American Horseshoes is an adaptation of the Horseshoes lawn game where players take turns throwing a horseshoe around or near a stake. This game supports up to four players taking turns. A single credit is required per player for three innings. The game uses a standing cabinet with two buttons and a trackball in the middle. At the start the player chooses a character: Diamond Dave, Lucky Lou, Mayhem Mary or Tossin' Tom. Per inning each player gets to throw twice. The horizontal axis of the trackball is used to position the player and the vertical one determines the distance of each pitch. A vertical roll fills the power gauge on the left side of the screen. Three arrows provide guidance, showing "Short", "Good" or "Over".
The left button is used to switch between throwing effects (left, center, right) and the right one to change the throwing angle. A maximum of three points is possible per throw: a ringer is three points (horseshoe around the stake), a leaner two (the horseshoe rests against the stake) and landing near the stake area is rewarded with one point. After each inning an overview of the points is shown as well as a top-down view of the landing positions. A game has a maximum of nine innings.