"Playground Twist" features a 3/4 time signature, which is unusual for rock music. The pacing of the song gives it a childlike (i.e. "playground") feel (along with references to childhood nursery rhymes), although the lyrics provide a much more sinister picture.
NME's Roy Carr hailed the single and wrote: "If Ingmar Bergman produced records, they might sound like this. The listener is immediately engulfed in a maelstrom of whirling sound punctuated by the ominous tolling of church bells, phased guitars, thundering percussion, a surreal alto sax and the wail of Siouxsie's voice. It demands to be played repeatedly at the threshold-of-pain volume to elicit its full nightmarish quality".