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When the game looks directly at the player and says 'yes, I know you're there.'
The fourth wall break occurs when a game acknowledges the player's existence outside the game world. This ranges from subtle (a character glancing at the camera) to overt (the game reading your save data and commenting on it). Games have a unique advantage over other media here because they can break the fourth wall mechanically, not just narratively -- they can read your actual files, remember your past choices across playthroughs, or refuse to let you proceed until you perform a real-world action. The best fourth wall breaks aren't just clever tricks; they use the meta-awareness to make a genuine narrative point about the relationship between player and game.
Example
Metal Gear Solid's Psycho Mantis reads your memory card and comments on your other save files, then tells you to put your controller on the floor so he can 'move' it with vibration. Undertale remembers your previous playthroughs even after you delete your save data, making the game itself judge your past choices. Doki Doki Literature Club manipulates actual game files as part of its horror narrative.
Why it matters
Fourth wall breaks remind players that games are a two-way relationship. When used thoughtfully, they create moments of genuine surprise and unease that exploit the medium's unique properties. They force players to confront their role as an entity with power over a digital world.
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