Games Like Pathologic Classic HD

Pathologic 2 is a groundbreaking open-world horror RPG. Resist the plague. Make medicine. Heal people. Perform an autopsy. Trade to get what you need. Fight and kill if necessary. Survive. Struggle with an outbreak in a secluded rural town that is rapidly turning into hell.

Why similar: Survival 13.6%, Story Rich 13%, Atmospheric 11.7%, Psychological Horror 11.1%, Difficult 10.1%

Why You'll Like It: This is a ground-up reimagining of the original that refines the brutal survival and plague-management mechanics into a more cohesive, high-stakes experience.

Darkwood - a new perspective on survival horror. Scavenge and explore a rich, ever-changing free-roam world by day, then hunker down in your hideout and pray for the morning light.

Why similar: Survival 15.6%, Psychological Horror 13.6%, Story Rich 11.7%, Dark 11.6%, Atmospheric 11.1%

Why You'll Like It: This top-down survival horror game excels at creating a suffocating sense of dread and mystery without relying on traditional jump scares.

Only brought to life by scarce sparks of Color, the bleak, grey Void is a peculiar place. The player gets to explore it, get to know the Sisters, Brothers, and other weird creatures inhabiting it, and learn the ways of Color, harvesting it and drawing sigils that change the world around them.

Why similar: Survival 16.9%, Story Rich 14.5%, Dark 12.9%, Atmospheric 12.6%, Difficult 11.5%

Why You'll Like It: Developed by the same studio, this game shares the surreal, oppressive atmosphere and unique resource-management systems that define the Pathologic experience.

Disco Elysium - The Final Cut is a groundbreaking role playing game. You’re a detective with a unique skill system at your disposal and a whole city to carve your path across. Interrogate unforgettable characters, crack murders or take bribes. Become a hero or an absolute disaster of a human being.

Why similar: Story Rich 31.7%, Choices Matter 18.6%, Atmospheric 16.8%, RPG 16.4%, Open World 6.5%

Why You'll Like It: It matches the philosophical depth and complex, text-heavy narrative style of Pathologic while exploring equally dark and existential themes.

Fear & Hunger is a horror dungeon crawler set in the dark and hopeless dungeons of fear and hunger. The game is a hybrid of survival horror and dungeon crawler genres with its influences ranging from Silent Hill to Nethack. There are roguelike elements to the game as well as a heavy foundation of a j-RPG.

Why similar: Psychological Horror 23.1%, Horror 19.2%, Difficult 16.2%, Dark 14.7%, RPG 12.5%

Why You'll Like It: This title captures the same sense of unrelenting, unfair brutality and dark, occult-influenced horror found in the most difficult moments of Pathologic.

Uncover secrets of past lives in this story-rich, tactical roleplaying game set in Sigil, a dark fantasy city at the heart of the Dungeons & Dragons multiverse. Explore the planes, survive combat alongside a party of bizarre companions, and solve puzzles unlike any ever seen in the genre.

Why similar: Classic 24.3% ★, Story Rich 23.4%, Atmospheric 17.8%, RPG 14.2%, Choices Matter 13.6%

Why You'll Like It: It provides a deeply philosophical RPG experience that challenges the player's perception of life, death, and morality.

London, 1918. You are newly-turned Vampyr Dr. Jonathan Reid. As a doctor, you must find a cure to save the city’s flu-ravaged citizens. As a Vampyr, you are cursed to feed on those you vowed to heal.

Why similar: Story Rich 20.3%, Atmospheric 14.6%, Choices Matter 13.6%, Open World 12%, RPG 11.9%

Why You'll Like It: Set in a plague-ridden London, this game forces players to make difficult moral choices that directly affect the survival of the city's inhabitants.

LOSE YOUR MIND. EAT YOUR CREW. DIE. Take the helm of your steamship and set sail for the unknown! Sunless Sea is a game of discovery, loneliness and frequent death, set in the award-winning Victorian Gothic universe of Fallen London.

Why similar: Survival 21.7%, Story Rich 16.1%, Dark 13.7%, Atmospheric 12.1%, Great Soundtrack 11.8%

Why You'll Like It: A dark, narrative-heavy survival game that emphasizes the psychological toll of exploration in a surreal and hostile environment.

Amnesia: The Bunker is a first-person horror game set in a WW1 bunker. A relentless, AI-driven monster stalks you. Survival depends on finding tools, crafting items, and keeping the lights on.

