Sega ROAD RASH II is a game where you race against others on bikes while simultaneously fighting them in hand-to-hand combat. You are able to punch, kick, and swing weapons to knock your opponents off their bikes. In order to win, you must finish in third place or better in each race. There are five ability levels and 11 different tracks in total. New bikes and tracks are unlocked as you progress through the levels.

The game has multiple modes, including:

• Solo: Race against the computer-controlled opponents.
• Take Turns: Two players take turns playing on the same console using the same controller.