OBJECTIVE: To evaluate the effectiveness and sustainable impact of a multifaceted community-based weight intervention program for children, including exergaming curriculum. METHODS: Eighty overweight or obese children, aged 8-12 years, were randomly assigned in a 2:1 ratio to an Exergaming for Health intervention group, comprising both exergaming and classroom curriculum, or to a control group with classroom curriculum alone. Outcome measures included body mass index (BMI), z-score change, and shuttle runs to assess cardiorespiratory endurance. RESULTS: Fifty-nine participants took part in the intervention and 21 in the control group, with 35 and 13 completing 6-month follow-up, respectively. Twenty-eight intervention children were followed-up at 1 year. At the end of the 6-month intervention, the intervention group reduced its BMI z-score by -0.06 (+/-0.12) compared to 0 (+/-0.09) change for the control group; additionally, intervention subjects were two shuttle runs higher than control. However, these differences were not statistically significant (P = 0.07 and P = 0.09, respectively). Over the 6-month period after the program, the intervention group did not have an increase in weight status (BMI z-score change -0.01 [95% confidence interval -0.08 to +0.06], P = 0.76). CONCLUSIONS: Use of exergaming in community pediatric weight management did not improve weight status at the end of programming, and study implementation was limited by small sample and missing data. However, there were clinically promising trends in fitness, screen time, and caloric intake. Weight status of intervention participants did not rebound 6 months after programming. Larger, longer term studies are needed to establish the impact of videogaming interventions.