Players compete on 12 courses with different vehicles. Points are awarded for performing tricks, passing through special gates, and knocking down opponents. Health dictates how easily a player can be knocked over by an obstacle or another racer, and decreases when a player accelerates. 2Xtreme has four different difficulty levels. A player can choose in the options to race without the other computer characters, and also turn off fighting.

On 2Xtreme a player can either do a normal 'Exhibition' race or a season which involves all 12 tracks and creates standings based on the score the player achieves in each track. The score is calculated mainly by the time the player finishes in and place in the race. Points from gates, knockdowns and tricks are then added to this. On 2-player mode both for Exhibitions and Seasons the screen is split horizontally and both players start at the back of the race. This makes the game a little more difficult as it becomes harder to see and avoid the obstacles in your path.