Gamification is increasingly being recognized as a tool to support a change in individuals’ health behaviors. However, how and under which circumstances gamification is able to support health behavior change is still largely unexplored. This study follows the call for more theory-driven research on gamification by investigating the role of gamification in health behavior change theories (HBCTs). In order to do so, we conducted a systematic review of extant literature and identified 25 studies that explore the role of gamification in the process of health behavior change to some extent. We found large discrepancies in how the authors of these studies conceptualized the role of gamification in their theory-driven health interventions. To further strengthen theory-driven research on gamification in health and well-being, we additionally propose concrete research questions. These may guide future researchers to identify valuable avenues for further explaining and predicting the influences of gamification on health behavior change.