As U.S. Army Sergeant John Baker, players join the battle at Kasserine Pass in North Africa, race to capture Messina in Sicily, and finally repel the German army at the historic battle of Monte Battaglia in the heart of Italy. Armed with a new arsenal of weapons, players will fight alone and with squad mates as they rush to stop the Axis powers.

The multiplayer game has been enhanced with the addition of Liberation Mode. In this mode, defeated players must be rescued by surviving teammates to continue the fight. In addition, players can drive tanks, artillery spotters can call in artillery strikes, and minesweepers can defuse mines. Players can also choose from American, British, Italian, and German skins in all multiplayer modes.

As with the original Medal of Honor(TM) game, the producers sought counsel from numerous outside sources to ensure the game is as historically authentic as possible. EALA continues to work closely with the Congressional Medal of Honor Society to ensure Medal of Honor Allied Assault Breakthrough reflects the ideals and integrity of the prestigious Medal of Honor. In addition, Capt. Dale Dye, who served as military technical advisor on the previous titles in the Medal of Honor franchise, continues his efforts with the Medal of Honor Allied Assault Breakthrough team.