In the ESRB rating system, Adults Only 18+ games are restricted and their suitable only for adults 18 or older. Such games may contain prolonged scenes of graphic/intense violence, strong sexual content and/or gambling with real currency.
So far, there have only been 29 games with an AO rating. Sony's, Nintendo's, and Microsoft's policies are not allowing AO-rated games on their consoles, making them available only for release on PC and (probably) macOS. Also, Twitch (a gaming streaming service) does not allow the streaming of video games whose ESRB rating is Adults Only.
Examples of titles with an ESRB rating of Adults Only:
- Thrill Kill (which was cancelled, content was "Animated Blood and Gore, Animated Violence")
- Grand Theft Auto: San Andreas (due to a mod its ESRB rating was temporarily changed from M to AO, content was "Blood and Gore, Intense Violence, Strong Language, Strong Sexual Content, Use of Drugs")
- Manhunt 2 (PC version; content was "Blood and Gore, Intense Violence, Strong Language, Strong Sexual Content, Use of Drugs")
- Hatred (content was "Blood and Gore, Intense Violence, Strong Language")
- Hatred is the only AO-rated video game released with no unambiguous sexual content.
- Contrary to popular belief, the AO rating is not used for adult/pornographic games, and most games of this nature are not submitted for ratings in the US.
|Entertainment Software Rating Board (ESRB)|
|Currently used ratings|