You play as Mario, who is working in a cement factory. Conveyor belts at the top of the screen drop cement into tubs below. Each tub can hold three lots of cement - if any more goes in, it will overflow and cover the driver of the cement truck below, scoring you a miss. You'll also score a miss if you misstep on the elevator, or get crushed at the top or bottom of the elevator shaft. If you reach three misses, the game is over.
Mario needs to manually operate the tubs' levers to open the valves and let the cement flow through to the lower level, and then into the cement truck below. Emptying cement from the upper tank scores you one point, while emptying it from the lower tank scores you two points. If you reach 300 points, all your misses will be cleared. If you have no misses when you reach 300 points, your score will be doubled until you do eventually score a miss.