Arm Wrestling was created by the same team that created the arcade games Punch-Out!! and Super Punch-Out!! and therefore uses some of the same sound effects, music and most notably uses the same dual screen cabinet. It also has a similar approach on characters, featuring quirky opponents, this time even more over the top, including a robot and a zombie. What makes it an In-universe spin-off of the Punch-Out!! series is however the player's character, that appears to be the same as in the arcade Punch-Out!! games, being a green haired man. He specifically has the same haircut as in the original Punch-Out!!
Additionally, the third opponent in the game is a masked character called Mask X. To defeat him the player has to surprise him by tapping up rapidly at the last moment, pulling his mask off. Underneath the mask is Bald Bull, one of the fighters from Punch-Out!! The only difference in his design is a x-shaped scar on his forehead, however his name is explicitly stated.
Copyrights for both series are held by Nintendo.