 Pathological gaming, PG, is a growing concern among children around the world. This study assessed the prevalence of PG among elementary school students in Japan and found that 5.6% of them met the criteria for PG. Factors associated with PG included unhealthy lifestyles such as skipping breakfast, physical inactivity, late bedtime, frequent irritability, frequent feeling of school avoidance, fewer close friends, low academic performance, no child-parent interaction, and no rules at home. Parental involvement appears to be an important factor in preventing PG in children. This article was authored by Masaaki Yamada, Michikaza Sikain, and Takashi Tatsus.