A rash of new "knockout game" incidents, in which teens assault strangers with the goal of knocking them out in one punch, have surfaced in recent weeks.
Community leaders are calling for an end to the violence after teenagers in New York, New Jersey and Philadelphia have been caught on camera.
Their violent actions have led to hospitalizations, and even deaths.
Approaching strangers and knocking them to the ground with one punch to the face or head, the brutal violence is all in the name of a game called "Knockout."
The "game" has also spread to Massachusetts, Illinois and Missouri.
A woman was approached eight males on bikes last week when one reached out, punched her in the head and rode away, NBC's News4 reported.
A 78-year-old woman fell victim to the pavement 10 days ago in Brooklyn, making her ninth purported "Knockout" victim in New York this year.
Authorities are investigating the senseless attacks as hate crimes, as some of the attacks appear to have targeted members of the Jewish community.
The alarming trend gained national attention back in May after a 51-year-old man actually died in Syracuse, N.Y., thanks to a group of teenagers.
In the same month, a 20-year-old man was sentenced to 55 years in prison after he similarly struck and killed a man in St. Louis back in 2011.
NBC10 in Philadelphia also reports that the online trend #SmackCam uses the Vine app to capture people being unexpectedly slapped in the face.
What started out as a (mostly) playful game spawned by boredom turned awry as more violent depictions of the game began popping up on social media.
Compilation videos on YouTube, such as this one below, are very popular:
Clearly, a pie to the face and skull-crushing blow to the back of the head from a stranger are different things. But is #SmackCam a gateway of sorts?
Regardless, what does it say about society if "knockout" is even a game?