Introduction: Approximately 91% of children ages 2 to 17 years in the United States play screen-based games. Massively multiplayer online role-playing games (MMORPG) have become a cultural phenomenon drawing in players, many of them adolescents, at an alarming rate.

Aim: The purpose of this scoping review is to provide an overview of the current evidence on the predictive and protective factors, and educational and psychosocial effects of problematic gaming in children and adolescents.

Methods: MEDLINE, CINAHL, PsycINFO, and Academic Search Premier were searched using key words individually and in combination. Sixteen eligible studies were included for review.

Results: Time spent gaming and age of the child were not predictors of problematic gaming. Being male, playing online versus offline, playing alone or with virtual teammates, and getting less sleep due to game-playing or nighttime waking to game were predictors of problematic gaming. Protective factors included positive family cohesiveness, high academic achievement, and satisfactory social relationships with family, friends, and teachers.

Conclusion: Predicting the development of problematic gaming remains challenging due to a lack of standardized criteria to study or diagnose problematic gaming.

Impact: Health care providers should educate parents on how to look for problematic gaming behaviors and provide strategies to change gaming behaviors.