Why similar: Survival 17.1%, Psychological Horror 14%, Atmospheric 12.9%, Difficult 11.8%, Horror 11.4%

Why You'll Like It: This game strips away linear progression in favor of immersive, systemic survival horror where every bullet and resource counts.

Re-discover what made System Shock the first of it's kind, a ground breaking immersive sim that would inspire a generation of games to come....

Why similar: Classic 32.5% ★, Horror 12.7%, Great Soundtrack 10.3%, RPG 8.5%, Atmospheric 8.3%

Why You'll Like It: As a foundational immersive sim, it shares the sense of isolation and environmental storytelling that makes Pathologic so compelling.

A classic survival horror experience set in a dystopian future where humanity has uncovered a dark secret. Unravel a cosmic mystery, escape terrifying creatures, and scavenge an off-world government facility as Elster, a technician Replika searching for her lost dreams.

Why similar: Psychological Horror 39.2%, Atmospheric 28.3%, Dark 23.2%, Adventure 3.7%, Singleplayer 3.4%

Why You'll Like It: A masterclass in psychological horror that uses cryptic storytelling and resource management to build a haunting, unforgettable atmosphere.

The adventure plunges you into the tortured and hidden past of five humans. Delve into their darkest fears. Outwit the Master Computer AM in a game of psychological warfare. Disturbing, compelling. An adventure you won't easily forget !!

Why similar: Classic 28% ★, Psychological Horror 16.7%, Horror 15.8%, Story Rich 12.2%, Dark 9.9%

Why You'll Like It: This classic adventure game explores dark, psychological themes of suffering and morality that resonate with the tone of Pathologic.

This critically acclaimed first-person RPG from Arkane Studios takes the player on an amazing journey into the fantasy world of Arx. Arx is wrought with turmoil, brought to the brink of destruction by a violent war.

Why similar: Classic 29.6% ★, RPG 17.2%, Atmospheric 15.2%, First-Person 13.7%, Story Rich 6.8%

Why You'll Like It: A classic immersive sim that features dark fantasy survival elements and a deep, interconnected world design.

A free-roaming squad based RPG. Focusing on open-ended sandbox gameplay features rather than a linear story. Be a trader, a thief, a rebel, a warlord, an adventurer, a farmer, a slave, or just food for the cannibals. Train your men up from puny victims to master warriors.

Why similar: Survival 46%, Open World 28.2%, RPG 17.7%, Singleplayer 3%, Adventure 2.9%

Why You'll Like It: A brutal, unforgiving sandbox survival RPG where the world is indifferent to your existence and every victory is hard-earned.

Surrounded by enemies and assaulted by terror from all sides, Philip must collect clues and solve vexing puzzles while combating the gnawing psychological terrors that assail his mind and threaten to strip him of his sanity.

Why similar: Horror 18.8%, Psychological Horror 16.6%, Story Rich 11.3%, Atmospheric 10.8%, First-Person 9.4%

Why You'll Like It: A first-person horror game that focuses on physics-based puzzles and a sense of vulnerability rather than combat.

Trapped in a dark, Victorian city consumed by an ancient curse, you must plan your survival and daring escape using nothing but stealth, an arsenal of eccentric weapons, and your wit in this haunting adventure inspired by the immersive sims and survival horror greats of the late 90s and early 2000s.

Why similar: Atmospheric 32%, Dark 24.1%, First-Person 21%, Immersive Sim 16.1%, Singleplayer 4.4%

Why You'll Like It: An immersive sim that captures a dark, Victorian-era aesthetic while emphasizing stealth and careful navigation through a hostile city.

Play as special agent Francis York Morgan in this open-world action-adventure as you solve the case of the Red Seed Murders and survive in a small, quirky American mountain town where supernatural creatures and a mysterious raincoat-clad, axe-wielding killer seek to end his investigation for good.

Why similar: Story Rich 24.4%, Great Soundtrack 22.7%, Horror 17%, Open World 12.1%, Atmospheric 8.8%

Why You'll Like It: It features a unique, surreal, and deeply atmospheric mystery that feels like a strange, small-town counterpart to the plague-stricken town of Pathologic.

An immersive power fantasy simulator with tactical stealth elements set in a sewage infused garbage world

Why similar: Psychological Horror 48.4%, First-Person 20.3%, Immersive Sim 16.4%, Surreal 12%, Action 2.9%

Why You'll Like It: A surreal, mechanically dense, and intentionally oppressive immersive sim that challenges the player's comfort zone in a way few games dare.

