This study aimed to evaluate the effectiveness of Exergaming in improving executive function and motor ability across different groups of children and adolescents. We searched several databases, including PsycINFO, Web of Science, Embase, PubMed, SPORT Discus, Scopus, and the Cochrane Central Register of Controlled Trials, for randomized controlled trial (RCT) studies published from inception until November 25, 2023, to identify studies investigating the effect of Exergaming on motor and executive function in children. The protocol was registered with PROSPERO (CRD42023482281). A total of 37 randomized controlled trials were included in this study. Our results indicate that Exergaming can influence children's cognitive flexibility (SMD 0.34, 95% CI 0.13 to 0.55, I2 0.0%, p = 0.738), inhibition control (SMD 0.51, 95% CI 0.30 to 0.72, I2 0.0%, p = 0.473), global cognitive (SMD 0.87, 95% CI 0.50 to 1.23, I2 0.0%, p = 0.974), working memory (SMD 0.18, 95% CI -0.16 to 0.52, I2 46.5%, p = 0.096), gross motor skills (SMD 0.82, 95% CI 0.30 to 1.35, I2 79.1%, p < 0.001), fine motor skills (SMD 0.71, 95% CI 0.22 to 1.21, I2 78.7%, p < 0.001), balance (SMD 0.61, 95% CI 0.34 to 0.88, I2 59.5%, p = 0.001), and cardiorespiratory (SMD 0.48, 95% CI 0.16 to 0.79, I2 58.4%, p = 0.019). While these findings suggest that Exergaming can promote children's cognitive flexibility, inhibitory control, global cognition and motor abilities, the effect on working memory was not statistically significant. Further high-quality randomized controlled trials are warranted to explore the potential benefits of Exergaming for different groups of children, including those with specific needs.

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