The possibility of leveraging video games for enhancing behavior and brain function has led to an emerging new field situated at the crossroads of cognitive neuroscience, health science, educational interventions, and game design. Here we review the impact of video game play, in particular action video game play, on attentional control. We also examine the underlying neural bases of these effects and the game design features hypothesized to drive the plastic changes. We argue that not all games have the same impact, with both differences in the characteristics of the games themselves as well as individual differences in player style determining the final outcome. These facts, mixed with changes in the game industry, (e.g., greater mixing of genre characteristics; greater freedom of player experience) calls for a paradigm shift relative to the approach taken in the field to-date, including iteratively alternating between targeted game design and efficacy evaluation.