Overall, I think the GBA version of A Link to the Past is an inferior version of the game. It’s still fine; they didn’t completely wreck the game. But the changes, big and small, add up to less than the original.
One change I’ll praise is the updated text. The translation was redone, changing references to the seven wise men to the seven sages to match the term used in Ocarina of Time. Link’s uncle’s dying speech is reworked to remove the “Zelda is your…” bit at the end; parts of the old speech are used in the bonus dungeon by one of the bosses. That’s about it for major changes, which is fine because the original text was clear and consistent. (The one typo in the original, the Great Faeries offering to "sooth" Link's wounds, was fixed. Also "faerie" has become "fairy," as used in the series' other games.) By the end of the game I was clicking through the text and barely reading it, even when I meant to like with some items with memorable text in the original; checking a text dump, the hookshot kept its BOING!s, and while the Cane of Somaria was slightly rewritten, it still doesn’t actually say what the cane does.
Because the GBA’s button layout is different, controls had to be remapped, and… I generally hate how they did it. Ocarina of Time shifted the controls around, but that was a different game; coming to the familiar A Link to the Past only having sword on the left and item on the right feels backward and threw me off for a long time. Definitely backward is Select to bring up inventory and Start to bring up the pause menu, which is a straight reversal from the original game; apparently this was done to keep controls consistent with Four Swords. The map and action buttons being mapped to L and R, which the original version didn’t use, is fine.
The other area where the game suffers is sound. The music is just not as good; the Dark World overworld theme, and especially the intro section, lost the most. High-pitched sounds became ear-splitting. And some genius decided what A Link to the Past really, desperately needed was for Link to grunt when he swings his sword and scream when he falls into a hole. The former I learned to tune out, just like with Ocarina of Time and Majora’s Mask, but I didn’t have Link fall into holes enough to get used to him screaming every time he did.
I had a good deal more difficulty with the game than I’m used to, which is probably just minor system differences throwing me off because I’m so used to the quirks and timing of the original. However, there were times where I was certain a gap was too small for enemies to squeeze through, only squeeze through they did. The outer ring of lamplight in dark corridors is now patchy rather than dim. Also, two enemies had significant changes. Unless I was just terribly inaccurate, flipped terrorpins were immune to the ice rod, and died instantly to ether rather than freezing, so they weren’t a useful resource for refilling magic like I was used to. Stalfos knights, while they still die after enough sword hits, became immune to the sword while collapsed, so doing it right and finishing them off with a bomb became a massive timesaver.
Other little changes: Arrows don’t start appearing until Link has the bow, but he gets ten immediately when he does [1] and they’re really plentiful for the rest of the dungeon, even with lots of eyegores between the bow and the boss. Link can destroy signs with the sword, and pots with the golden sword. A few items can destroy bushes or pots when they couldn’t before. The shovel can dig north and south, rather than just east or west. Occasionally, Link will come across a sparkling rock that spits out rupees when he hits it with his sword. Dungeons now display their name when Link enters, and the Tower of Hera has been renamed the Mountain Tower. The inventory has been revamped, with each bottle getting its own slot, and the shovel taking over the old bottle slot and staying after Link gets the flute. Link can dive while swimming. After a certain point – I’d guess once Link unlocks the portal there – a ninth flute stop is added atop the Light World version of Turtle Rock. The goriyas in the cave with the last heart piece are replaced with eyegores – I suppose because goriyas are Dark World only – but the room is still designed with goriyas in mind. Maple from the Oracle games has set up as the witch’s apprentice who runs the potion shop.
Finally, the final puzzle of the Ice Palace was basically removed, and the room it was in and the room above it were redesigned. The flow of the dungeon is basically unchanged; Link still has to go down to the old puzzle room and through a door to the right, hit a switch crystal, and work his way back up to the room above and fall through to the southern half of the old puzzle room, but the actual puzzle is gone. So there’s no reason to sequence break and grab the Cane of Somaria from Misery Mire anymore. Oddly, the part I always used to have trouble with (until I learned the way through) was the route back after hitting the switch crystal, so while I do like the change (for the most part; having the puzzle room split like it is feels weird), it wouldn’t have helped me back in the day.
Next: The Four Swords-unlockable content.
[1] It’s entirely possible this always happened but I was always maxed out on arrows (30) by time I got the bow.