Background: There has been research on the use of offl ine video games for therapeutic purposes but online video game therapy is still fairly under-researched. Online therapeutic interventions have only recently included a gaming component. Hence, this review represents a timely fi rst step toward taking advantage of these recent technological and cultural innovations, particularly for the treatment of special-needs groups such as the young, the elderly and people with various conditions such as ADHD, anxiety and autism spectrum disorders. Material: A review integrating research fi ndings on two technological advances was conducted: the home computer boom of the 1980s, which triggered a fl ood of research on therapeutic video games for the treatment of various mental health conditions; and the rise of the internet in the 1990s, which caused computers to be seen as conduits for therapeutic interaction rather than replacements for the therapist. Discussion: We discuss how video games and the internet can now be combined in therapeutic interventions, as attested by a consideration of pioneering studies. Conclusion: Future research into online video game therapy for mental health concerns might focus on two broad types of game: simple society games, which are accessible and enjoyable to players of all ages, and online worlds, which offer a unique opportunity for narrative content and immersive remote interaction with therapists and fellow patients. Both genres might be used for assessment and training purposes, and provide an unlimited platform for social interaction. The mental health community can benefi t from more collaborative efforts between therapists and engineers, making such innovations a reality.