The debate regarding adolescent video gaming often oscillates between fears of potential risks and hopes for benefits, yet few studies examine how gaming behaviors evolve individually over time. This study addresses the need for longitudinal research by identifying distinct developmental trajectories of gaming and their relationship with psychosocial functioning (self-esteem, life satisfaction, and social competence). We utilized four waves of longitudinal data from 1,331 adolescents (Mean age at Wave 1 = 12.51; 57.1% boys). Guided by the Differential Susceptibility to Media Effects Model, we employed Growth Mixture Modeling to map heterogeneity in gaming patterns. The analysis revealed sex-specific trajectories: boys followed four trajectories (“Stable Low,” “Decreasers,” “Increasers,” “Stable High”), while girls followed two (“Stable Low,” “Decreasers”). Contrary to concerns of universal risk, the vast majority of adolescents followed a “Stable Low” trajectory associated with favorable psychosocial outcomes. However, distinct vulnerabilities emerged for smaller subgroups: male “Decreasers” displayed lower initial social competence and life satisfaction, while female “Decreasers” experienced steeper declines in self-esteem over time. These findings challenge the utility of aggregate screen-time metrics. Practical implications are discussed, emphasizing that educators and schools should focus on the context and function of gaming—specifically peer dynamics and social skill gaps—rather than duration alone.