Exergames have been suggested as an innovative approach to enhance physical activity in the elderly. The objective of this review was to determine the effectiveness of exergames on validated quantitative physical outcomes in healthy elderly individuals. We used Centre for Review and Disseminations guidance to conduct systematic reviews. Four electronic databases were searched. We included randomized controlled trials (RCTs), the study participants were healthy elderly individuals, and the intervention of interest was exergaming. The title and abstract screening of the 1861 citations identified 36 studies as potentially eligible for this review, and an additional nine were identified from reference lists. The full text screening identified seven studies with a total of 311 participants, all reporting RCTs with low-to-moderate methodological quality. Six of the seven studies found a positive effect of exergaming on the health of the elderly. However, the variation of intervention approaches and outcome data collected limited the extent to which studies could be compared. This review demonstrates how exergames have a potential to improve physical health in the elderly. However, there is a need for additional and better-designed studies that assess the effectiveness and long-term adherence of exergames designed specifically for the elderly.