Your girlfriend is once again kidnapped by aliens, and you have to rescue her, forcing your way through various levels.

The gameplay and the design haven't much changed since Adventure Island II: there is a world map, you can choose items before starting a level, the levels themselves are quite short (unlike Adventure Island, where each large level contained several stages). You perform standard "adventure island" activities: ride various types of dinosaurs, throw boomerangs at snails, birds, snakes, and skulls, collect grapes and apples, jump over stones, and of course, ride your old trusty skateboard.