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Abstract Background This study aimed to investigate the prevalence, correlates, comorbidities, and suicidal tendencies of problematic game use in a nationally representative sample of Korean adults. Methods Of the 6022 subjects who participated in the 2011 Korean Epidemiologic Catchment Area study and completed the Composite International Diagnostic Interview 2.1, 1397 game users were evaluated for problematic game use using 9-item DSM-5 proposed criteria for Internet gaming disorder. Respondents who responded “yes” to five or more of the nine DSM-5 criteria were considered as problematic game users and the reminders were considered as normal game users. Results 4.0% (56/1397) of game users were classified as a problematic game user. Problematic game users were more likely to be in younger age group and live in urban area compared with normal game user. Problematic game use was positively associated with several psychiatric disorders including nicotine use disorder, depressive disorder, and anxiety disorder, but not associated with alcohol use disorder and obsessive-compulsive disorder, after adjusting for age, sex, and residential area. Problematic game use was significantly and positively associated with suicide plans, after controlling for psychiatric disorders as well as socio-demographic factors. Conclusion Problematic game use is relatively prevalent in Korean adult population and highly comorbid with other psychiatric disorders and suicidality. Therefore, preventive strategy for problematic game use is needed for game users who were more likely to be addicted such as young adults in urban area, and mental health screening and appropriate treatment are needed for individuals with problematic game use.