The game is based on the story of Frankenstein. SpongeBob appears as Victor Frankenstein, the scientist who creates a living monster. Patrick appears as Frankenstein's monster, and Sandy appears as the bride of the monster.
Aside from the gears, the game is in black-and-white to evoke the look of an old horror film. The levels are overlaid with film-style burns and flickers.
The goal of the game is to raise Franken Patrick's elevator by matching gears together. There are five levels with multiple rounds in each. In each round, only one gear is spinning to power the elevator. The player must drag gears to the spinning one in order to create more power. Only gears with the same inner or outer colors will click together. Once all of the gears in a round have been matched, the elevator goes up another floor, giving more power to Franken Patrick.
At the end of each level, Franken Patrick is zapped with electricity, which causes him to gain more sentience and change his expression. In the first level, Franken Patrick's eyes are closed and his mouth is open. In the second level, he starts to frown. In the third, he starts to raise his head. In the fourth, he opens his eyes, and in the fifth, he is fully alive.
The rounds in each level are timed. If the player does not match the gears in time, the game ends.