Vote Yes on Question 7 was led by MGM Resorts International, The Peterson Cos. More than $90 million was spent between the two campaigns in their efforts to sway voters. Voters approved the expansion of gambling, Question 7, with 52 percent of the vote.

In November 2012, after the most expensive political campaign in Maryland's history, voters approved a 6th casino license in the state, as well as the addition of table games at all Maryland casino sites. In October 2018, the Horseshoe announced a multi-year marketing deal making it the official casino partner for the Baltimore Ravens.

Inside entertainment was provided by legendary Motown artist Gladys Knight, with 'break music' provided by Iggy Azalea and Pauly D. Outside entertainment included a live performance from Andy Kushner Entertainment's Rhythm6 band and vertical dance performances by BANDALOOP and pyrotechnics before doors opened to VIPs. On August 26, 2014, the casino opened with a full night of celebration that included a performances inside and outside of the Casino. Following the construction approval, revised renderings were prepared by Cleveland-based KA architects, who designed the Horseshoe Casino Cleveland. Initial designs of the casino were prepared by Baltimore-based architects Ayers Saint Gross. In July 2012, the Maryland Lottery Commission approved a Caesars Entertainment-led consortium bid to develop and operate a gaming facility in downtown Baltimore. In a 2008 constitutional referendum, Maryland voters approved a video lottery terminal casino facility in Baltimore City, and at four other locations throughout the state.

Other members of the CBAC consortium include Jack Entertainment CVPR Gaming Holdings, LLC STRON-MD Limited Partnership and PRT TWO, LLC. The casino is owned by CBAC Gaming, a group led by Caesars Entertainment, and is managed by Caesars. The $442-million worth casino is located along Russell Street on Baltimore’s south side, neighboring professional sports venues M&T Bank Stadium, home of the NFL Baltimore Ravens, and Camden Yards, home of the MLB Baltimore Orioles, as well as Baltimore’s Inner Harbor. Horseshoe's 20,000-square-foot Baltimore Marketplace features Charm City food outlets, three premier restaurants, and several bars and lounges. The multimillion-dollar facility features video lottery terminals, table games, and a World Series of Poker room. Horseshoe Baltimore is an urban two-story casino, and the second largest casino in Maryland with a 122,000-square-foot gaming floor. Horseshoe Casino Baltimore (the United States) Show map of the United States

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