Aim Many youth in residential care suffer from post-traumatic symptoms that have adverse effects on a range of psychological, behavioural and physiological outcomes. Although current evidence-based treatment options are effective, they have their limitations. Meditation interventions are an alternative to traditional trauma-focused treatment. This pilot study aimed to evaluate three game-based meditation interventions in a sample of traumatized youth in residential care. Methods Fifteen participants were randomly divided over three conditions (Muse, DayDream and Wild Divine) that all consisted of twelve 15-minute game-play sessions. Physiological measurements (heart rate variability) were conducted at baseline, post-treatment and during each intervention session. Post-traumatic symptoms, stress, depression, anxiety and aggression were assessed at baseline, post-treatment and 1-month follow-up. Results Physiological stress regulation was improved during the meditation sessions of all three interventions. User evaluations were in particular high for Muse with a rating of 8.42 out of 10 for game evaluation. Overall, outcomes on psychopathology demonstrated the most robust effect on stress. Muse performed best, with all participants showing reliable improvements (reliable change indexes [RCIs]) in post-traumatic symptoms, stress and anxiety. Participants who played Daydream or Wild Divine showed inconsistent progression: some participants improved, whereas others remained stable or even deteriorated based on their RCIs. Conclusions Preliminary findings show promising outcomes on physiology, psychopathology and user evaluations. All indicate the potential of this innovative form of stress regulation intervention, and the potential of Muse in particular, although findings should be considered preliminary due to our small sample size. Further studies are warranted to assess intervention effectiveness effects of Muse or other game-based meditation interventions for traumatized youth.