Attention deficient hyperactivity disorder (ADHD) is the most common childhood neurodevelopment disorder, and severe digital game use has recently shown significant promise in this psychotherapeutic area. Digital serious games have also been used as an innovative teaching and learning approach. This study aimed to explore middle school teachers' perceptions of the use of digital severe games for students with ADHD. The conceptual framework for this study was Sherry's model of game engagement. The two research questions for this basic qualitative study focused on middle school teacher perceptions regarding the benefits and challenges related to the use of digital serious games for students with ADHD. Semi-structured interviews were conducted with ten middle school teachers from southern U.S. school districts who had used digital serious games for at least one academic school year. Data analysis using emergent codes showed that middle school teachers reported that the social aspect of digital serious games encouraged teamwork and camaraderie while also emotionally building student confidence. Challenges included students being distracted by their peers, anxiety, frustration caused by not understanding the game concepts, and time constraints that influence a student's performance within a game. The results of this study may contribute to positive social change by providing teachers and administrators with the knowledge and leverage they need to understand the benefits and challenges of using serious games when teaching students with ADHD, thereby improving student success through teacher support and professional development.