Mario's stuck in the bottom of a Tetris-style pit of falling blocks in Yoshi, and his hands are raised up in the air to support four spinning plates. You control the plumber himself, and not the blocks – they cascade automatically while you shift the plates on Mario's hands, stacked up with blocks that have already settled on top. It's a different take on the falling block puzzle genre, but it can be cumbersome to manage. If you need to get the stack on the far left all the way over to the far right, for example, you'll have to spin and move Mario three times to do it – and all the while the other stacks you've shifted are getting moved backward along the path you just took.
Your goal is to line up like blocks together, as matching two of the same kind eliminates both – each one is emblazoned with a different Mario enemy character, so connecting two Goombas, two Boos, two Bloopers or two Piranha Plants together is the idea. Yoshi enters into the mix himself with an alternative method for clearing the field – his signature eating. Mixed in with the tumbling baddies will occasionally be the bottom half of a Yoshi egg. If you allow enemy blocks to stack on top of the egg piece and then finish the sandwich by allowing a top half eggshell to settle on the summit, each block caught in-between will be munched and eliminated by a newly-hatched Yoshi.
That's all well and good. The problem is that it's just not a lot of fun – Yoshi's boring. Bland. You've seen pretty much all there is to see after only a few minutes with the game, and the challenge is never really there. It's just waiting around for the next set of enemies to fall, or biding time until the next egg piece appears. There are multiple modes, one of which has a defined end goal of eliminating all blocks on the screen, but even that doesn't help much because it's too easy to achieve.
Yoshi's best placed as a beginner's puzzler, holding little appeal for experienced players who'd prefer the deeper challenge of other designs.