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Serious Games (SG) are developing a reputation with some educationalists as a useful supplementary approach for teaching and learning. Two important issues for SG application developers and educationalists are how the learning is assessed and how assessment is integrated into a SG application. This chapter presents the results of a systematic literature review on assessment integration in SG and highlights the state of the literature in this area by outlining important papers to act as a guide for educationalists tackling this important issue. This chapter defines assessment and discusses formative and summative assessment and embedded and external assessment. A discussion of traditional assessment approaches and assessment approaches in SG are presented along with a discussion of existing frameworks for the integration of assessment into a SG application. The chapter presents a number of examples of assessment in serious games.