The aim of this study was to examine trajectories of pathological video game symptoms over a 6-year period from adolescence to emerging adulthood. We also examined a number of predictors and outcomes for different trajectories. Participants included 385 adolescents (M age = 15.01 at the initial time point) who completed multiple questionnaires once a year over a 6-year period. Analyses showed there were 3 distinct trajectories. Approximately 10% of adolescents (called "increasing symptoms") showed moderate levels of pathological gaming symptoms at the initial time point and then increases in symptoms over time. Conversely, 18% of adolescents (called "moderate symptoms") started with moderate symptoms that did not change over time. Finally, 72% of adolescents (called "nonpathological") were relatively low in symptoms across the 6 years of data collection. Being male predicted both the increasing and moderate groups. The increasing group tended to show the worst outcomes over time, with higher levels of depression, aggression, shyness, problematic cell phone use, and anxiety than the nonpathological group, even when controlling for initial levels of many of these variables.