The show's reception is generally mixed: it has been lauded for its announcements and criticized for its lack of acknowledgement of events, use of promotional content and treatment of award winners.

The show was not considered successful, aimed more for comedy than celebration, but it prompted him to develop something akin to the Academy Awards for video games later in his career.

[3] Spike opted to rename the awards from VGA to VGX as to reflect that they wanted to focus more on next-generation games that were being ushered in by the onset of the eighth generation of consoles, as well as bringing comedian Joel McHale to co-host alongside Keighley.

[7] He invested around US$1 million of his own personal funds to support the new show,[3] and was able to secure space at The AXIS theater in Las Vegas for hosting the live event.

Without a broadcaster, Keighley and the other producers agreed to live stream the show on the consoles' networks and on Valve's Steam service to be able to reach a much larger audience than Spike TV previously had.

[10] The 2019 show included a simulcast in partnership with Sony Pictures for select Cinemark movie theaters throughout the United States.

He considers the crowning moment of this approach was being able to secure the first gameplay reveal of The Legend of Zelda: Breath of the Wild at the Game Awards 2014.

For 2020, with the COVID-19 pandemic causing cancellations of many of these events, Keighley invited about one hundred fans to private chats with himself and other top organizers of the program to help solicit their input.

It is meant to represent "the evolution of the video game medium by way of an angel that ascends through digital building blocks".

[71][72][73] The ratio of time spent on honoring awards winners compared to advertisements for upcoming games is a common point of criticism.

[74][75][76] After news of Activision Blizzard's sexual misconduct scandal broke, Keighley opened the 2021 awards show with a statement denouncing abuse in the industry.

[77] The statement was criticized for failing to refer to Activision Blizzard by name and appearing to be designed to preserve "valuable industry relationships" over taking a more meaningful stance.

[78][79] The incident raised questions about the show's close relationship with the industry and unwillingness to paint business partners in a bad light.

[76] The 2023 ceremony was criticized for allowing celebrity guests several minutes to speak while winners were allocated thirty seconds before being prompted to "wrap it up" and cut off by music.