Squacketball is played on a traditional Racquetball court (40 feet long and 20 feet wide) but utilizes a Squash ball (usually double yellow dot), Racquetball racquet, and follows general Squash rules.

The front wall contains a horizontal line 36 inches above the floor and the ball must strike the wall above this line. Ceiling is considered out bounds while the entire side and back walls are considered in bounds.

During service, the server chooses on one half of the court between the racquetball "Short Line" and "Receiver Line" and must serve to the opposite side of the court with the ball passing the "Receiver Line" before first bounce. The server must then alternate between the sides of the court for subsequent serves after a point is scored. The British scoring rules of squash are applied (only server scores, 9 point game and "Set 2" if tied at 8-8).

Since there is not the traditional squash "Board" on the front wall or "Receiving Boxes" marked, any disagreements of ball placement are replayed.

Game variations are Singles (2 players), Triples (3 players playing against each other), or Doubles (2 teams of 2 players) with Triples being the most popular.

This game is very strenuous, even more so than squash, since the court is 8 feet longer and the racquets shorter.

The World Squacketball Federation(WSF) is the Governing Body for oversight of Squacketball and is responsible for maintaining the rules of Squacketball.