BACKGROUND Introduction: Gaming is a billion-dollar industry growing at a Compound annual growth rate (CAGR) of 9 %- 14.3% with biggest market in South East Asian countries. Availability of Low-cost smart phones, ease of internet access has made gaming popular among youth who enjoy it as a leisure activity. According to the WHO excessive indulgence in Gaming can lead to Gaming disorder. Medical students indulging in excessive gaming can succumb to gaming disorder which can affect their scholastic performance. Hence this study was done to assess the gaming practices and its effect on scholastic performance. OBJECTIVE Objective: 1. To assess the various Gaming practices and the Prevalence of Gaming addiction among medical students. 2. To study the effect of Gaming practices on Scholastic performance of medical students. METHODS Methods: The present study used a case control design where the 448(N) study participants were recruited using non probability sampling technique.91 (Nc) cases who were Gaming for past 6 months were identified using rapid preliminary survey .91 controls (Nco) who never played games were selected and matched for age and sex. Internal Assessment scores (%) of cases and controls were compared. Snedecor F test and Student t test were used to find out the association between the hours of gaming and internal assessment scores (%) and difference of Internal assessment scores between cases and controls respectively. Odds ratio was calculated to identify the risk of Poor scholastic performance. Prevalence of Gaming addiction was assessed using Lemmen’s Gaming addiction scale (GAS). RESULTS Results: Frequency of gaming (hrs) was not associated with the Mean internal assessment scores (p>0.05). Male students (cases) showed significant reduction in both their internal assessment scores (p<0.001,<0.01) whereas no reduction was observed in Female cases. A negative correlation was observed between GAS and internal assessment scores (r=-0.02). Prevalence of Gaming addiction using GAS was found to be 6.2% among the study population(N=448) and 31% among Cases (Nc=91).The risk of low scores was (OR =1.80-1.89) times more in cases than controls. CONCLUSIONS Conclusions: Excessive Gaming adversely affects scholastic performance in males than females.Awareness about Gaming addiction needs to be created among students, parents and teachers. Institutionalized De-addiction services should be made available to medical students. CLINICALTRIAL No