Review Article 1 This is an open access article under the CC BY license Leveling Up Esports Health: Current Status and Call to Action David P. Schary 1 , Seth E. Jenny 2 , Aaron Koshy 3 1 Department of Physical Education, Sport and Human Performance, Winthrop University, USA 2 Department of Exercise Science and Athletic Training, Slippery Rock University of Pennsylvania, USA 3 Translational and Clinical Research Institute, University of Newcastle, UK *Correspondence: Dr. Seth E. Jenny, Department of Exercise Science and Athletic Training, Slippery Rock University of Pennsylvania, 338 Patterson Building, Slippery Rock, PA 16057 USA. Email: dr.sethjenny@gmail.com Abstract Esports is growing at an exponential rate. While there are benefits to playing esports, little is known about the long-term health implications. This article reviews the current state of esports health-related research, focusing on physical health (i.e., physical activity, musculoskeletal injuries, eye health), sleep, nutrition, performance-enhancing drugs, and mental health (i.e., gaming disorder, emotional regulation). It identifies areas of interest with a call to action for all stakeholders within the esports ecosystem, providing a short list of recommendations to consider based on the current literature. Future research should utilize both quantitative and qualitative methods, with a particular emphasis on longitudinal and large-scale studies using validated tools to fully explore the association between esports and health. Keywords: esports medicine, wellness, health promotion, physical health, mental health Highlights: • Much of the current esports health-related research focuses on players’ physical activity and sedentary behavior patterns. • Other major, but under researched, esports health concerns surround player injuries, sleep, nutrition, and performance-enhancing drug use. • Many of the health concerns such as performance enhancing drugs require input from game publishers and tournament organizers for regulation to take place • The health issues present in esports suggest significant value in regular health checks for competition level players.