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Like its predecessors, Cutie Q plays like a mix of pinball and Breakout style games. The playfield has features derived from pinball games, such as a spinner in the middle, various rollovers, an entry lane for the ball (though without a plunger), and drains in the bottom corners. However, as in Breakout, the ball is unaffected by gravity, and continually bounces. You control a pair of paddles that slide horizontally across the screen, and there are rows of blocks to break.
A similar (most likely unauthorized) game called Pinball Spectacular was released by Commodore for the VIC-20 and Commodore 64 home computers. The VIC-20 version features a board layout almost identical to Cutie Q (even including the ghost rollover), while the C64 version is slightly altered, including some aspects of the board for Bomb Bee (most notably, the bumpers in the top corners), and replaces the ghost rollover with a Commodore logo.
This game was featured in the Japanese release of Namco Museum Volume 2 for the PlayStation. For the American version of Namco Museum Volume 2, Super Pac-Man was featured in place of Cutie Q, but an analysis of the disc's files reveals that Cutie Q's files are still present, including the executable file. However, attempts to run the executable file directly fail, so the game is rendered unplayable in the American version of Namco Museum Volume 2, due to not having a menu icon to run it during gameplay. In 2007, the game was also added to Namco Museum Remix for the Wii console.