Bejeweled Twist plays similarly to its predecessors. Instead of swapping two adjacent gems, the player rotates four gems in a 2x2 space clockwise. Like its predecessors, the game involves attempting to create matches of three or more gems in a row to clear them from the board. When this occurs, the gems above it are affected by gravity, falling down and potentially creating cascades.
Unlike previous entries in the series, it is no longer required for a move to create a match of gems. Making consecutive valid matches adds ticks to the multiplier bar at the top left of the screen. When the multiplier bar is filled, the score multiplier increases, with the multiplier going as high as 10. When the multiplier is filled at the tenth multiplier, it will begin filling in a new rainbow layer onto the bar. When it is filled, a Bad Gem (or if there is not any, a random gem) will turn into a Fruit Gem, which destroys all gems of its color off the board when matched, similar to the Hypercube in previous entries, as well as adding extra ticks to Bomb and Doom Gems, and destroying all locks from the board.
Like its predecessors, Special Gems return. Making matches of four gems in a row, L, +, or T shape matches create a Flame Gem, which destroys the eight gems surrounding it when matched. New to the game is the Lightning Gem, created by making a match of five gems in a row. The Lightning Gem destroys all gems on its row and column when activated. Additionally, matching six or more gems in a row creates a Supernova Gem, which destroys all the gems in its row and column on a 3x3 radius.
New to this game are Coals, which cannot be matched, but release a large point bonus when destroyed. Twist introduces Bad Gems, which usually hinder the player's progress. Bomb Gems must be destroyed before their counters hit 0, which causes them to explode and end the game. Locked Gems prevent the player from rotating an area of gems with a lock. Doom Gems cannot be matched or moved, and their counter only goes down when matchless moves are made.
Other new gimmicks include the Speed Bonus, which gives the player a score bonus if consecutive matches are made quickly enough, the Bonus Challenge, which provides the player with extra ticks and the destruction of a Bad Gem when the gems shown on the panel are matched in order, and the Mega Fruit Bonus, which is activated after the detonation of a Fruit Gem and awards a large number of points when performed successfully.
Bejeweled Twist features a ranking system, which increases depending on how well the player plays. Completing levels in Classic and Zen, completing challenges in Challenge, and completing games of Blitz awards the player with stars, which vary in amount based on how much the player has scored in the game mode/level.
There are several different modes of gameplay available.