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In January 2023, the USK began using various content descriptors alongside their age ratings. These include descriptors specifying the level of violence, horror, sexual content, profanity and drug and alcohol use featured in the game, as well as those indicating the game promotes gambling or puts pressure on the player to act, such as via a time limit.[3]

In January 2023, the USK also introduced descriptors indicating additional features in the game, such as in-game purchases and online interaction.[3]

According to the USK itself, the state uses the age-rating symbol to regulate whether a computer game may be publicly supplied to children and young persons. Retailers are obliged to comply with the restrictions indicated by the rating. For example, a game approved for children aged 12 and above may not be sold to a 10-year old. Outside of business relations (e.g. parents or adult friends giving the game to a child or youth) there is no such restriction.[1]

Advertisement of games rated USK 16 or below is not restricted only if the advertisement itself has no content that is harmful to minors. Games without a USK rating are treated like a USK 18 game.

Additionally the BPjM maintains a List of media harmful to young people (colloquially known as the "Index"). Titles that are on this list may only be sold on request to adults 18 or older, are not to be advertised in any media or put on display in retail stores. German retail stores, mail order and internet vendors tend to sell only games that do have a USK rating, due to the massive restrictions. These games are still sold from vendors outside Germany into the German market, but the numbers are low.

Only games that are not rated harmful to young people by the BPjM may get a USK rating. Many non-German publishers and developers choose to release edited versions of their games to try to prevent an 18+ rating either fearing the same negative sales impact an AO rating would have in the US, or out of fear that an 18+ title might be indexed by the BPjM.

In 2006, Microsoft chose not to release Gears of War on the German market. Since the game was imported to the German market nonetheless (without any age limit), the BPjM became involved and put the game on the index list. The same applied to the second instalment. Afterwards the rating procedure was revised, and imported games without a USK rating are automatically considered 18+ regardless of content. The third game did get classified with a USK 18 rating.