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The possibility of co-creation exists for all media, but game design has developed a culture that is unusually open to co-creation. This dissertation investigates significant cases of co-creation in mainstream games in order to explore how games can be co-created as alternative or critical media by their players. The core argument in the dissertation is that players co-create the design of a game only if certain conditions are met, namely: (1) player creation of a text or communication infrastructure that modifies the properties of the game and from which play emerges; (2) that this is done for a considerable group of players who share a particular practice of play; (3) that this is done not only by playing the game but by changing how others play it in a distinct creative activity, and (4), with the potential to subvert or contest the original design of the game. This situation where player creators have influence over the design of the game (but little power to enforce their interests) is problematic from the perspective of alternative or critical media, as alternative, local, production is seen as one reason for why a medium can have an alternative message. The industrial production of games as cultural commodities does limit the potential of co-creative game design for subversion because it reduces the level of participation in the creation process, thus keeping player creators relatively disempowered. Player creators do have influence on the design of the game, while at the same time having very little power to enforce their interests and design visions. The influence of player creators comes from the consumer power of millions of players who use co-created assets and who want to them to continue exiting, and this creates a mutually dependent relationship (and even partnership), between co-creators and commercial owners. The dissertation concludes that co-creative game design, despite limitations related to the industrial production of games as cultural commodities, is already happening, and shows a potential for turning games into alternative media.