Mahjong as its own game began in Asia several centuries ago. It didn't make its way to the United States in even remotely large numbers until around 1920, when Joseph Babock, after a visit to China, brought the game back to the U.S. and "Americanized" it into the game we know now as Mahjong Tiles. Mahjong Tiles was a game in which you'd remove tiles from a configuration (typically a pyramid) on a basis of matching them. The original mahjong, before Babcock brought it to the U.S., was actually much different, more like the card game of poker.

In 1992, the Nihon Bussan company, noted developer of the NES and arcade game Crazy Climber, created an RPG game known as Mahjong Taisen, a game that combined elements of typical RPGs with those of the original mahjong. This game remains alone in a series - no prequels or sequels have been since this.