The relationship between online game use and creativity remains contentious. Self-worth orientation theory suggests that online gaming can fulfill individual self-worth needs, implying that self-worth may moderate this relationship. Study 1 assessed online game use, self-worth, and creativity among 184 college students through a cross-sectional survey. Results indicated that self-worth moderated the relationship between online game use and creativity; for high self-worth action/shooter gamers, game use positively correlated with fluency but marginally negatively correlated with usefulness. Conversely, for low self-worth action/shooter gamers, game use negatively correlated with fluency. Additionally, low self-worth casual/puzzle gamers showed a marginal negative correlation with originality, while high self-worth casual/puzzle gamers exhibited a positive correlation with originality. To enhance the internal validity of this study, Study 2 involved 55 participants in a pre-/post-test experimental design with a nongaming group and two gaming groups. Results showed that, in the pre-test higher creativity group rather than the pre-test lower creativity group, self-worth moderated the effects of action/shooter game use on fluency and originality. Although the main effect of online game use and moderating effects of self-worth were generally weak, these findings contribute to addressing the controversy surrounding the relationship between online game use and creativity identified in prior research and offer theoretical insights to enhance overall creativity.