Aim: To provide an overview, with respect to Sweden, of the cultural history of gambling, the commercialization of gambling, problem gambling research, the prevalence of problem gambling and its prevention and treatment. Method: A review of the literature and official documents relating to gambling in Sweden; involvement in gambling research and regulation. Results: Gambling has long been part of Swedish culture. Since about 1980 the gambling market, although still largely monopolistic, has been commercialized. At the same time, problem gambling has emerged as a concept in the public health paradigm. Debate regarding whether or not Sweden's national restrictions on the gambling market are compliant with European Community legislation has helped to put problem gambling on the political agenda. Despite expanded gambling services, the extent of problem gambling on the population level has not changed significantly over the past decade. Conclusions: The stability of problem gambling in Sweden at the population level suggests a homeostatic system involving the gambling market, regulation, prevention and treatment and adaption to risk and harm by gamblers. We have relatively good knowledge of the extent and characteristics of problem gambling in Sweden and of how to treat it, but little is known of how to prevent it effectively. Knowledge is needed of the effectiveness of regulatory actions and approaches, and of responsible gambling measures implemented by gambling companies.