This study aimed to examine the mediating effect of academic stress and the moderating effect of parental emotional support in the relationship between problematic game use and depression among elementary school students 4th, 5th, and 6th grade. Data were drawn from 21,021 students with gaming experience who participated in the 2021 Comprehensive Survey on Game Overindulgence conducted by the Korea Creative Content Agency. The main findings are as follows. First, significant correlations were found among all major variables. Second, using Model 4 of the PROCESS Macro, a mediating effect of academic stress on the relationship between problematic game use and depression was confirmed. Third, Model 1 verified the moderating effect of parental emotional support on the relationship between academic stress and depression. Finally, Model 14 confirmed the moderated mediating effect of academic stress, conditioned by parental emotional support, in the relationship between problematic game use and depression. Based on these results, the study highlighs the crucial role of parents in influencing the relationship among problematic game use, depression, and academic stress. Lastly, limitations of the study discussed and directions for future research are suggested.