Purpose: To evaluate the effectiveness of game-based approaches on game performance, fundamental movement skills, health-related indicators, and physical activity outcomes among children (5-12 years) when delivered in the primary physical education school setting. Method: A systematic search of six electronic databases without date limitation was conducted on June 11, 2021. Results: Among included studies (N = 17), positive outcomes were found for children's game performance, fundamental movement skills, physical and mental health, and/or physical activity. Game-based approaches intervention success appears to be related to the contents of teacher training, especially the inclusion of a theory-based syllabus, mentoring, and reflection sessions. Conclusions: The findings of this review confirm that hybrid sport education-invasion games interventions delivered in primary schools are beneficial for improving a range of student outcomes. To improve physical self-perception, intrinsic motivation, well-being, physiological, and potential psychological outcomes for children, it is necessary to explore more game-based approaches' longitudinal and intervention research with high quality.