In Medal of Honor, the player takes the role of the fictional Lieutenant Jimmy Patterson, a former C-47 Skytrain pilot in the Air Transport Command who was later recruited to the OSS. The game takes place near the end of World War II (mid 1944-mid 1945). The goal of the game is to complete various Office of Strategic Services (OSS) missions, such as rescuing an American pilot, going undercover to board and destroy a U-boat, recovering stolen art work, and sabotaging the Nazi war effort.
The game includes a split screen deathmatch mode, pitting two players against each other in various maps. Players can unlock several secret characters after completing the game or through cheat codes, including notable historical figures such as Filipino patriot José Rizal and playwright William Shakespeare, as well as outlandish characters such as a German Shepherd and a dinosaur.