By collecting teeth that are dropped by foes or found scattered about the levels, the player can upgrade these items to more powerful versions. The Teapot Cannon fires tea sieves that explode to cause heavy damage and, like the Hobby Horse, break barriers. The Hobby Horse is used as a sledgehammer to inflict heavy damage and break barriers and defenses.

The Pepper Grinder becomes a crank operated Gatling gun, used to attack at a distance and pepper pig snouts. The remainder of her arsenal is somewhat akin to the benign and mundane items that take on a deadly quality in Alice's tainted Wonderland in the first game.

Her primary weapon is the Vorpal Blade, a decorated kitchen knife. In combat, Alice gains a small number of weapons that can be utilized in several ways. The player controls Alice for the entirety of the game for running, jumping, dodging, attacking, and shrinking. Alice as seen in Madness Returns, wielding the Vorpal BladeĪlice: Madness Returns is played from a third-person perspective.

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