It is a NiGHTS-themed pinball game where the player can collect and match picture cards to score Rings. It also has a challenge of collecting Ideya in a bonus playfield.
The game plays like a regular pinball game with Sonic (in constant Spin Attack) as the ball. The object is to score as many Rings as possible. The players have three "balls" which they will will loose if Sonic falls down the drain. The players can use the flippers to keep Sonic from falling down it. If the players loose all balls with less than 100 Rings, they will fall into Casinopolis' garbage and sewers. If the players score more than 100 Rings, they will end up in front of the vault to deposit them.
The NiGHTS Pinball game has two separate playfields as well as miniature cutscene events that depend on the players' performance.
Square picture cards of various characters from NiGHTS into Dreams can be collected. A maximum of five cards can be collected, and depending on how many of the same cards the players have, it may result in points and rings.
Two same cards
Two same cards, two same cards.
Three same cards
Three of a Kind
Three same cards, two same cards.
Four same cards
Four of a Kind
Five same cards
When the players score a set of cards, a door at the top-right of the playfield will open, granting access to the bonus playfield of cards where the players can collect more cards and attempt to collect Ideya.
The bonus playfield allows the players to collect more cards with ease. Above the playfield is an Ideya Capture. By launching Sonic with the flippers and ricocheting off the bumpers, it is possible to attack the Ideya Capture which plays a cutscene of Sonic and NiGHTS flying around Twin Seeds.
Falling down the drain in the bonus area will show Sonic flying around a Spring Valley like room where NiGHTS is taunting him over the Ideya Palace, showing how many Ideya are collected and return the players to the main playfield without loss of balls. When all five ideya are collected, the players get a 500 Ring bonus and the process starts over again.
Prototype images of Sonic Adventure in its early stages show that Card & Pinball was once going to be played from a third-person perspective rather than a overall bird view perspective.