There is increasing interest in the use of games to scaffold social skills training for autistic children and youth. However, there is no consensus on how to best approach their design, so that learning opportunities are maximised. This article presents a systematic scoping review of empirical studies that use games as social skills training for autistic children and youth. We set out to describe the different types of game-based interventions observed, to identify those that typically bring successful outcomes (while noting the social skills targeted in each), and to highlight the psychological intervention approach taken. Through a search of five databases, 3070 studies were identified and reduced, through screening, to a sample of 17 studies. Each study reported that their game successfully promoted social skills training for autistic people. Although not a part of the criteria, all studies included a technological element. However, across the sample, there was also a lack of specificity in how 'social skills' were defined and in which skills were chosen as the focus of the intervention. Moving forward, we recommend a more theoretically driven approach to defining behavioral targets for game-based interventions, as well as the inclusion of autistic voices earlier and more centrally in the design processes.