Unlike its predecessor which is played using the GBA's buttons, Rhythm Heaven is played using the touch screen with the DS held vertically, similarly to a book. Throughout the game, players use the stylus to play through several rhythm-based levels known as Rhythm Games, each with their own specific rules. Controls used include tapping the touch screen, holding the stylus down on the touch screen, dragging it across the screen and flicking it off the screen. A guitar-based minigame late in the game known as Rockers 2, along with the unlockable guitar lessons, also include the use of the DS's shoulder buttons to bend guitar notes. The game's fifty Rhythm Games are split into ten sets, each consisting of four Rhythm Games and a themed Remix level that incorporates the previous games (or more) into one song. In each Rhythm Game, the player must attempt to keep with the rhythm throughout the level. Several Rhythm Games have sequel levels in later sets which use the same mechanics as their predecessors but have increased difficulty and, in a few cases, introduce new patterns. Most levels allow the player to practice before attempting to clear the game, the exceptions being the Remix stages and some sequel games (namely those that include previously unseen patterns). The player is given a rank at the end of a game depending on how well they did, which ranges from 'Try Again' for a poor performance, to 'Superb' if they complete the stage with few or no misses. To clear a Rhythm Game and progress onto the next level, the player needs to get a 'Just OK' or 'OK' rank. By receiving a 'Superb' rank on each Rhythm Game, players receive Medals which unlock bonus content, such as Endless Games, Rhythm Toys and Guitar Lessons. Sometimes, a Rhythm Game that a player has received a Superb rating on may be randomly selected for a Perfect attempt. Only appearing on the menu three times before moving elsewhere, these runs require the player to complete a Rhythm Game perfectly without making any mistakes. Completing a Perfect run earns more bonus features in the cafe, such as song sheets and lyrics. While the game is automatically set to be played on right-handed mode, there is also a left-handed mode for left-handed individuals.