Video gaming is a routine setting for adolescents’ identity development. Research so far has focused on gaming disorder symptoms or narrow subgroups and separated personal identity (commitment, in-depth exploration, reconsideration, identity styles, clarity) from social identity (identification as a gamer, with a gaming community, or with an avatar). This preregistered review synthesized 34 articles reporting 38 studies of adolescents with mean ages between 12 and 25 years: 21 quantitative and 17 qualitative, 5 longitudinal, with at least 41,404 participants. One survey supplied 82% of them, so the total reflects that study’s size, not evidence strength. Samples were mostly European, then East Asian and North American. The median proportion of boys was 67%. Gaming was associated with identity processes and clarity, not identity statuses: more intense gaming and more gaming disorder symptoms accompanied less settled commitment, more reconsideration, and lower clarity. Outcomes depended more on what youth identified with, and whether anything outside the game confirmed it, than gaming time. Community identification was associated with higher well-being and game-system identification was associated with gaming disorder symptoms. Avatar identification went either way depending on outside confirmation. No study observed identity change over time, and none measured gaming time with a validated instrument. For practice, professionals should consider what adolescents identify with in gaming, not only how much time they spend playing.