Previous research has shown that violent video game exposure increases aggressive thoughts, aggressive feelings, aggressive behavior and physiological arousal. However, most of the research in this field has only focused on the “video” aspect of these games, and little attention has been paid to the “audio”. In this study, both background music within video games and the games themselves were used as two independent variables to test their influence on physical excitement and aggression. Physical excitement was measured using biofeedback equipment and aggression was measured using the hot sauce paradigm. Results showed that both music and video games can cause significant increases in physical excitement, while violent video games cause higher levels of physical excitement than non-violent games. The excitement level of the background music interacted with the game content to give a combined effect on aggression. Thus, the present study extended prior findings by showing that background music has an indispensable role in the level of aggression induced through video games. The results also demonstrated that it is both necessary and beneficial to design background music for video games in such a way that it matches the action taking place in the game.