Each team has five players on the pitch (and up to three substitutes), who compete to score in their opponent's goal, which is suspended two metres above the water. The ball can be thrown by hand, or shot with the paddle to pass between players and shoot at the goal. Pitches can be set up in swimming pools or any stretch of flat water.

Canoepolo combines boating and ball handling skills with a contact team game, where tactics and positional play are as important as the speed and fitness of the individual athletes. The game requires excellent teamwork and promotes both general canoeing skills and a range of other techniques unique to the sport.