Super Real Mahjong PIV Custom was released on December 17, 1993 by Naxat Soft.

Originating in the arcades, this installment of the Super Real Mahjong series puts the player in the role of a mahjong club member who competes against three female opponents. Rounds won by the player lead to undressing animations; however, while the computer version has explicit nudity, console versions are censored. All the versions have the same opponents, cutscenes, and gameplay rules. The computer version adds a versus mode in which girls can compete against each other, while the Super Famicom (SNES) version has a so-called "puzzle mode", which reveals parts of a puzzle as the player wins mahjong rounds.