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Conceptual and procedural knowledge is essential for mathematical problem solving. The current study aimed to examine how students’ conceptual and procedural knowledge developed in digital game-based learning (DGBL). Thirty-nine middle school students were recruited to participate in a pretest-posttest experimental study with repeated measures. The results of the study indicated that (a) students constantly developed their conceptual and procedural knowledge over time in DGBL, and (b) the influence of each type of knowledge was asymmetrical. These results support an iterative account of the development of students’ conceptual and procedural knowledge for mathematical problem solving in ratio reasoning in DGBL.