This systematic review and meta-analysis examined how different gambling motives are related to problem gambling severity. Across 63 studies, nearly all gambling motives were linked to problem gambling severity, especially motives related to coping with negative emotions and escaping distress. Positive reinforcement motives, such as enhancement and financial gain, were also linked to problem gambling severity. Social motives showed a smaller but still significant association. The findings suggest that problem gambling is associated with multiple motives.