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Aim: The lack of protocols and research on this aspect of this effective emerging practice led the researchers to identify the ergonomic considerations in the delivery of exergaming (exercise and gaming) in rehabilitation. Methods: A comprehensive literature search was performed in seven electronic databases from July 8 to August 3, 2021. Experimental studies written in English, with randomized controlled trial (RCT) design that included adult participants with orthopedic or neurologic conditions utilizing exergaming to improve balance, muscle strength, or muscle endurance were considered. Two reviewers screened articles through a set inclusion and exclusion criteria using the Rayyan and Mendeley applications. A spreadsheet software was used for the data collection process. The frequency and percentage of the study characteristics, appraisal score, and considerations highlighted, and the nature and type of its controls were obtained. The RCT Critical Appraisal Sheet of the Centre for Evidence-Based Medicine was used to appraise the included articles. Results: A total of 68 studies were included, with 61 (89.71%) reporting safety or health considerations, 36 (52.94%) of which reported ergonomic considerations. Most ergonomic considerations were under the environment control (n = 31, 20.13%), and 13 (8.44%) under the task and 12 (7.79%) the individual controls. Conclusion and Implications: Ergonomic considerations alongside physical and safety hazard considerations were found in the literature. The review highlights the importance of these considerations as it precludes injury and thus strengthens the effectiveness of the intervention. Further investigation on the correlation of exergaming effectivity and these considerations is warranted.