Black & Bruised is an arcade-style boxing game featuring cel-shaded graphics and a cast of 18 larger-than-life characters, ranging from a bald-headed prison inmate to a midriff-baring blonde. The bouts take place primarily from a third-person perspective inside the ring, although solo players are free to select a first-person view for close-up fighting. Each character offers a variety of jabs, uppercuts, and super punches as well as an individual storyline and the ability to taunt opponents.

The main mode of play is Boxer's Life, where players take a character through the events leading up to his or her professional career, viewing cut-scenes along the way. This mode also features specific objectives to accomplish during the fight depending on the character selected. A boxer may have to protect his ribs during a bout, for example, after a cut-scene shows him getting into a car accident. Other modes of play include Training, Survival, Tournament, and both 1P or 2P Fight.

Training has players learning each boxer's combination attacks by following a string of punching sequences within the allotted time. Survival involves defeating a series of opponents without suffering a knockout, while the Tournament has players advancing through assigned pairings until they win the championship belt. Both 1P and 2P Fight are essentially exhibition matches against either the computer or a friend, with the player's choice of boxers and venue.

Apart from the cel-shaded graphics and outlandish characters, Black & Bruised further distinguishes itself by featuring a power-up system. Each successful punch earns players one star, which is depicted as a graphic on the bottom left corner of the screen. When the boxer reaches ten stars, one of six random power-ups will become available, ranging from heavy punches and poison to automatic combos and super punches, which are activated by pressing a button. Players can also enhance each power-up two additional levels by accumulating more stars.