FMOD is audio middleware that provides features for real-time 3D audio and digital sound effects in video games. It supports many platforms and over 20 file formats. Games that use FMOD include Guitar Hero III, BioShock, and Crysis. FMOD can create thousands of simultaneous sounds, handle 3D positioning, and apply effects chains through a C++/C# API. Configuration options include output settings, Doppler scaling, and hardware channel counts.