Hidden Island 10 shares Machine Labyrinth's design. The island is a fully mechanical location dominated by metallic stream-powered machinery, with various types of pipes and grids everywhere. With steam plumes emitting all around, the place is quite jaunty. The stage specifically occurs within a building with metallic archways and pillars decorating the insides. Also, the surfaces are constructed from a patchwork of orange, brown and green metal blocks, and the winding roadways are made of grey beams webbed together.
Like most other Hidden Islands, Hidden Island 10 is a short stage which can be finished in less than a minute. However, it does not focus on a certain gameplay style or gimmick.
Hidden Island 10 borrows several exclusive gimmicks from Machine Labyrinth. This includes the Hang Glider for midair traversing, steam plumes that can push the characters into the air like Springs and enable Trick Actions (sometimes they are capped by a plug which can be broken) and vac-tubes (based on the Winding Tunnels/High-speed elevators) that suck the characters through a pipe and deposit them in another area. Finally, there are 3D drums that send the characters bouncing into the foreground or background, thus enabling the player to get around solid walls, before depositing them back in the level proper.
At the start, follow the path and gimmicks through a shuttle loop. When sent up a vertical shaft, enter the horizontal path on the right to a room. The player can then either go through a vac-tube on the bottom of the room for a long route, or one in the upper right corner for a shot route (the later can only be reached upon entering the room). Regardless, the two paths come together up ahead and lead to a vac-tube in the floor.
If the player choose the latter route, they can reach a new upper route using a purple throwing-gimmick in the room that the first vac-tube leads to. This route leads to a Hang Glider which can be used to reach a section with power-ups and a vac-tube leading to the previously-mentioned vac-tube in the floor. This vac-tube leads to a new path which has the Treasure Chest at the end.