In Aaaah!, players control stick figures and navigate through a dark, silhouette-based map to reach a pharmacy. One player, with the most points, is designated as a "guide" and is supposed to help the other players reach the pharmacy by drawing a path. Players can press Space to scream loudly and push away any nearby characters. Like other Atelier 801 games, it has an online room system, but does not have an English translation. Aaaah! also features a map editor, which has spawned a rather large community of custom map makers.