Pitfall II: Lost Caverns is a platform video game set in Machu Pichu, Peru. The player controls Pitfall Harry, whose goal is to find and rescue Quickclaw the cat as well as Harry's niece Rhonda, and to recover the Raj diamond.

Pitfall Harry moves left and right and can jump over and onto objects, climb up and down ladders, ascend via balloons and swim to seek treasure and achieve the game objectives. The player can additionally collect gold bars scattered throughout the playfield for more points.

Unlike the original Pitfall! video game, there is no swinging on vines and there are no timed levels. There is also no "classical" approach to the number of player lives Pitfall Harry has; accidentally falling or interacting with traps and enemies merely causes the player's score to diminish. The player can find red crosses across the ground that act as checkpoints; when the player is hit by an enemy, Pitfall Harry returns to the last checkpoint he located.