Il Piccolo Freakstein is an educational game to teach children the anatomy of the human body. Loosely based on the story of Frankenstein, the game has you control professor Freakstein. With the notes of his grandfather, he manages to build a creature. His work is not complete however. The player has to analyze the creature's body, identify the problems and solve them by performing surgery.
Before starting the operation, the player has to watch an education film, read articles in an encyclopedia and collect a few items gathered through a mini-game. The professor and the creature ride a cart through a tunnel. The needed items need to be clicked when they appear while monsters dry to drain energy. Clicking a monster is sufficient to get rid of it. There are also cans that restore energy. When all items are found, the professor can work in the operation chamber. Before performing surgery, a few questions need to be solved. The answers to these can be found either in the films or in the encyclopedia articles.
For an operation, Dr. Freakstein needs a diagnosis of the problem, an anesthetic, and items to perform the operation and the transplantation. As in most of these types of games, the scenes also include clickable objects with no function except to trigger a funny animation.