It is recommended that each day youth get 60 minutes or more of moderate-to-vigorous physical activity that includes aerobic, muscle, and bone strengthening activities. The majority of youth, however, do not meet these physical activity guidelines. Children and adolescents spend on average seven hours engaging in sedentary "screen-based" activity each day. Lowered levels of youth leisure-time physical activity can be attributed at least in part to advancements in modern technology, most specifically video games, which have been shown to reduce energy expenditure throughout the day. Active video games, which offer easy "at home" access, fun and social interaction qualities, as well as goal-achievement feedback could serve as a suitable alternative to sedentary leisure-time activities. Youth cite several physical activity participation needs including skill development, fun, affiliation, excitement, fitness, and success. Interventions that consider these needs have the potential to decrease the risk of sedentary behavior among youth. Screen-based technologies, along with smartphone apps, represent excellent initial steps in combating sedentary behavior among youth. This article assesses (1) the potential health benefits of active video games, especially for youth who would otherwise be sedentary; and (2) opportunities to incorporate smart technology to foster long-term commitment.