Background The purpose of this study was to compare entertainment-themed active video game (AVG) and fitness-themed AVG play with traditional exercise to examine the interaction between physiological and psychological responses. Methods Participants (N = 23) were randomly assigned to 30-min of (i) self-selected intensity exercise (SS-EX), (ii) moderate intensity exercise (MOD-EX), (iii) entertainment-themed video game (ET-VG) and (iv) fitness-themed video game (FT-VG). Physiological and psychological outcomes were recorded before, during and after each trial. Results All trials met the ACSM criteria for moderate or vigorous physical activity. The (68.3±13.9%) and rate of energy expenditure (10.3±3.1kcal/min) was significantly higher in the SS-EX trial with lowest values reported for ET-VG (p<0.05). No differences were found in % heart rate reserve between SS-EX and FT-VG (66.9±12.5% and 67.1±6% respectively). The AVG’s were significantly more enjoyable than the exercise trials (p<0.05) and the ET-VG resulted in the highest core flow and psychological well-being (p<0.05). Conclusion AVG’s can elicit physiological responses that meet recommended exercise intensities but are more enjoyable than conventional exercise in young inactive adults. While further work is required, this study highlights the importance of examining the interaction between physiological outcomes and psychological states to increase physical activity and reduce sedentary time.