Video games and gambling often contain very similar elements with both providing intermittent rewards and elements of randomness. Furthermore, at a psychological and behavioral level, slot machine gambling, video lottery terminal (VLT) gambling and video game playing share many of the same features. Despite the similarities between video game playing and gambling there have been very few studies that have specifically examined video game playing in relation to gambling behavior. This study inquired about the nature of adolescent video game playing, gambling activities, and associated factors. A questionnaire was completed by 996 (549 females, 441 males, 6 unspecified) participants from grades 7-11, who ranged in age from 10-17 years. Overall, the results of the study found a clear relationship between video game playing and gambling in adolescents, with problem gamblers being significantly more likely than non-problem gamblers or non-gamblers to spend excessive amounts of time playing video games. Problem gamblers were also significantly more likely than non-problem gamblers or non-gamblers to rate themselves as very good or excellent video game players. Furthermore, problem gamblers were more likely to report that they found video games, similar to electronic machine gambling, to promote dissociation and to be arousing and/or relaxing.