An excessive, problematic gambling pattern has been regarded as a mental disorder in the Diagnostic and Statistical Manual for Mental Disorders (DSM) for more than 3 decades (American Psychiatric Association [APA], 1980). In this study, its latest prevalence in Macao (one of very few cities with legalized gambling in China and the Far East) was estimated with 2 major changes in the diagnostic criteria, suggested by the 5th edition of DSM (APA, 2013): (a) removing the "Illegal Act" criterion, and (b) lowering the threshold for diagnosis. A random, representative sample of 1,018 Macao residents was surveyed with a phone poll design in January 2013. After the 2 changes were adopted, the present study showed that the estimated prevalence rate of gambling disorder was 2.1% of the Macao adult population. Moreover, the present findings also provided empirical support to the application of these 2 recommended changes when assessing symptoms of gambling disorder among Chinese community adults. Personal risk factors of gambling disorder, namely being male, having low education, a preference for casino gambling, as well as high materialism, were identified.