The video game spans through the entire 51 episodes of Fullmetal Alchemist, and is a side-scrolling brawler in the vein of classic titles like Final Fight or Battletoads. Players control Edward Elric, and his brother Al will often fight alongside him. The touch screen feature of the Nintendo DS is used to draw transmutation circles for alchemy, as well as to trigger special moves, some of which are necessary to progress through the game. For example, the player may have to create stone walls to cross a bed of spikes, create weights to trap enemies inside hatches, or summon cannons to break down walls. Most boss battles also require use of alchemy in order to complete them.
Dual Sympathy also features many bonuses such as a second gameplay mode called Character Mode, which allows the player to replay the story with other characters