The game retains all three modes from the NES game, though with some alterations. Game A, the single player game, remains largely unchanged. Game B, which originally was the 2 player game, has been updated to allow for up to four players through download play. Game C, Balloon Trip, now features more pre-defined stage patterns and includes checkpoints, but otherwise functions like the original mode.
The most apparent change to all modes is the game's use of the system's dual screens. Instead of showing the game on just one of the two screens, the game is effectively stretched out between both, as if the two screens were one tall continuous screen. To account for this, the sprites are larger and the player's vertical speed is increased compared to the NES game.
One entirely new feature in this game is the gallery, in which the player can unlock 20 Tingle-themed pictures by accomplishing certain tasks while they play the other modes.
All of the 12 phases from the original game return, but due to the game being stretched across both screens, all of the phases have been altered slightly to be taller. Some phases also have some minor adjustments to make them easier, including phases 3, 4, 5, 6, 7, 8, 11, and 12. At Phase 100, the game will stop to congratulate the player.
Unlike the original game where phases are separated into groups with unique colors for the platforms' grass, the phase groups are now distinguished by times of day. The times of day that the game cycles through are daytime, sunset, and night. Each phase will always appear at the same time of day.
The scoring system for the game is identical to that of the original game. The following chart describes the point values of each action the player can perform:
|Popping a Giant Bubble||500|
|Kicking a Balloon Bird||750 (Pink)
|Popping a Balloon Bird's Balloon||500 (Pink)
|Ripping a Balloon Bird's Parachute||1000 (Pink)
|Attacking any other player||1000|
|Popping a free-floating Balloon||300 (Pink)
|Getting a Super Bonus||10000 (First Bonus Round)
15000 (Second Bonus Round)
20000 (Third Bonus Round)
25000 (Fourth Bonus Round)
30000 (Fifth Bonus Round and beyond)
This game was exclusively available through Club Nintendo in Japan as a reward for reaching platinum rank. It has never been released since then in any other form or in any other region. While Nintendo has never released this game in English, there was an attempted fan translation, though the project has been abandoned.
While the game is largely faithful to the original, there are several major differences compared to the NES game.
- Game B now allows for up to four players, with each player playing as Tingle, Ankle, Knuckle, and David Jr. respectively.
- Balloon Trip mode now includes more pre-set patterns for sparks, which are now also split into discrete phases like the other modes. Between phases, there are Rest Islands which save your progress.
- The music and sound effects have all been completely remade or replaced with new clips. This includes new, unique songs for the each level group, Balloon Trip, and Bonus Stages. However, the player has the option to switch the audio back to the original music and sound effects.
- The player can set the number of lives they start with in Game A to anywhere between one and six.
- This feature existed in Vs. Balloon Fight by changing dip switch settings, and leftovers of this functionality exist in the NES version, though go unused.
- The Balloon Fish uses a purple color scheme similar to that of the Japanese box art for the original game. However, unlike the design from the box art, the design used in-game has a spiked back and pink lips.
- Free-floating Balloons now carry Rupees, which are the currency used in the Legend of Zelda series.
- The player is given the option to start playing from the latest phase they've reached, and automatically saves their progress when they end a game. This also works in Balloon Trip mode, but does not work in multiplayer. The player also cannot save and return to a Bonus Phase.
- Balloon Birds falling using parachutes can now bounce off of Propellers, instead of falling through them while they spin.
- Sparks no longer bounce off of the edges of the screen, and will instead simply continue flying off-screen. It also only kill the player if it directly touches their body, not their Balloons.
- Occasionally, it is possible for multiple clouds to shoot lightning at the same time. This was not possible in the original.
- In Balloon Trip mode, there is only one extra tier of Balloon. The Balloons will go from pink to green, but will not progress from green to yellow.
There are 20 gallery pictures which are unlocked by reaching certain milestones in the various game modes. Any time the player unlocks one, they will be notified the next time they go to the title screen with the new Super Bonus jingle and Tingle chanting his catchphrase, "Kooloo Limpah!"
- A picture of Tingle laying next to a pink rose. Unlocked by starting a game in either Balloon Trip or single player.
- A picture of Tingle falling rapidly with both of his Balloons. Unlocked by starting a game in both single player and Balloon Trip.
