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NES box art for Dr. Mario, the cover of NEStalgia episode 389

389 · Dr. Mario

▶ Game info
August 8, 2025 · 35 min · transcript available

In this Tetris-style game, you play as Dr. Mario, who must drop differently coloured pills onto viruses to remove them from the bottle. Each pill is split into two, with each side being of one of three different colours, red, blue or yellow. Align three pills of the same colour to a virus of the corresponding colour (or any combination of pills and viruses totaling four or more) and it will be removed from the bottle, along with the aligned pills. The level is cleared when there are no viruses left, and the game is over when the pills reach the top and Dr. Mario can't drop any more pills.

Our verdict: Play it

Mike and Sean played this one as a duo, with Joe out (Sean introduced himself twice in his honor). It is Nintendo R&D1's follow-up to Tetris: Mario in a lab coat, throwing two-color vitamin capsules into a medicine bottle to wipe out red, blue and yellow viruses. The manual says only that he now works in the virus research lab at the Mushroom Kingdom Hospital, with no word on how he got his license.

What works

  • Match four, clear the viruses. It looks like Tetris, but stacking four of a color makes it play closer to Puyo Puyo. You only advance when every virus is gone.
  • The capsules. Each piece is two squares, and when part of one clears, the other half stays behind or drops. That leaves fragments you can lock yourself out with. It looks like Tetris baby mode at first, and then you start offsetting a capsule so it hangs off a column.
  • Chain reactions. Setting one up on purpose is the satisfying part, and when one happens by accident you play it off like you meant it. Meanwhile Mario stands in the corner like a smug lab supervisor, and the music is excellent, close to Tetris in quality.
  • Enough game. Twenty levels get busier and faster, and we agreed it has about as much strategic depth as Tetris, more than we expected. Most of the replay value is in versus play, side by side.

What doesn't

  • Not much Mario. Take him out and nothing of value is lost. In earlier games his jobs, plumber, construction worker, cement factory hand, were things you did as him, and here we didn't feel like we were controlling Mario. There are no Koopas and almost no cutscenes. We joked about a rival Dr. Bowser racing to a vaccine.
  • The viruses. The box art's blue one looks like a furry rabbit thing that doesn't belong in the Mushroom Kingdom.
  • Late-level pressure. Early levels are easy, but later most of the bottle is viruses and the speed climbs. One wrong placement costs several rotations.
  • Anticlimactic. Mario in the title and a Nintendo pedigree set us up for more than we found.

Beyond the game

It was also a Game Boy game, and we guessed that's where the real story lies. Later versions add a computer opponent, an N64 story mode, and online play.

The bottom line

Play it. Mike voted no on the Essential Games List: it's competent, but by the time he needs to turn his brain on he'd rather be playing something else. Sean called it a definite Play it but not essential, though he'd return in a Tetris mood and found a groove early on. With no yes votes it stayed off the list. If you like Tetris, give it a go, because it's a different kind of game, not a Mario skin.

Written from our conversation in this episode.

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