The therapeutic value of games in therapy has been well-established and is a common practice among clinicians, especially those working with children and families. However, an underlying assumption is that games are universal, without attention to the role of culture. The incorporation of traditional cultural games, such as Lotería, brings the benefits of game play with the addition of cultural sensitivity. Lotería is a traditional Mexican game, similar to Bingo, that is recognizable and accessible within the Mexican/Mexican American community. Mental health disparities among Latinx populations, and Mexican/Mexican Americans specifically, have been well-documented and exacerbated with the COVID-19 pandemic. In this article, we will discuss how the game Lotería helps to address the needs of this community, outlining the theoretical underpinnings of the approach, providing a detailed didactic application of the game, as well as presenting a case study to illustrate these components. This is all framed within the context of the pandemic, attending to both in-person and virtual applications.