The effect of playing video games on the developing brain during childhood is a huge topic of debate in society today. Extant studies show that video games have a negative impact on behaviour. Previous studies have reported that children born preterm tend to spend more time playing video games as opposed to their full-term-born peers. Preterm birth is also associated with behavioural deficits and impaired motor difficulties. However, their effect on the brain and behavioural difficulties is less clear. Therefore, this study investigated the association between playing video games and children’s attention ability and brain structure in children born full-term and preterm. The data was gathered through patients filling out questionnaires and MRI scans. OLS regression models were used for all the analyses and the parameters including gaming time, brain structures, behaviour etc. The covariates controlled were age in months, sex, scanner sites, socioeconomic status (SES), gaming time (h), birth weight (lbs) and the relevant brain regions. The dependent variable investigated was attention score and the different brain regions (the prefrontal cortex (mm3), basal ganglia (mm3), insular cortex (mm2) and total brain volume (mm3). The total cohort of this study was 6190 children aged 9 to 10 years old. The results revealed a negative impact of video games on attention in both cohorts, with a more pronounced effect observed among children born full-term (β coefficient: 0.349) compared to preterm children (β coefficient: 0.2165). Moreover, an association was observed between video gaming and the surface area of the insular cortex, particularly in children born full-term, where an increase in surface area was evident. However, no significant correlation was found between video gaming and structural alterations in children born preterm. The overall findings indicate that video games do not enhance preterm brain development. Instead, attention difficulties were noted in both preterm and full-term children as a consequence of video game exposure. Given the limited understanding of the brain trajectory in preterm children, no structural alterations were discernible at ages 9 to 10. Consequently, further investigation is essential to comprehensively explore the growth trajectory of preterm-born children and its relation to the insular cortex.