Pathologic 2
A brutal survival RPG about a plague doctor fighting an outbreak in a dying town where every hour counts and every choice costs something real.
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About Pathologic 2
Pathologic 2 is not comfortable. It is not supposed to be. Ice-Pick Lodge's reimagining of their 2005 cult classic drops you into a remote steppe town in the grip of a spreading plague, casts you as Haruspex - a surgeon returning home - and then systematically strips away every safety net you thought you had. The genre label says RPG, but the experience sits closer to a philosophical fever dream that happens to have inventory management and a hunger meter. If you want a game that treats you like an adult and punishes you like one too, this is worth your attention. The core loop is survival under pressure. You have twelve in-game days before the plague wins or loses, and the town's clock keeps moving whether you engage or not. Each day you are juggling infection spreading through districts, NPCs with their own schedules who will die permanently if you ignore them too long, resource scarcity that makes every bandage feel like a moral decision, and a body system that tracks hunger, exhaustion, immunity, and disease separately. Combat exists - you can brawl or use whatever improvised weapons you scavenge - but the game frames violence as a symptom of desperation, not a solution. The real currency is time, and the game is relentlessly honest about how little you have. What earns Pathologic 2 its reputation is the writing. Every character in this town has a consistent interior logic, a way of speaking that feels excavated rather than invented. The town itself, the Gorkhon region with its meat-processing mythology and sand-steppe bleakness, functions as a full worldbuilding system with its own cosmology that rewards paying attention across multiple playthroughs. Dialogue is dense and sometimes deliberately oblique - this is a game that respects your willingness to sit with ambiguity. It will not explain its symbols to you. It will not apologize for being strange. The narrative payoff for players who engage seriously is genuinely rare in the RPG space. The weaknesses are real and worth naming. The performance has historically had rough edges on PC. The interface carries some legacy jank that modern players will find friction-heavy. The difficulty, while thematically intentional, reaches points where resource scarcity tips from meaningful into punishing in ways that feel less designed and more like survival math going wrong. The game does include a difficulty slider added post-launch, which helps calibrate the harshness, but even on lower settings this is a demanding experience. If you need clear quest markers, structured progression, and reliable feedback loops, Pathologic 2 will make you miserable in the wrong way. For the right player, though - someone who finished Disco Elysium and wanted the world to be even less forgiving, someone who likes their RPGs to have genuine stakes baked into the design rather than bolted on as difficulty modes - this is something close to irreplaceable. The choices here do matter in the specific way that matters most: not through branching dialogue trees but through what you chose to prioritize when you had time for exactly one thing. That weight does not lift. It compounds. Monika, Scout Team
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Game Info
- Developer
- Ice-Pick Lodge
- Publisher
- tinyBuild
- Release Date
- May 23, 2019