Purpose: To compare the video and computer game play patterns of young adolescent boys and girls, including factors correlated with playing violent games. Methods: Data collected in November/December, 2004 from children in grades 7 and 8 at two demographically diverse schools in Pennsylvania and South Carolina, using a detailed written self-reported survey. Results: Of 1254 participants (53% female, 47% male), only 80 reported playing no electronic games in the previous 6 months. Of 1126 children who listed frequently played game titles, almost half (48.8%) played at least one violent (mature-rated) game regularly (67.9% of boys and 29.2% of girls). One third of boys and 10.7% of girls play games nearly every day; only I in 20 plays often or always with a parent. Playing M-rated games is positively correlated (p <.001) with being male, frequent game play, playing with strangers over the Internet, having a game system and computer in one's bedroom, and using games to manage anger. Conclusions: Most young adolescent boys and many girls routinely play M-rated games. Implications for identifying atypical and potentially hannful patterns of electronic game use are discussed, as well as the need for greater media literacy among parents. (c) 2007 Society for Adolescent Medicine. All rights reserved.