along the Z and X axes and the ring will instantly rotate 90 degrees to give a better view of the action if the player's view gets blocked. The available moves are punch, kick, and grab. The objective is to wear down the opponents' life bar, then pin them.

The Mega Drive version was not released in North America, though some advertising from the era suggests that such a release was once planned.