The protagonist's name was originally going to be rendered as "Miss Pac-Man", but the developers then realized that because she was married and had a child, the "Miss" honorific was grammatically incorrect and would also imply she conceived out of wedlock, so the name was changed to "Ms. Pac-Man" (pronounced "Mizz Pac-Man"). However, this didn't stop future Pac-Man-centric games from mispronouncing the first part as "Miss", such as the Mario Kart GP games and Pac-Man World 3 among a few others.

Ms. Pac-Man originally started out as an unlawfully modified version of the Pac-Man arcade game called "Crazy Otto". Crazy Otto was bought by Pac-Man's North American distributor Midway, and rebranded as Ms. Pac-Man.