 This systematic review found that serious games are not superior to no or passive interventions and conventional exercises at improving executive functions among older adults with cognitive impairment. The low quality of the evidence, small sample size in most included studies, and paucity of studies included in the meta-analyses limit the conclusions. Further reviews are needed to assess the long-term effect of serious games on specific executive functions or other cognitive abilities among people from different age groups with or without cognitive impairment.