The widespread availability of advanced technology has made online gaming accessible to a vast population. While gaming can offer recreational and social benefits, excessive use may lead to problematic patterns of behavior, including addiction. This systematic review aimed to synthesize and evaluate existing evidence on the association between online gaming addiction and mental health outcomes in the Indian context. The review was conducted in accordance with PRISMA guidelines. A comprehensive search was performed across PubMed, DOAJ, and Dimensions using keywords related to online gaming addiction and mental health. Studies published between January 2015 and March 2026, focusing on the Indian population and reporting quantitative empirical data, were included. The initial search identified 102 papers, and after a thorough screening process, 23 studies were selected for inclusion in the review. The findings indicated consistent associations between online gaming addiction and a range of adverse mental health issues, including depression, anxiety, stress, loneliness, aggression, sleep disturbances, impulsivity and poor psychological well-being. These findings highlight the need for increased awareness and relevant interventions based on a holistic approach to address the potential negative consequences of online gaming addiction in India.