Purpose of Review <p>To summarize longitudinal research findings on the trajectory, chronicity, and etiology of problem gambling.</p> Recent Findings <p>Problem gambling is not usually progressive. Rather, most people with early problems reduce their subsequent involvement and sustain this reduction. Problem gambling is also not usually chronic and unremitting. A minority do have a sustained chronic course, particularly more severe cases. It is also enduring in that relapse and risk of relapse remains high in anyone who has ever had the condition. However, the condition most typically remits, with some people having sustained remission and others having repeated relapses and remissions. In terms of etiology, up to 20 variables additively contribute to the initial onset of problem gambling with different combinations of variables being present in different people. That said, intensive gambling involvement, gambling fallacies, addiction-propensity, a social group that regularly gambles, and impulsivity tend to be particularly important factors.</p> Summary <p>Problem gambling has a biopsychosocial etiology with a trajectory and chronicity very similar to substance use disorder.</p>