Idol Janshi Suchie-Pai IV is the fourth main game in the Idol Janshi Suchie-Pai series (discounting Bishōjo Janshi Suchie-Pai). Kyoko Misaki (Suchie-Pai) is missing, and Shoko Misaki has come to town looking for her. Shoko can also transform into a hero: Suchie-Pai S. She is the manager at the You and Me Cafe, and she enlists the help of maids from other cafes to find Kyoko.

Like previous titles, you play strip mahjong against young attractive girls. This time, however, no actual nudity is present. Characters include both new and familiar faces. There is also a sound test for listening to vocal tracks, a dialogue replay mode, and a photo mode with costumes that can be purchased, as well as a replay match mode.