Gaming technology -exergaming -is a novel tool to facilitate exercise, improve balance, and encourage rehabilitation training. This review will describe some of the key exergame research to promote physical activity and its use in rehabilitation in other diseases or clinical populations. We will then describe the current state of research in exergaming in people with multiple sclerosis and describe the theories for the mechanism behind some of the improvements in outcomes seen after using exergaming. Lastly, we will identify gaps in the literature and provide directions for future work in this growing area. The current work is contradictory and there is no consensus with regards to training duration/intensity and the outcomes used to assess the clinical effectiveness. This in part is due to the off-the-shelf nature of the games used. A more satisfactory approach would be the development of bespoke games which match a clinical need. Exergames are seen as enjoyable and could be effective in enhancing adherence to rehabilitation. However, the definitive RCT has yet to be carried out comparing exergaming to traditional exercise.