The board assigns ratings to games based on their content, using judgment similar to the motion picture rating systems used in many countries, using a combination of six age-based levels intended to aid consumers in determining a game's content and suitability, along with a system of "content descriptors" which detail specific types of content present in a particular game. More recently, the ratings also include descriptors for games with online interactivity or in-game monetization.

Games with this rating contain content that is suitable for all ages. May contain minimal cartoon, fantasy or mild violence and/or the infrequent use of mild language.

Games with this rating contain content that is suitable for ages 10 and over. May contain more cartoon, fantasy, or mild violence, mild language, and/or minimal suggestive themes.

Games with this rating contain content that is suitable for ages 13 and over. May contain violence, suggestive themes, crude humor, minimal blood, and the infrequent use of strong language. 

Games with this rating contain content that is suitable for ages 17 and over. May contain intense violence, blood and gore, sexual content, and strong language.

This symbol is used in promotional materials for games which have not yet been assigned a final rating by the ESRB.

This symbol is used in promotional materials for games which have not yet been assigned a final rating by the ESRB, but are anticipated to carry a "Mature" rating.

Games with this rating contain content that is suitable for ages 18 and over. May contain prolonged scenes of intense violence and/or graphic sexual content. The majority of AO-rated titles are adult video games that received the rating for sexual content. There have been isolated cases of games receiving the rating for other reasons such as violent content and allowing players to gamble using real money.

The content of games with a PEGI 3 rating is considered suitable for all age groups. The game should not contain any sounds or pictures that are likely to frighten young children. A very mild form of violence (in a comical context or a childlike setting) is acceptable. No bad language should be heard.

Game content with scenes or sounds that can possibly be frightening to younger children should fall in this category. Very mild forms of violence (implied, non-detailed, or non-realistic violence) are acceptable for a game with a PEGI 7 rating.

Video games that show violence of a slightly more graphic nature towards fantasy characters or non-realistic violence towards human-like characters would fall in this age category. Sexual innuendo or sexual posturing can be present, while any bad language in this category must be mild.

This rating is applied once the depiction of violence (or sexual activity) reaches a stage that looks the same as would be expected in real life. The use of bad language in games with a PEGI 16 rating can be more extreme, while the use of tobacco, alcohol or illegal drugs can also be present.

The 18 rating, which indicates content suitable only for adults, is applied when the level of violence reaches a stage where it becomes a depiction of gross violence, apparently motiveless killing, or violence towards defenceless characters. The glamorisation of the use of illegal drugs, explicit sexual activity, and gambling should also fall into this age category.

In addition to age ratings, there is a special rating represented by an exclamation point labeled "Parental Guidance Recommended". These contents are available for all ages, but it is recommended that parents (mostly with children who are under the age of 18) supervise activities within the program.