Simultaneous 4 player pinball. As crap as it sounds. Why it's called American? I have no idea. With games like this you have to make up your own background story. "A hundred years in the future, mankind has survived a nuclear holocaust and resorted to barbarism. In America, the only source of entertainment is a deadly version of giant pinball, where every ball you lose costs someone their life! Now corrupt governments bet on blood soaked games of bumpers and pins, can you survive?"