Players can play as either Ellen Ripley or Corporal Hicks, who both begin the game with a smart gun and can upgrade to other weapons such as flamethrowers and missile or grenade launchers.

[7][8] The arcade game made its worldwide debut at the Amusement Trades Exhibition International (ATEI) in London, United Kingdom.

[5] It went on to win a Silver award from the American Amusement Machine Association (AAMA) for sales achievement in 1990, making it Konami's second best-selling arcade game that year after Teenage Mutant Ninja Turtles.

[15][16] Upon release, Julian Rignall of Computer and Video Games gave Aliens an overall score of 91%, noting its "simply brilliant" graphics and describing it as "one of the goriest coin-ops since Splatterhouse.

[9] CU Amiga gave Aliens a 44% rating and criticized its "uniformly bland and drab" graphics, its "irritatingly unresponsive" controls, and its "dull" action.

[7] Brett Alan Weiss of AllGame gave Aliens three and a half stars, calling it an "enjoyably fast-paced" and "graphically creepy, smoothly animated game".