The Japanese name for hill gardens, Tsukiyama-sansui, means hills and water: the foundations of a classic hill garden. This garden is like a three-dimensional picture. Whereas traditional gardens were viewed from only one point, modern gardens are designed with winding paths throughout them, to display the garden to its full advantage. Usually these paths are made of carefully selected flat stones.

Water plays a very important role, and nearly every garden contains a waterfall and a pond. Waterfalls are an essential part of hill gardens, as they not only help water flow down the hill, they also provide great symbolism. They are usually constructed with two large stones, giving the appearance of great distance and size. They are often shaded by several tasteful bushes or trees which form a partial screen. The ike, or pond, is meant to represent a sea, lake, or pond in nature. It is usually rimmed with stone-work piling, and always contains an island.

Islands have great symbolic significance in Japanese hill gardens. The islands are built with rocks as their base and dirt piled neatly on top, in order for plants to grow. Sometimes a garden designer will include a bridge to an island. If so, often there will be a stone lantern or other worshipping object.

The general layout of this type of garden is designed to give the appearance of great distance and expansiveness, as if the whole world were contained in this one garden. Some have suggested that this is because there is so little space in Japan. A more philosophical viewpoint is that the creators of these gardens wish to present the essence of nature, or nature boiled down to its essential components.