Objectives: Studies on internet game addiction focused mostly on individual or family factors, and social or environmental influence has received less attention. In order to raise awareness of the social responsibility in preventing internet game addiction, this study examined among youth the extent of exposure to internet game advertisements and the relationship of their exposure to the risk of internet game addiction. Methods: The sample consisted of 1,838 middle school students living in Seoul and Gyeonggi province, who completed a survey measuring exposure to internet game advertisements and other game related behaviors. Results: About 6% of the respondents were classified as the internet game addiction risk group. Respondents were exposed to internet game advertisements through various media including TV, application search windows and ads posted in public transportation. The addiction risk group showed higher perception of game advertisements. Multiple logistic regression results indicated that the exposure to advertisements and receptivity of the advertisements increased the risk of internet game addiction. Conclusions: Study findings confirmed the role of environmental factors associated with internet game addiction. In order to decrease and prevent internet game addiction, more attention should be given to strategies targeting social responsibility of the society and the game industry. More effective regulation and self-regulation efforts in regards to game advertisements are needed.