INFRA puts you into the boots of a structural analyst on a routine mission. Quickly though, your task turns into a fight for survival, all caused by deep-rooted schemes of the past. Your tools are simple: your camera and the wits to navigate a labyrinth of debris.

Why similar: Atmospheric 19.3%, Great Soundtrack 15%, Walking Simulator 14.1%, Story Rich 13.7%, First-Person 11%

Why You'll Like It: A slow-paced, atmospheric exploration game that focuses on the decay of infrastructure and the stories hidden within abandoned places.

The Beast Inside is a unique, gripping twist on thriller and survival horror. Immerse in the story of long-buried secrets, personal tragedies, and madness. Play as two protagonists bounded by dark heritage. Combat the enemies, solve riddles and experience real terror in the 3D-scanned environment.

Why similar: Horror 21.8%, Survival 13.2%, Psychological Horror 12.7%, Story Rich 10.6%, First-Person 8.4%

Why You'll Like It: A first-person horror adventure that blends historical mystery with psychological tension.

Roleplaying in the ruins of interplanetary capitalism. Live the life of an escaped worker, washed-up on a lawless station at the edge of an interstellar society. Inspired by the flexibility and freedom of TTRPGs, explore the station, choose your friends, escape your past and change your future.

Why similar: Story Rich 38.4%, Atmospheric 30.1%, RPG 19.6%, Adventure 6.4%, Indie 5.5%

Why You'll Like It: A narrative-driven survival game set on a decaying space station that emphasizes the struggle to maintain humanity in an oppressive system.

In this psychological horror game, you are a doctor with only 12 days to save a town from a mysterious plague. Make ruthless decisions and diagnose with precision. Shape the town's future and rewrite the past. Hold yourself together while it all falls apart.

Why similar: Psychological Horror 18.7%, Horror 12.3%, Story Rich 11.9%, Survival 10.9%, Atmospheric 10.7%

In Rise of Insanity, as a doctor of psychology you will explore the darkest recesses of the human mind. Overcome your fear to find the truth behind the tragedy that has befallen your family.

Why similar: Psychological Horror 16.8%, Great Soundtrack 13.7%, Horror 13.6%, Atmospheric 10.9%, Walking Simulator 10.4%

Why You'll Like It: A psychological horror game that delves into the fractured mind of its protagonist within a dark, simulation-heavy setting.

Empathy: Path of Whispers is an atmospheric and story-driven adventure game where you explore a seemingly abandoned world through the emotions and memories of the people who once inhabited it, trying to restore the world’s lost balance by journeying through its past.

Why similar: Great Soundtrack 26.5%, Story Rich 21.6%, Atmospheric 18.4%, Walking Simulator 14.6%, Adventure 7.9%

Why You'll Like It: A story-rich, atmospheric adventure that focuses on exploring the memories and emotions of a forgotten world.

UnderRail is an old-school turn-based isometric role-playing game that features a large open post-apocalyptic world, deep and challenging combat and an intricate storyline.

Why similar: RPG 39.2%, Atmospheric 20.5%, Open World 14.2%, Difficult 13.8%, Indie 5.2%

Why You'll Like It: A hardcore, dark, post-apocalyptic RPG that demands careful planning and resource management to survive its hostile underground world.

A horror game about claustrophobia. During a storm your service dog is forced down a broken sewer drain. You find the nearest sewer entrance and run in after it. Along the way you will meet others that are also stricken by abnormal or psychological fear.

Why similar: Psychological Horror 23.2%, Great Soundtrack 17.3%, Atmospheric 16.6%, Horror 15.3%, Survival 12.9%

Why You'll Like It: A surreal psychological horror experience that excels at creating a claustrophobic, dreamlike atmosphere.

The Initiate is a mystery puzzle game. You awake in a house full of traps and puzzles - This is your trial; complete it, or die!

Why similar: Great Soundtrack 20.2%, Atmospheric 16.9%, Psychological Horror 15.3%, Story Rich 14.6%, Horror 13.3%

Why You'll Like It: A puzzle-heavy horror game that traps the player in a mysterious, hostile environment where observation is key to survival.

Penumbra: Overture is a first person survival horror game, emphasizing on survival and problem solving instead of mindless violence and gore.