- A picture of Tingle laying in a field of small yellow flowers. Unlocked by clearing Phase 1 of single player.
- A picture of Tingle standing in a field. Unlocked by popping all Balloons in Phase 1 of Balloon Trip.
- A picture of Tingle's face reflected in a drop of dew on a leaf. Unlocked by clearing Phase 2 of single player.
- A picture of Tingle sitting with a cup of coffee. Unlocked by starting a game of Balloon Trip five times.
- A picture of Tingle in a field of red flowers with a butterfly on his nose. Unlocked by clearing Phase 3 of single player.
- A picture of Tingle flying over a swamp, appearing concerned. Unlocked by clearing Phase 1 in Balloon Trip.
- A sketch of Tingle standing outside a house with many Balloons tied to his back. Unlocked by clearing Phase 4 of single player.
- A picture of Tingle standing on a leaf and getting dressed. Unlocked by clearing Phase 5 of single player.
- A picture of Tingle waving to the camera while standing on a road. Unlocked by clearing Phase 3 of Balloon Trip.
- A picture of Tingle holding a DS sideways and sweating. Unlocked by reaching the fourth Bonus Phase in multiplayer.
- A sketch of Tingle laying down in the corner of a room. Unlocked by clearing Phase 6 of single player.
- A picture of Tingle crouching, with a red-and-green striped background. Unlocked by reaching the first Bonus Phase in multiplayer.
- A picture of Tingle crawling in distress on a beach. Unlocked by popping all Balloons in Phase 3 of Balloon Trip.
- A picture of Tingle standing happily in front of a red flower. Unlocked by getting a Super Bonus in four Bonus Phases. 
- A picture of Tingle in a spacesuit, floating in front of the moon. Unlocked by clearing Phase 7 of single player.
- A picture of Tingle sitting in a hot air balloon, which is shaped like his own face. Unlocked by reaching Phase 5 in Balloon Trip mode.
- Currently unknown.
- Currently unknown.
Unlike the NES version, there is a new animation for changing direction in mid-air. If you begin flying in the direction opposite to the one you are turning toward, you can fly backwards for as long as you hold that direction. For example, if you are facing left and then tap right, you will begin turning to face right. If you press and hold left before you finish turning toward the right, you can now fly toward the left while your character is facing right. If you release left and then press it again, you will return to flying leftward normally.
- The composer is believed to be a 'ghost composer' named Morihiro Iwamoto, who isn't credited in the game.
- This is not the first official character-swapped remake of a Balloon Fight game. 15 years earlier, Balloon Kid was remade for the Famicom as Hello Kitty World.
- While the game doesn't feature any developer credits beyond the Nintendo copyright, several unused graphics in the game are similar to those found in Game & Watch Collection, another Club Nintendo exclusive game developed by TOSE.
- In the background of all phases, the Tingle Tower is visible. This was the home of Tingle in the Legend of Zelda: the Wind Waker.
- If you hold L, R, A, B, X, and Y while the game is starting up, a prompt will ask if you would like to delete all of your save data. The option on the left is "yes" and the option on the right is "no."
- In the game’s files, there is an unused arranged version of the game start jingle from the NES game. Strangely, although the original can be heard in game, there is no equivalent when using the arranged soundtrack.
|Balloon Fighting Games||Vs. Balloon Fight (Arcade) - Balloon Fight (NES)|
|Remakes||PC-8801 - Sharp X1 - Sharp MZ-1500 - Tingle's Balloon Fight DS (DS)|
|Ports||Playchoice-10 - Sharp Zaurus - Balloon Fight-e (GBA) - Famicom Mini: Balloon Fight (GBA) - Wii Virtual Console - Balloon Fight (3DS) - Wii U Virtual Console - Nintendo Switch Online - Arcade Archives VS. BALLOON FIGHT (Switch)|
|Balloon Trip Games||Balloon Fight (Game & Watch) - Balloon Kid (GB) - Balloon Trip Breeze (Wii U)|
|Remakes||Hello Kitty World (Famicom) - Balloon Fight GB (GBC)|
|Ports||Balloon Fight GB (3DS) - Balloon Kid (3DS)|