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. Sometimes, a Rhythm Game that a player has received a Superb rating on may be randomly selected for a Perfect attempt. 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. To clear a Rhythm Game and progress onto the next level, the player needs to get a 'Just OK' or 'OK' rank.

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. 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). 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. In each Rhythm Game, the player must attempt to keep with the rhythm throughout the level. 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. 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. 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.

Throughout the game, players use the stylus to play through several rhythm-based levels known as Rhythm Games, each with their own specific rules.

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. The game was released in Japan on July 31, 2008, in North America on April 5, 2009, in Europe on May 1, 2009, and in Australia on June 4, 2009. It is the second game in Nintendo's Rhythm Heaven series and the first one released worldwide, following the Japan-only Game Boy Advance title Rhythm Tengoku, and was succeeded by Rhythm Heaven Fever for the Wii and Rhythm Heaven Megamix for the Nintendo 3DS. Rhythm Heaven, known as Rhythm Paradise in Europe and Rhythm World in Korea, is a Japanese rhythm video game developed by Nintendo SPD for the Nintendo DS.

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