Quiffy must collect all of the various pieces of litter on the level and then find the exit to complete each level. In general the litter is not particularly hidden, it is just distributed around the level. Quiffy can climb on most walls and ceilings, and swim through water. He has energy which depletes upon touching dangerous objects, but can also die instantly when touching any of the few lethal objects. Although he can swim and has the appearance of an amphibious life-form, he can only breathe above water and will start to drown if he runs out of air.
In each level, you are followed by the ghost of your Aunt Matilda. She copies your movements exactly and starts off about 15 seconds behind you. However, she is very slightly faster than you and will eventually catch up with you. Touching the ghost will hurt Quiffy.
Most of the levels have taps in them, which pour water in to the level. The modelling of the water was quite advanced for a home computer game of its time; the water will flow to the lowest point that it can and when multiple taps are pouring water in one place, it will fill up proportionally fast. A lot of levels feature taps in all areas so the entire level will eventually flood, leaving Quiffy with no available source of air. This aspect is how the game derives its title.