The game was published in 1996 in the United States by Jaleco, shortly after the company signed an agreement with Blue Planet Software giving Jaleco exclusive rights to publish Tetris games for the Saturn and PlayStation in the United States for the following two years. This can be used to remove any unwanted pieces until the piece the player wants appears. The ceiling will also destroy any placed blocks that are in its way. The player is able to make the ceiling go back up, however, if they can clear three or four rows at once. About once every eighteen seconds, it will move down one row, slowly taking away workable space. Upon starting the level, the spiked ceiling will start at the top of the play area.

If these blocks lead too closely to the spikes, the professor will die. But if he is unable to move, he will fall asleep until either a block comes down onto him or the ceiling reaches his current position. Conversely, if blocks are placed on top of him, he will climb up them until he reaches the top. If he comes across a gap that is large enough for him to fit through, he will fall down onto the blocks below him. Two blocks wide and tall, he will aimlessly walk forward until he bumps into a block, after which he turns around and walks the other way. The objective is to get the professor to fall to the bottom, by placing blocks and clearing lines, before the spiked ceiling at the top comes down and crushes him. Once the game starts, the player is presented with a cluster of pre-placed bricks, and a professor character who enters the play-area through a disappearing gate.

Each of the four locations has a different level set. The final area, Atlantis, is unlocked by successfully completing the other four stages. The player starts with the first zone, the Egypt later there are in order: Angkor Wat, Maya and Knossos. The biggest addition to Tetris Plus is the Puzzle Mode. The console versions also have a two-player Versus Mode, which is essentially puzzle mode with two players racing for the finish line.

Also included is an editor for making Puzzle Mode levels, and capability for competitive multiplayer in either game mode. Puzzle Mode is a mission-based mode where the player must clear a pre-arranged puzzle layout in a limited time. The game consists of two main modes, Classic Mode and Puzzle Mode.

Ports were to be developed for the Atari Jaguar and Nintendo 64 but these were never released. The game would be followed by a sequel, Tetris Plus 2, in 1997. Tetris Plus ( Japanese: テトリスプラス, Hepburn: Tetorisu Purasu) is a puzzle video game developed by Natsume and published by Jaleco for arcades in 1996, and ported to the Sega Saturn, PlayStation, and Game Boy later that year.

Tetris game with little man