Patchwork Express features the same basic gameplay as Patchwork, but with a smaller playing area and with larger and less complex pieces.

In the game, each player tries to build the most aesthetic (and high-scoring) patchwork quilt on a personal 7×7 game board. To start play, lay out all of the light-colored patches at random in a circle and place a starting marker in a particular location. Each player takes some buttons, the currency/points in the game and someone is chosen as the start player.