Worms Pinball is a pinball simulation game set within the Worms franchise. The game features a single pinball table themed around two main modes, one inspired by martial arts and the other by a Western setting. Players control a pinball table that incorporates multiple objectives, rule sets, and sub-games presented through a three-dimensional LED display.

The table includes transparent ramps, moving mechanical components, user-controlled elements, and magnetic fields. Gameplay mechanics replicate standard pinball techniques such as tilt functions, hit combinations, ball control maneuvers, and recovery actions. The table contains a large number of animated elements and extensive rendered animation sequences used for the LED display. Sound effects and music are integrated to accompany gameplay events. The design emphasizes depth through layered objectives and complex table rules, supporting extended play for both casual and experienced pinball players.