To examine the cognitive and physical changes associated with consuming an energy drink concurrent to video gaming, we examined a convenience sample of nine elite League of Legends (LoL) e-sport players (21 ± 2 y, BMI 25.6 ± 3.4 kg/m²) consuming an energy drink (Reload^TM) or placebo (Placebo) in a randomized, double-blind, placebo-controlled cross-over trial. Participants completed the same test battery prior to treatment consumption and after playing each of three competitive LoL games. Primary outcomes included measures of attention (Erikson Flanker Test), reaction time (Go/No-Go test) and working memory (n-back test). Secondary outcomes examined fatigue (hand grip strength and finger tap speed). Statistical analysis was performed by repeated-measures analysis of variance (RM-ANOVA) and reported as the mean (standard deviation [SD]) or mean change (95% confidence interval [CI]). Participants reported sleeping 8.1 (1.2) h/night, playing LoL 10.3 (2.1) h/d, playing other video games 1.8 (2.8) h/d, and exercising 4.2 (1.7) times per week. Overall, we observed no significant time, group, or group-by-time interactions for any measured performance index with the exception of a significant improvement for the n-back test, where the Reload group demonstrated a significant within-group improvement: Reload [−171 ms (95% CI, −327.91, −14.09), p < 0.004], Placebo [−92 ms (95% CI, −213.63, 29.63)]. However, no between-group differences were noted (38.50 ms, 95% CI, −141.89, 64.89, p = 0.803). Our findings suggest that elite eSport athletes do not demonstrate a mental or physical improvement in performance relative to the treatment supplement or indices measured in this study.