Competitive e-sport players manage performance pressure, negative emotions, and ultimately what it is known as tilt - a common phenomenon described in the game League of Legends (LoL) as frustration associated with performance decline. The purpose of the present study was to gain an understanding of factors and processes related to tilt in LoL e-sport players. A qualitative methodology, grounded in post-positivism, was applied to explore tilt antecedents, its effects on players, and the strategies used to manage tilt-inducing situations at emotional, cognitive, and behavioural levels. Male LoL players (N = 14), aged 19-28 (M = 23.7, SD = 2.3 years), were interviewed, and their responses analysed using reflexive thematic analysis. Tilt antecedents identified included: teammates failing to meet players' expectations; teammates' displaying toxic behaviours; players failing to meet their own expectations; and players experiencing negative emotions. Such tilt experiences were reported to result in players feeling discouraged, losing control, misplacing attention, and displaying toxic behaviours. Ultimately, players reported to manage tilt by muting the in-game chat, refocusing attention, accepting and letting go of tilt-inducing events, and taking breaks. Findings provide a process-based understanding of tilt in relation to antecedents to tilt, its impact on players, and how players ultimately manage such tilt experiences in the e-sport game of LoL.