The physiology of respiration is a challenging subject for many medical students. To assist students, we have developed an active learning game that physically places students within a model outlining the respiratory control pathway. Participants were provided with a vodcast describing the physiology of respiratory control and instructed to view this before the activity. Once in the classroom, groups of students sat at tables marked to represent components of the respiratory control pathway (e.g., apneustic center, diaphragm etc.). Tables were connected with green and red ropes indicating excitatory or inhibitory effects, respectively. Students were presented with various scenarios (e.g., diabetic ketoacidosis) and asked to predict and illustrate the scenario's effect on subsequent steps in the respiratory pathway by waving the appropriate connecting rope. The next table would continue the pattern to simulate the collective physiological adaptation of the respiratory pathway. Thirty first-year medical students participated in this study. Following the activity, 25 out of the 30 participants completed an optional survey. The survey aimed to assess the benefits of adding this activity to our first-year medical curriculum to build a foundational understanding of the physiology of respiration. Responses were overwhelmingly favorable, and participants reported that playing the game significantly improved their perceived understanding of the physiology of respiratory control. All but one of the participants recommended using the activity in future classes. Because the small size of the study group may limit generalizability, future larger scale studies are planned.