Though novel and addictive, this game fared poorly in the marketplace due to botched marketing. Accolade gave it little print advertising, but even the ads it did for the game gave little clue as to what type of game Ballz was. One just had an image of a Christmas Tree made of spheres and contained the caption "Tell your mom you want Ballz for Christmas." The box of the game also gave little hint of the type of game it was, since it depicted just a jumbled image of numerous spheres. Most people assumed it was some sort of Tetris clone.
The opening of the game PF Magic developed for the game stated "To be the champion, you gotta have Ballz!" Due to its racy double-entendre, Nintendo demanded the wording be changed. Since Nintendo was the only manufacturer that could produce any SNES game, Accolade had little choice but to conceed. So the SNES version of the game states, "...you gotta play Ballz," while the Sega version uses the original version of the intro.
The Sega version of the game had a lot of trouble with sprite breakup, a common problem for many video games. Sega opposed to the great deal of breakup and rejected the game. Accolade and PF Magic fixed the problem by using a DSP chip on the catridge board, which fixed all instances of breakup. However, the chip added to the cost of each cartridge, forcing the developers to remove some features of the game. Therefore, many of the game's sound effects were removed—to save on the cost of the additional memory chip—and as a result some of the characters share sound effects. The entire catalog of sound effects is found on the SNES version.