Vertigo alternates between arcade style racing and precision steering, all using the Wii remote or Balance Board. You move the ball by tilting the Wii remote (contrary to other ball-balancing games where you tilt the environment) , "A" and "B" buttons are used for speed boost and breaking respectively. The emphasis is on fast completion times, you can earn bronze, silver and gold medals. Fast times will earn you specially themed skins and Xorb models. Xorb handling can be adjusted by spending points in customization, these are earned in arcade and career modes. Special items can be collected from hard to reach places for more unlockable skins, models and new courses.