Twitch uses algorithmic ad-serving systems — integrated with Amazon's advertising platform since 2020 — to evaluate ad opportunities, match ads to audiences based on interest and behavior signals, and implement brand safety and fraud prevention measures.

Per the State of Engineering 2023 blog, Twitch's Ad Product Engineering team builds "a robust set of services that evaluate opportunities to show ads and identify the best set and types of ads to show," alongside "brand safety, ad fraud prevention, and measurement tools." In 2020, Amazon opened Twitch inventory to programmatic buyers through Amazon Advertising, enabling interest-based targeting powered by Amazon's audience data. Twitch's proprietary SureStream technology (introduced 2016) stitches video ads directly into broadcast streams, enabling personalization "according to audience interest and product preference." Twitch also explored a Brand Safety Score system (discovered in internal API code in 2021) that automatically rates streamers on multiple factors for advertiser matching; Twitch confirmed the concept but stated "nothing has launched yet."