The game is set in a cursed old school or laboratory facility, where the protagonist is trapped for some reason. The environment is covered in blood and mutated creatures, and danger lurks around every corner. However, unlike traditional horror games, Horror Spranky Beats' core gameplay isn't entirely based on hiding or fighting, but rather on rhythm. Monster movements, the activation of traps, and opportunities for escape are all closely linked to the rhythm of the music. Players must constantly monitor the rhythmic changes in the background music, tapping and dodging precisely while navigating the monsters.

The game's control logic blends the percussive feel of a rhythm game with the tense atmosphere of an action-horror game. In certain scenarios, the system enters a rhythm challenge mode, requiring players to press buttons at the right time to follow the music. Each tap not only responds to the rhythm but also reflects specific in-game actions, such as opening doors, dodging, counterattacking, sprinting, and even solving puzzles. Mismatched timing not only impacts your score but can also lead to your character being discovered or even being tackled, resulting in immediate failure.

The overall rhythm mechanics are meticulously designed, with a wide variety of musical styles, ranging from low, oppressive ambient sounds to explosive electronic music, metal rock, and even industrial noise. Each style reflects a different level style and monster characteristics. For example, some monsters approach in time with the rhythmic beats of drums, requiring players to dodge at each accentuated beat. Other scenarios require players to follow the rhythm to solve puzzles, with any mistake resulting in a closed path or a trap being triggered. As levels progress, the rhythmic difficulty gradually increases, with faster tempos and more complex beats. Visual distractions, such as flickering screens and darting shadows, also intensify, creating a highly demanding rhythmic challenge both mentally and mechanically.