Repeated exposure to violent media is related to negative outcomes, including aggression, hostility, and cognitive and social deficits. We examined if cardiovascular and emotional responding to video game play changed across 3 weekly sessions. Participants were 41 adolescents (M age = 14.8; male = 29; female = 12) from rural Appalachia. Participants attended 3 weekly sessions and played I of 3 video games (basketball, fighting, or horror) each time. Measures included heart rate (HR); systolic blood pressure (SBP); diastolic blood pressure (DBP); self-reported aggression, anger, and reactions to game play; and history of video game play. Resting and posttest cardiovascular measures did not differ from session to session. Adolescents displayed HR and SBP reactivity to game play within each session. They also demonstrated decreased SBP and DBP responding to video game play across the 3-week period, regardless of game content. Affective responses did not change significantly across the course of the experiment. Adolescents who played the violent games reported more frustration and arousal than those who played the sports game. The implications of these findings are discussed.