The escalating prevalence of Internet Gaming Disorder (IGD) worldwide has prompted heightened concern about its potential impact on the mental health of adolescents. In the context of Pakistan, a country experiencing rapid technological advancements, the intersection of IGD and mental health remains underexplored. This cross-sectional study examines IGD and mental health in adolescent boys (N = 240) and girls (N = 136) who play online games, recruited via a convenient sampling technique. The study also examines the mental health of Gamers (G1) and Non-gamers (G2). The results of two-way ANOVA show that adolescent boys and girls differ in IGD, depression, anxiety, and stress scores. In addition, results indicated evidence of the significance of the main effect for the assessment of Depression with F (1,374) = [4.105], p = .043, Anxiety with F (1,374) = [4.618], p = .032, and Stress with F (1,374) = [4.934], p = .027 respectively. Further results of Mixed Factorial ANOVA indicated significant differences in the mental health of G1 and G2, male and female participants. The findings emphasize the importance of monitoring and regulating adolescents’ gaming behaviors, especially excessive gaming. Parents, educators, and healthcare professionals can help identify adolescents at risk of IGD and provide appropriate support and therapies. Promoting appropriate gaming habits and preventing the detrimental effects of excessive gaming in adolescents is essential.