Like its predecessor, Super Basketball, the player controls a five-man basketball team playing against the computer-controlled team, or controlled by a second player. When a coin is inserted, a credit is displayed on the bottom of the screen, along with a timer indicating one minute. The player is then prompted to enter their initials before starting the game.
The gameplay is a marked difference and improvement from its predecessor, as the characters look and move better around the court. Like a traditional basketball game, the centers come out to the middle of the court, and the referee institutes a jump ball to begin the game.
The goal for Double Dribble is for the player to have scored more points than the computer team before the time runs out. Doing so awarded the player with another minute of time, and the game continues. The long the game is played, the more difficult it becomes. If the computer team has as many points or more as the player's team when time runs out, the game ends.