This level starts with three battls, after which the player reaches a branching path with a sign on the left and a blue Warp Pipe on the right. The left path requires the player to clear more Dark Orbs than other Orb types, and the blue Warp Pipe on the right requires more Water Orbs to be cleared.
Taking the path on the left, the player encounters four battles before the boss fight with "Blooper Nanny & Babies".
Taking the blue Warp Pipe down, the player enters an underground sewer area and encounter a single battle, then comes across a ? Block. The player then takes a red Warp Pipe back to the main path and faces the last battle before the boss fight at the end.
The player has all Orb types on the Orb field for this course.
★World 4-5 is a difficult version of World 4-5 from ★World 4. The Orb configuration for this Special World course matches that of its normal world counterpart.