The fight is split into two sections; initially the Teethalon chases Shovel Knight and the player must evade it until they reach the arena. When they arrive Teethalon becomes vulnerable, as his chest will open, and he will perform a fast charging attack shortly after sitting in place and he and Shovel Knight must fight it out. It has a total of twelve hit points.
Teethalon's only weakness is to strike the glowing orb in the Chest on its lure. The Chest is immune to a Shovel Drop and can only be slashed at. It is also vulnerable to a well-aimed Propeller Dagger strike, a fireball from the Flare Wand, or a blast from the War Horn.
Throughout the chase and the direct confrontation, Teethalon will continually spawn Mini Anglers from its writhing tongue. These smaller fish swim towards Shovel Knight, dealing damage if they hit him. If they miss, then they simply continue in the direction they were headed in. They can be killed with a single hit and can be Shovel Dropped to bounce over gaps between platforms during the chase.