The game features Thrilla Gorilla, a surfing/skateboarding mascot of the company, Town & Country Surf Designs, on a quest to save his girlfriend (Barbie Bikini) who has been kidnapped by a witch doctor named Wazula, as you find out in the opening scenes. Unlike the original game, which is set in Hawaii, the sequel is set in Africa. The game features levels such as jungles, deserts, waterfalls, rivers, and submerged caverns. Thrilla rides a skateboard through the jungle and desert levels, a surfboard through the river and waterfall levels, and a shark in the submerged cavern levels.

Gameplay involves steering Thrilla around obstacles, over pits and past creatures while collecting coconuts used in the shell game to gain extra lives, bananas to gain extra life, and powerups such as the handstand powerup which grants temporary invulnerability to all manners of danger but pitfalls. Enemies include elephants, giraffes, giant spiders, carnivorous plants, spear-wielding humans, snakes, electric eels, and many others.

T&C Surf Designs features both skateboarding and surfing games. The skating section (called Street Skate Session) is a side scrolling action game where you need to navigate through an obstacle course within the given time limit. Ideally you want to earn as many points as possible by performing tricks, jumping over items, and collecting bonuses. If you crash too many times (or fall into a hole, run out of time, etc...) then the game will be over. In the surfing section (called Big Wave Encounter) you need to surf a giant wave all the way to the beach. As with skating, you can earn points by performing tricks and collecting bonuses; likewise the game ends if you crash too many times. You can choose to play either game individually, or alternate between the two (the Wood & Water Rage option). You can select several T&C Surf Designs characters to play as, including Thrilla Gorilla, Kool Kat, Joe Cool, and Tiki Man.