As in other Carcassonne games, players take turns placing tiles to create the landscape and placing meeples to score points from the map they're creating. The player with the most points at the end of the game wins.
Instead of cities, roads, and farms, Carcassonne: Hunters and Gatherers has forests, rivers, lakes, and meadows. Players' meeples can represent hunters (when placed in the meadows), gatherers (in a forest), or fishermen (on a river segment). They also have huts, which can be placed on rivers or lakes to get fish from the entire river system.
It includes many of the familiar mechanics from Carcassonne with a few new rules, including:
- A player who completes a forest with a gold nugget in it gets to immediately draw and place 1 of 12 bonus (menhir) tiles.
- A meadow is worth 2 points for every animal in it, except tigers, which negate certain other animals.
- A river segment is worth the number of tiles in the segment plus the number of fish in the lakes at each end.
- A fishing hut scores at the end of the game and is worth the number of fish in all the lakes connected by rivers.