Neander-Pacs first appear in this game. They first appear in Crisis Cavern and try to attack Pac-Man with their clubs. Because of their slow speed, they are easily disposed of for 100 points. Their in-game description reads: "Ever wonder what the Pac-People evolved from? This club-carrying enemy is definitely a block-head!"
A group of Neander-Pacs appear in the Lava tubes and are summoned in the Spooky boss fight.
Neander-Pacs are enemies of Ms. Pac-Man in the stages Pacfooticus Stompicus, Freezer Burn, and Boulder Over. They are slow enemies, but are able to breathe a large amount of fire at Ms. Pac-Man. They are easily defeated after eating a Power Pellet.
- The Neander-Pacs appear in the Pac-Man animated series in the episode Neander Pac-Man, though they are depicted as round rather than square.