Video games are often highlighted as risk factors in relation to physical inactivity and increasing levels of obesity. Now a new type of video game, the exergame, has entered the market. In recent years, several countries have increasingly foregrounded exergames as a possible activity for use in school PE and as perhaps improving young people’s knowledge, skills, attitudes, and behaviors in relation to health and physical exercise. The purpose of this study is to explore Swedish PE teachers’ perceptions and use of exergames and also the barriers to and reasons for using exergames based on a survey containing closed- and open-ended questions. A total of 493 teachers (10% of all Swedish PE teachers) answered the questionnaire. The responses were coded and entered into SPSS, allowing for both descriptive data and cross-table analyses. The results show that 80 percent are familiar with exergames, 17 percent are recreational exergamers, and a few (3%) have tried using exergames in physical education and health. The reasons for introducing exergames are generally as follows: encouraging physical activity, offering different types of movement, and having fun. The barriers to introducing exergames are mainly: financial, prioritizing other activities, and the teachers’ own knowledge. The majority of the PE teachers are generally positive to introducing exergames as a teaching aid into their subject. However, this requires developing the teachers’ own knowledge of exergames. The choice of teaching content and the introduction of new activities and teaching tools also involve critically examining the games, and this, in turn, entails didactic reflection.