The US version has the "Winners Don't Use Drugs" screen.

The Japanese version is very unlike any other version to appear in other countries :
* Most obviously, both APC driving levels have been entirely deleted.
* As such, the subplot of rescuing Newt is gone. Therefore, Newt never appears in Stage 1.
* When you take on the 'Shrinky-Dink Alien Quartet', the first one to fully enlarge hops off-screen, leaving you to only battle the other three.
* Many of the aliens, zombies, and mid-bosses can be killed with fewer shots.
*Two new kinds of minor enemy appear in the game :
a) An adult alien bursts out of the background wall during the vent portion of what we consider Stage 5. It functions much like the Ground-Poppers and is destroyed just as easily, but with new animations and from a different angle. It is the only one of its type in the game.
b) The small form of the Shrinky-Dink Alien, as seen in the form of the second mid-boss in Stage 5, reappears in Stage 7. It stands alone on the catwalks with a ring of orange energy circling it and the catwalk in a kind of 'shield'. A few shots destroy it.
* Titles have been given to each level. They are as follows, transcribed as they appear in the game.
Level 1 - Living Quarters
Level 2 - Factory
Level 3 - Factory2
Level 4 - Queen Alien's DEN
Level 5 - Escape Route
Level 6 - Battle Ship SULACO
* Special weapons and bombs appear much more frequently in the game, dropping from the sky for the players to use at regular intervals.
* It is now possible to attain 1-ups in the game. If a player is still carrying a weapon from the last special weapon power-up, the next one to fall on-screen will contain a 1-up. It comes in the form of a red ribbon with a bow wrapped around the word '1up'.
* In addition to the other enemies in this section, ground-popping aliens now appear earlier, during the nest portion of what we know as Stage 3.
* In addition to the other enemies, flying aliens now appear during the first power loader segment, in Stage 3.
* Flying aliens are much more frequent throughout the outdoor portion of Stage 5 and Stage 7.
* Extra exploding barrels appear throughout the game.
* Numerous aliens have changed color. Adult aliens are now purple instead of maroon, face-huggers are now flesh-toned instead of green, etc.
* Many of the adult aliens in the elevator sequence of Stage 3 have been removed. They have been replaced with flying aliens that do NOT damage the cables. This makes this sequence much easier.
* The beams from the 3-Way gun have changed color from purple to orange.
* During the final battle, the queen does NOT breathe fire/acid at you. Instead, after flashing white, she sends out multiple images of herself as a projectile! These are wider and therefore are easier to be hit by.
* The queen charges at you constantly even if you are in the power loader. This makes the final battle much more difficult.