Queen of Hearts is a early pinball game. The ball is launched from the top right of the screen. The player controls flippers in the bottom half of the screen, and attempts to prevent the ball from falling through the hole in the bottom center of the screen. Gameplay features include: a "realistic" tilt feature, two different play fields, and 4 sequences which allow the player to rack up a large score if the sequence if struck in order. Each play field contains a variety of bumpers and bonus features. The player gets 3 balls per game, with the goal to maximize score. The player's score per ball is displayed on the right during gameplay.