The game, carrying the same basic premise as the Flash version, sees players taking on the role of a small animated cube of meat who must save his girlfriend Band-Aid Girl from the evil Dr. Fetus. Players must guide Meat Boy to the end of each level, using his wall clinging ability, whilst avoiding buzzsaws, salt, and other various death bringing obstacles. The game will contain at least 300 levels, unlockable content and multiplayer co-op and versus modes, as well as a four player party mode. The multiplayer modes will also feature playable characters from other independent games, which must be unlocked by the player by collecting Band-Aids in the game. Completing a level with an 'A' grade will unlock a harder alternate level. Occasionally warp zones appear that warp the player to either an indie game, where players can play as and unlock characters such as Tim from Braid, or retro levels, which are shown in 8-bit and even Game Boy style graphics. These levels will also have retro rules applied to them (such as a three life limit). There will also be a replay function, showcasing failed attempts simultaneously. A full level editor was planned, but was later removed due to new regulations concerning user made content, although the PC version may receive a free level editor later on.
Meat Boy began as a flash game created by Edmund McMillen and programmed by Johnathan McEntee, released on Newgrounds on October 5, 2008. It has currently garnered over 740,000 views since its release. A map pack for the flash version was later released on December 8, 2008.
Super Meat Boy began development after Nintendo requested the game be brought over to WiiWare, having been impressed by the success of Team Meat's Flash game Aether and the previous Meat Boy title. According to the developers, the game is "a big throw back to a lot of super hardcore NES classics like Ghosts 'n Goblins, Mega Man and the Japanese version of Super Mario Bros. 2", with the plot "a mash-up of every videogame story from the early 90s".
In April 2009, Team Meat announced that Tim, the protagonist from Braid, would be the first unlockable indie game character for use in multiplayer. Later, Commander Video from the Bit.Trip series and Alien Hominid were revealed to be additional unlockable characters. Fly Wrench from Fly Wrench and Ogmo from the Jumper series were also recently confirmed as playable characters for the game too. Each character has different attributes, such as Commander Video's ability to float midair. Meat Boy himself makes a cameo appearance in the game, Bit.Trip Runner.
The game was initially announced for WiiWare and PC, but a picture released on Team Meat's Twitter page on February 22, 2010 revealed that the game would also come to Xbox Live Arcade. They announced the next day that, whilst all versions will be released in the same month, the game would be released for XBLA first due to 'contractual obligations'.
In response to the removal of Tommy Refenes' iPhone OS app, Zits & Giggles, from the iTunes store, a week after Refenes criticised the App Store, likening the iPhone to a Tiger Electronics Handheld, Team Meat created Super Meat Boy HANDHELD, an iPhone app styled on a Tiger Handheld, which was released on the iTunes store on April 3, 2010. Edmund McMillen has also released a Meat Boy microgame for WarioWare D.I.Y.