Video diffusion models (DMs) have enabled high-quality video synthesis. Yet, their substantial computational and memory demands pose serious challenges to real-world deployment, even on high-end GPUs. As a commonly adopted solution, quantization has proven notable success in reducing cost for image DMs, while its direct application to video DMs remains ineffective. In this paper, we present QVGen, a novel quantization-aware training (QAT) framework tailored for high-performance and inference-efficient video DMs under extremely low-bit quantization (e.g., 4-bit or below). We begin with a theoretical analysis demonstrating that reducing the gradient norm is essential to facilitate convergence for QAT. To this end, we introduce auxiliary modules ($Φ$) to mitigate large quantization errors, leading to significantly enhanced convergence. To eliminate the inference overhead of $Φ$, we propose a rank-decay strategy that progressively eliminates $Φ$. Specifically, we repeatedly employ singular value decomposition (SVD) and a proposed rank-based regularization $\mathbfγ$ to identify and decay low-contributing components. This strategy retains performance while zeroing out additional inference overhead. Extensive experiments across $4$ state-of-the-art (SOTA) video DMs, with parameter sizes ranging from $1.3\text{B}\sim14\text{B}$, show that QVGen is the first to reach full-precision comparable quality under 4-bit settings. Moreover, it significantly outperforms existing methods. For instance, our 3-bit CogVideoX-2B achieves improvements of $+25.28$ in Dynamic Degree and $+8.43$ in Scene Consistency on VBench. Code and models are available at https://github.com/ModelTC/QVGen.