Video games have amassed an immense socio-cultural impact, with direct benefits and adverse impacts on human cognition. In this chapter, we provide a high-level picture of the cognitive benefits and challenges of gaming. Literature on cognitive benefits and challenges of gaming is heterogeneous and complex due to several reasons. Studies have shown improvements across various cognitive domains, such as attention, memory, executive functions, and spatial abilities. These benefits have made video games a popular candidate for alternative and adjunctive therapies for a wide range of psychiatric, developmental, and neurocognitive disorders. While the positive impacts of gaming are noteworthy, there is also a growing body of research on pathological gaming behaviors, particularly Internet gaming disorder (IGD). Preliminary findings on IGD show that real-time strategy and role-playing video games, such as massively multiplayer online role-playing games, are most prevalent among pathological play. The combination of game factors, along with risk factors, influences the positive or negative cognitive impact of gaming across populations. Future research should focus on studying diverse populations, standardizing the game features and cognitive constructs under study, and using sophisticated methods for robust causal insights.