
One of the NPCs the Twinkle Elementary school, one kid asks if you've beaten Dragon Quest 4, and states that he's still stuck on Dragon Quest 3. Some female enemies were also redone to have their breasts redone, in order for there to not be an unintentional nipple. This was done in order for the game to be made more appropriate. In the English version, a couple of enemy changes were made to avoid references of blood, smoking and such.

The main characters include Ninten, a young boy who has psychic powers, Lloyd, a young boy who is often picked on because he is a weakling and a nerd, Ana, a young girl who is gifted with great PSI abilities, and Teddy, a former gang leader who wants to avenge the death of his parents. Mother's seemingly average characters are what greatly set it apart from other RPGs and games in general. The rate at which battles will start is high for an RPG.

Unlike the two games following it, enemy encounters are random (thus meaning you won't enter a battle by touching an enemy on the overworld, but rather a battle will randomly start just by walking around). You'll take turns fighting, and once you've defeated an enemy you'll get experience points and items.

When in battle, the action will be seen through a first-person perspective, similar to that of the Dragon Quest series. The other members of the party will still be seen even if they've been killed in battle - but their sprite will simply be replaced by that of a ghostly figure. While on the overworld, not only your main character but everyone else in the party will be visible, contrary to other games where only the most prominent character is seen. Nevertheless, it is still one of the most traditional video games in the genre, and while the plot was wacky, the gameplay didn't stray too far from other games. The game takes many RPG elements made popular in various similar titles and throws them out the window - it features a humorous plot, strange enemies that have never before been present in any video game, let alone an RPG, and various other things that were incorporated into the two sequels.
