According to the TV Parental Guidelines, programming rated TV-MA in the United States represents content intended for mature audiences. For movies, it's an R rating and an NC-17 rating, and for video games, it's an M rating and an AO rating. Generally, these shows aren't for kids under 17 (some sources say 18). The content has mature themes, such as gore, sexual violence, strong language, nudity, substances, smoking, and sex.

Due to FCC regulations on obscene programming, this rating is rare on free-to-air TV. It was originally called TV-M, but that name was only used from January to July 1997. Video games have a similar "M for Mature" rating, which was changed because of trademark issues. TV-MA became the rating we know today.

This rating is given to most HBO and Showtime shows. There are lots of shows that have this rating, including South Park (Comedy Central), Jackass (MTV), Nip/Tuck (FX), The Sopranos (HBO), Preacher (AMC), Ren & Stimpy: Adult Party Cartoon (Spike), Dexter (Showtime), Robot Chicken, The Boondocks, Mr. Pickles (Adult Swim), and Game of Thrones (HBO).

American television's TV-MA ratings are among the most diverse in the world. A TV-PG program and a TV-14 program tend to have similar content, but the intensity of a TV-MA program may vary. It is mainly dependent on the network on which the program is broadcast. It is likely that an HBO series will contain stronger language, nudity, and/or violence than a basic cable network would allow. It should be noted, however, that basic cable has made strides over the years due to channels such as FX (the biggest exception so far) which are known for transcending the confines of content limitations. The content of programs with this rating may, however, be edited or censored in some cases.

The TV-MA rating indicates a program is designed for 17-year-olds (18 in some cases), but programs with this rating can sometimes contain more graphic and severe content than those rated R, thanks to the availability of premium cable networks and certain online streaming services. Consequently, most online services, like HBO and Showtime, require people to confirm their age before watching TV MA episodes. This rating is very serious online, so parents should take it seriously. Before March 16, 2022, no TV-MA-rated content could be streamed on Disney+ in the United States; it was offloaded to Hulu.

IMDb says there are over 102,000 TV-MA titles as of October 27, 2022.