Toxicity in video games, acting in a rude, abusive, bullying, or deliberately losing manner, ruins competitive team-based video game experiences for everyone involved. Companies are experimenting with the detection, regulation, and bans of toxic players. Regulation attempts are foiled by the ease with which players can switch accounts by creating new profiles to evade consequences. This article applies the framework of Friedman and Resnick (2001), “The Social Cost of Cheap Pseudonyms”, to address the reputational and repetition cost of online pseudonyms in the niche environment of video game toxicity. Four potential solutions are discussed in the context of modern video game regulation: resource-intensive account set-up, paid dues, real-world identification, and a once-in-a-lifetime identification system that creates a permanent, traceable record of toxicity. The article covers the strengths, weaknesses, feasibility, implementation challenges, and player impact of the potential implementation of these solutions in video game networks.