Madden NFL 2003 on the Game Boy Advance is based directly on the previous year's iteration, using the same graphics engine and even the same menus.

All gameplay options from the 2002 game are included, including the exhibition, season and playoff modes. Besides slightly changed controls and an updated playbook, new additions are player trades, four player support via link cable, and a create-a-player mode. In this mode, several mini games determine the stats of the new athlete, depending on his position: a quarterback will get a throwing game, a receiver a catching game, a running back a sprinting game.

The teams and stats are updated for the 2002 NFL season, with all 32 teams reorganized into the new divisions. Commentary is provided by John Madden and Al Michaels.