Tetris Attack plays very differently from other Tetris games, because it started as a different game called Panel de Pon. The name and characters were changed to Tetris and the Yoshi series to be more recognizable to North Americans. Henk Rogers, the CEO of The Tetris Company, says that he regrets granting permission to Nintendo to use the Tetris name on a game that has nothing to do with Tetris.

According to the British magazine Nintendo Magazine System, before settling on Yoshi's Island characters for Tetris Attack, Nintendo reportedly asked Rare to replace Panel de Pon's fairies with characters from the Killer Instinct series.

Yoshi's dialog in Tetris Attack was not rewritten from Lip's dialog in Panel de Pon to account for the dinosaur's more laid back, cheerful personality, resulting in him saying rather stoic fantasy hero lines such as "Together we own our world" or "We can't just be strong, we must be strongest".

One prominent difference between Panel de Pon and its international counterpart, Tetris Attack, is that the former does not feature an options menu in normal gameplay. However, one does exist in Panel de Pon's code; re-enabling it with hacks reveals that it is slightly more expansive and features a slightly different set of features compared to the one in Tetris Attack.

The unused Panel de Pon menu features an option to adjust the timer for Time Trial mode, which is replaced with a Language Select menu in Tetris Attack. The Panel de Pon menu also features an "Etc." option, which opens a sub-menu that allows the player to toggle both combo markers and the game level (though not skill level) of the three difficulties in story mode at the cost of disabling the ending. In Tetris Attack, only the combo marker toggle is featured, replacing the "Etc." option. The full sub-menu is similarly present in Tetris Attack's code, albeit in a visually glitched state.

Additionally, one other feature only found in the Panel de Pon options menu is the ability to view the game's character bios. These include not only all the bios which appear when idling on the title screen, but also two additional bios for Thanatos and Corderia which are otherwise inaccessible.