M.I.A.: Missing in Action is a sequel to Rush'n Attack (or Green Beret), featuring the same type of action. You control a nameless soldier on a mission of rescuing prisoners of war. Armed only with a knife the soldier navigates five stages of hostile territory overcoming countless enemies. Like in the original game, most areas are divided into three horizontal planes and you can move up and down using ladders. This game introduces underground areas containing detours and hidden weapons. Weapons are dropped by certain enemies as well. Your soldier can pick up and use grenades, a flame-thrower, an assault rifle, and a bazooka, all with very limited ammo supply. The game features simultaneous two-player co-op.

The game was released in several slightly different versions, the most notable difference being that on some stages the scrolling is changed to right-to-left, and the order of stages is randomized.

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