This article explores Macao residents’ perceptions of the impact of gaming development at a significant time in Macao’s long experience with gaming, just after the end in 2002 of the 70-year-old monopoly system for the gaming sector and the introduction of new casino operators into the market. Principal components analysis, cluster analysis, and analyses of variance were used to understand the dimensionality of perceptions of gaming impact and differences among subgroups of gender, age, income, educational background, and marital status. The results could help the authorities and gaming operators to understand the perceived costs and benefits to residents regarding different dimensions of gaming impact and to design appropriate promotional messages to reinforce or alter resident perceptions about gaming. The findings led to the conceptualization of a gaming impact perception matrix (GIPM), creating a perception typology based on cost-benefit perceptions of gaming development in different time periods. An attempt was made to apply the typology with current theories of tourism development.