He spends several months traveling to different studios around the world to secure announcements and trailers, and he typically has meetings with developers to find the best way to reveal their games. He shifted into full work on the show in July 2018, following his work for YouTube Gaming and E3 Coliseum at E3 2018. Show producer and creator Geoff Keighley began working on The Game Awards 2018 immediately after the previous ceremony, starting by conducting a postmortem of the show and booking the Microsoft Theater. The Game Awards 2018 began with a group speech by (left to right) Sony's Shawn Layden, Microsoft's Phil Spencer, and Nintendo's Reggie Fils-Aimé, representing unity in the gaming industry between the three major studios. It received a generally positive reception from media publications, with praise directed at the opening speech and new game announcements but some criticism for the focus on reveals over the awards.

The 2018 was viewed by over 26.2 million streams, the most in its history to date, with four million concurrent viewers at its peak.

In association with the event, sales were held on most digital storefronts for nominees and former winners. Several new games were revealed during the show, including Far Cry New Dawn, Hades, and The Outer Worlds. At the show, Red Dead Redemption 2 tied for the highest-awarded game in the show's history with four wins, and God of War was awarded Game of the Year. God of War and Red Dead Redemption 2 received eight nominations each. The show opened with a group speech by Microsoft's Phil Spencer, Nintendo of America's Reggie Fils-Aimé, and Sony's Shawn Layden, representing the unity of the industry. The show featured musical performances from Harry Gregson-Williams, Daniel Lanois, Lena Raine, and Hans Zimmer, and presentations from celebrity guests including Jonah Hill, the Russo brothers, Brendon Urie, and Christoph Waltz. The event was live streamed across more than 40 digital platforms. It was produced and hosted by Geoff Keighley, and took place at the Microsoft Theater in Los Angeles on December 6, 2018. The Game Awards 2018 was an award show that honored the best video games of 2018.

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