Twisted City is a simulation game that features tile-rotation and logic-puzzle play. The player must perform the job of a city intern and planning specialist who helps design the intricate layout of streets between buildings. The game displays the city on a flat island-style landscape that features a two-tone grass checkered board with fir trees and segments of streets.
As the intern, the player must rotate the tiles in logical ways across 30 levels and several bonus levels to complete tasks given to them by the Mayor. For example, they might need to rotate tiles to connect street segments to help a delivery driver bring pizza to the Mayor's house. They must complete each task within a specific number of seconds or moves. If they perform their job well, the player receives new titles, including the title of Assistant Mayor.
Twisted City also tasks the player with ordering the construction of new buildings, including a school, a firehouse, a hospital, a bank and a police station. The player must then connect segments of streets between locations. For example, they might connect the firehouse to a building during a fire or the police station to the bank during a bank robbery.
It's important to note that the street positions aren't permanent. The player must twist the tiles in different directions, even if it means that they block off previous pathways by doing so.