This study evaluated the performance of surgical residents on a training program for laparoscopic surgery, in comparison to their performance on video games and their past experience playing video games. Residents who had played video games extensively in the past demonstrated significantly superior laparoscopic skills, and laparoscopic skills were closely correlated to current video gaming ability. While simulation in surgical training has been extensively evaluated, a recent review did not find evidence for the superiority of any specific type of surgical simulation (eg, video, computer, or cadaver-based). As prior research has demonstrated a high incidence of remediable errors in laparoscopy, video games may prove to be a useful adjunct to simulation training.