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We investigated how middle-school children engaged in metacognitive comprehension processes when analyzing video games as multimodal texts, particularly related to semantic and syntactic features (Block, 2004). The Gamer Response and Decision Framework (Author, 2016) and the concept of metacognition serve as our conceptual framework. Our descriptive case study follows a qualitative approach (Merriam & Tisdell, 2016) in which we analyzed 124 written reflections from 31 middle-school students via template analysis, examining how they engaged in metacognitive literacy practices to interpret multimodal symbols in video games and how these interpretations influenced decision-making processes during gameplay. Results indicate the middle-school students engaged in metacognition related to semantic and syntactic processes with a variety of multimodal symbols present in video games.