Macau’s Gaming industry is facing ever fierce international competition. How should Macau maintain sustainable development and how should it acquire and maintain long term competitiveness? These are the concerns of the Macau government and society. It is found in a literature review of the studies on Macau’s gaming industry that the most important sources of competitiveness are location, industrial clustering, scale, integrated resorts and continuous innovation. CRM is not a source of competitiveness, nor the first mover advantage. The factors that may hinder the sustainable development of the industry include the decreasing number of non-Macau junkets, disappearance of irregular funds, over reliance on Mainland visitors, legal defects and social problems related to the gaming industry.