It has five floors, each containing four levels and a boss. The tower serves as the setting and hub world of the single-player game. Frightened and angered, Peppino sets out to ascend the tower and defeat Pizzaface to save his pizzeria. Pizzaface threatens to destroy Peppino's pizzeria with a nuclear laser atop a nearby tower. Its story begins when Peppino Spaghetti, a pizza chef and the owner of a struggling pizzeria, is approached by Pizzaface, a sentient floating pizza. Pizza Tower is a side-scrolling platform game. Gameplay Peppino, the player character, dashes towards the level's entrance during the 'Pizza Time' phase. They considered Pizza Tower a worthy substitute for Wario Land, and some called it a rare spiritual successor that is better than its inspiration. Critics favorably compared its art style to 1990s Nicktoons and the sense of speed to the Sonic the Hedgehog series.

Pizza Tower received positive reviews, with praise for the gameplay, score, visuals, and humor. It was released for Windows on January 26, 2023. Pizza Tower developed a large fandom during its development through early access builds offered to Patreon backers and game demos. Wario Land 4 (2001) served as the basis for the gameplay and level design. It was developed with GameMaker and features a cartoonish, high-resolution pixel art style inspired by SpongeBob SquarePants and French comics. Pizza Tower began as a role-playing video game with survival horror elements before evolving into a platformer inspired by Nintendo's dormant Wario Land series, to which McPig wanted to provide a spiritual successor. The development began around March 2018 and was led by the pseudonymous designer McPig and programmer Sertif. Pizza Tower does not feature health or lives, and its difficulty depends on what the player chooses to achieve. At the end of each level, they activate an escape sequence and must return to the beginning within a time limit.

Across 20 side-scrolling levels, the player increases their score by gathering collectibles and defeating enemies to build combos.

It follows a pizza chef, Peppino Spaghetti, who must scale a tower to prevent the destruction of his pizzeria. Pizza Tower is a 2023 platform game created by the indie developer Tour De Pizza.

Leaning tower of pizza delivery area