The NES version is much less forgiving when it comes to rotation, locking, random generator, etc... It also has a single preview, no hold piece and no hard drop. At high level, a major challenge is to move pieces fast enough to reach the sides, including a technique called "hypertapping" where you mash buttons extremely quickly to move the pieces faster instead of just holding a direction.

Modern Tetris is much faster. At high level, you get to "20G" mode, where the pieces drop immediately and you have to rely on the lock delay and rotation system to move pieces around. Later versions introduced T-Spins as an alternative to Tetrises for high scores and attacks in multiplayer.