The game's graphics are pretty much what you would expect from a Zuma game, except with an underwater theme. Here, you are in control of a humanoid water creature positioned at the center of the screen atop a cannon that shoots variously colored balls at the track. The scene's underwater theme is filled not only with a coral-covered sea floor, but there are also several types of fish and sea life that will swim across the screen on occasion.
Aqua Pearls' music is pretty basic and about what you would expect out of most casual puzzle games. It's enjoyable to listen to, but you don't really feel like you are losing anything when you turn it down or off when you are in more quiet surroundings or would rather listen to your own music.
When you do have the sound turned up, the game's sound effects actually lend a lot to the overall feel of the game. In order to reinforce the underwater style, sound effects typically consist of various aquatic noises, and the most prominent of these is the bubble popping sound that happens when you line up three or more same-colored balls.