The growing popularity of esports has sparked interest in understanding how esports participation might pose unique mental health challenges and opportunities for players. To address this, this scoping review aimed to systematically map mental health and well‐being research in esports. Specifically, we sought to (1) describe the methodological characteristics of existing studies, (2) synthesise findings on mental health and well‐being outcomes and (3) identify gaps to guide future research and practice. A systematic search identified 10,348 records, of which 89 studies met the inclusion criteria. Results reveal a nuanced picture in which indicators of mental well‐being, such as intrinsic motivation, self‐efficacy and psychosocial skills, can coexist with mental ill‐health symptoms, including anxiety and gaming addiction. Prevalence estimates varied widely, with anxiety reported in 38%–82% of players and depressive symptoms in 25%–37%. These outcomes appear to vary depending on factors such as player experience, coping strategies and the competitive environment, highlighting how indicators of well‐being (e.g., motivation and confidence) can co‐occur with symptoms of distress (e.g., anxiety), reflecting the dynamic nature of mental health in esports. While research in this area has recently proliferated, the majority of studies were cross‐sectional (56.2%), with only 6.7% longitudinal and 4.5% intervention based. Significant gaps remain, including methodological inconsistencies, a lack of longitudinal and intervention studies and limited inclusion of diverse populations (e.g., various genders, geographical location and competitive settings). This review underscores the need for standardised measurement tools to accurately ascertain the prevalence, severity and nature of mental health challenges in esports. There is also a need for gender‐balanced samples and tailored mental health frameworks that reflect the unique pressures of this population, such as performance demands, digital toxicity and irregular schedules. Future research should develop and evaluate evidence‐based interventions and organisational policies aimed at safeguarding player well‐being.