In recent years, video game addiction has received considerable empirical attention. Unfortunately, this research is stymied by inconsistencies in both conceptual and operational definitions of video game addiction. Moreover, the use of several video game addiction scales makes it difficult to estimate the prevalence and potential effects of video game addiction. While game genre is often treated as a predictor of video game addiction, existing measures often downplay the structural and social characteristics of video games that may contribute to behavioral outcomes such as increased playing time and addiction. In an effort to provide the clarity necessary to overcome these issues, we review research on video game addiction with a focus on the largely ignored unique characteristics of video games that are crucial for a more complete conceptualization of video game addiction. With this review in mind, we offer a conceptual framework for the integration of video game addiction within the broader context of behavioral addictions. Finally, we consider the neurological foundation of addiction and suggest opportunities for media neuroscientists to increase understanding and prediction of video game addiction and explore how game content features interact with reward systems in the brain.