Introduction: Video game addiction has emerged as a significant concern among adolescent children in recent years. With the widespread availability of technology and the increasing popularity of video games, a substantial number of adolescents are displaying addictive behaviours. Aim: To estimate the prevalence of video game addiction among adolescent school children in Chennai, Tamilnadu, India and find out the various risk factors associated with it. Materials and Methods: A cross-sectional study was conducted at the Department of Community Medicine, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chengalpattu, Chennai, Tamil Nadu, India among 300 school children aged 10-17 years from four private schools in Chennai, Tamil Nadu, India from February 2023 to June 2023. Data collection involved the Gaming Addiction Scale for Adolescents (GASA) and a pretested semistructured questionnaire. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 22.0. Results: The study revealed that approximately 31.7% of the participants had video game addiction. Categorical variables were analysed using the Chi-square test, with a significance level of p <0.05. Bivariate logistic regression was utilised to determine unadjusted odds ratios, and variables with p <0.05 were included in the multivariate model to calculate adjusted odds ratios and construct 95% confidence intervals. Conclusion: Video game addiction among adolescent school children is a significant issue with multiple associated risk factors. By promoting awareness, encouraging healthy coping mechanisms, and fostering balanced lifestyles, we can effectively address video game addiction and enhance the wellbeing of adolescent school children.