This study examines how 31 middle-school children conducted multimodal analyses of video games. Over four consecutive days, students played video games for 30 minutes and then wrote written reflections about the multimodal symbols within the game and how these symbols influenced their interpretation and decision-making processes during gameplay. Students produced 124 reflections in total, which were analysed via template analysis to determine how children metacognitively reflected on different types of multimodal symbols and used those symbols to comprehend the games and make decisions. Results illustrate how students engaged in metacognitive semantic and syntactic processes with a variety of multimodal symbols, such as written language, dynamic visuals and abstract symbols, during gameplay that aided their understanding of the games and influenced their decisions. This study contributes to the limited empirical research on video game literacies and illustrates children's meaning-making processes while engaged with video games as multimodal interactive texts.