The core gameplay remains a turn-based tactical RPG where you control a "Medarotter" and their three-part robots (Head, Left Arm, Right Arm, Legs). However, Medarot DS added Wi-Fi battles, a medal link system, and over 200 new parts. Without an English patch, the game is impenetrable due to heavy story dialogue and complex kanji menu systems.

Medarot DS is a sci-fi RPG set in a world where humans and robots coexist. Players take on the role of a Meda-Rooter, tasked with collecting and battling Medarots, robotic creatures with unique abilities. The game features a rich storyline with multiple characters, an intricate mech customization system, and turn-based combat.