The COVID-19 pandemic led to concerns about increased time spent playing video games and potential impacts on mental health. In this meta-analysis, we synthesized studies to quantify changes in gaming time during the pandemic and examine its association with positive and negative mental health metrics. We searched databases for studies published from March 2020 to December 2021 reporting gaming time and mental health positive (e.g., happiness, positive affect, relaxation) or negative (e.g., depression, anxiety, stress, loneliness, anger) indicators during the pandemic. We employed random effects meta-analyses with robust variance estimates. We accounted for potential moderators (e.g., world region). In 17 studies (26 effects, n = 18026), we found a small increase in time spent gaming during the pandemic versus pre-pandemic, d = 0.26, 95% CI [0.14, 0.37], p = .0004). In 22 studies (100 effects, n = 19752), gaming time was not associated with mental health (r = -0.03, 95% CI [-0.08, 0.02], p = .22), regardless of whether it was for well-being or ill-being measures. Moderator analyses indicated negligible differences across study characteristics (d < 0.20). These results highlight the need to carefully consider assumptions equating more gaming time with poorer (or improved) mental health during pandemics. They provide insights relevant to researchers, policymakers, educators, caregivers, and gamers. Our findings are crucial for further evidence-based public health policies and recommendations for gaming in possible future pandemics and lockdowns.