Medical discussions around video games usually revolve around addiction, physical health, mental health outcomes, and even acts of violence. The authors of this chapter want to interject race into these discussions to explore the role that race, racialization, and racism have in conversations about gaming. By exploring the social harms of race in gaming, the authors explore how these emerge, from the radicalization of white youth to the toxic cultures that surround gaming, among others. We argue that significant harms occur also because of the ways in which spaces and technologies are designed that might facilitate the process of these racialized harms. The authors conclude with a list of recommendations and future research that focus on how we could imagine, design, and implement our technologies in ways that challenge, rather than reproduce, structural inequalities.