Them: A Paranoid Fantasy is an arcade action game divided into five stages, each with completely different gameplay. Stage 1: The player controls his character from a top down perspective and has to collect two visas and an exit pass to unlock the exit while at the same time avoiding the bad guys that move around. Contact with enemies or walls will lead to a life lost although a shield can be used for protection. Stage 2: Five blocks of different sizes move back and forth across the screen at different speeds. The player has to make a stack of the blocks by pressing a key when the lowest block is directly beneath the block above it. They will then lock onto each other. Stage 3: The player is located in the middle of the screen and is surrounded by demons that shoot bombs toward him. The player has to avoid these and kill the demons with his entropy bolt. Stage 4: The player finds himself on a conveyor belt leading to a doomsday machine. On both sides of it are demons that run the belt. To stop the belt the player shoots up and down at the demons as they move past him. Stage 5: The player has to match the tops and bottoms of bones. At the top of the screen are eight faces that the bones belong to. When moving the cursor over a bone the face of it's owner will turn yellow. The player then has to remember which bones belong to which face and match accordingly. The stages can be played in sequence and will then restart at a higher level when all stages have been completed but it's also possible to play each stage on its own.
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