Why similar: Horror 23.6%, Psychological Horror 14.8%, Atmospheric 12.4%, First-Person 10%, Story Rich 9.8%

An orphan returns to the house of the deceased fortune-teller to uncover the secret of his family's death. He must accept his legacy and become a prognostic before supernatural madness engulfs people of his town.

Why similar: Story Rich 16.4%, Horror 13.4%, Atmospheric 11.3%, Walking Simulator 10.3%, First-Person 9.8%

Moscow: somewhere in the near future. The city and perhaps the Earth's surface has turned into a radioactive ash. Those who decided that they could not exist in such conditions began to live under the ground.

Why similar: Story Rich 19.7%, Classic 15.8% ★, Great Soundtrack 15.8%, Atmospheric 12%, Survival 10.5%

Motherland (A sad fairytale for adults) is an indie-game that allows you to immerse in the atmosphere of a provincial town during the epidemic.

Why similar: Atmospheric 14.4%, Psychological Horror 14.1%, Walking Simulator 12.9%, Story Rich 11.8%, Horror 10.7%

"The Last Visit: 98th" is a psychological indie horror from the first person, in the genre of a walking simulator, in the setting of the post-Soviet winter space. The main focus is on the atmosphere of horror, which is emphasized by realistic 3D graphics.

Why similar: Psychological Horror 18.4%, Atmospheric 15.6%, Horror 14.4%, Dark 13.4%, Walking Simulator 11.7%

Dive into a hostile world that challenges your very existence, in this survival horror game with RPG elements. Unravel a thousand-year-old mystery, risk your sanity and face the Outer Gods with your skills. Every bullet and every decision counts now, are you up to the task?

Why similar: Survival 14.7%, Psychological Horror 13.8%, Story Rich 12.4%, Dark 11.5%, Atmospheric 10.6%

Grab your headphones and play one of the most atmospheric horror games on Steam!

Why similar: Horror 14.9%, Classic 13.6% ★, Psychological Horror 13.4%, Survival 11.4%, Atmospheric 9.6%

Doorways: Holy Mountains of Flesh is an Immersive Horror Adventure, featuring a Complex Story and Deep Atmosphere.

Why similar: Survival 14.6%, Psychological Horror 13.3%, Horror 10.9%, Dark 10.5%, Difficult 10.4%

Husk is a purebred FPP horror inspired by the most classical representatives of the genre. Discover Shivercliff - a daunting town where you uncover the ominous and tantalizing plot. Face the worst nightmares, solve mysteries and survive the devouring darkness in order to find your family.

Why similar: Psychological Horror 14.8%, Atmospheric 13.7%, Horror 12.2%, Walking Simulator 11.3%, Story Rich 11.2%

A third‑person psychological horror game where you explore both the real world and the spirit realm. As a medium drawn to a deserted resort, you’ll uncover dark secrets, confront echoes of trauma, and face the consequences of seeing more than one truth.

Why similar: Psychological Horror 17.2%, Horror 14.9%, Atmospheric 13.4%, Great Soundtrack 12%, Story Rich 11.9%

Follow the grim tale of young Amicia and her little brother Hugo, in a heartrending journey through the darkest hours of history.

Why similar: Story Rich 29%, Atmospheric 16.4%, Great Soundtrack 14.6%, Dark 10.9%, Survival 9.6%

A Dark Presence stalks the small town of Bright Falls, pushing Alan Wake to the brink of sanity in his fight to unravel the mystery and save his love.

Why similar: Story Rich 19.2%, Horror 17.7%, Atmospheric 15.5%, Psychological Horror 15.2%, Great Soundtrack 13.5%

Your main task is to find out who is involved in the spread and experiment on the "E" virus - Ebola, you need to stop the spread of the virus, and at the same time survive yourself! Millions of people may die.

Why similar: Survival 15.5%, Psychological Horror 15.1%, Atmospheric 13.7%, Horror 12.1%, Story Rich 10.2%

Caligo is the darkness everyone descends into one way or another, and to each of us it's something different. For some it's a short but exciting adventure, some will see it as a place to relax. Yet others will be reminded of their worst nightmare, while for a few, it might come as a revelation.

Why similar: Great Soundtrack 17.7%, Walking Simulator 14.1%, Atmospheric 12.8%, Story Rich 11.2%, Psychological Horror 10.1%

Doorways is an immersive horror adventure, featuring a complex story and deep atmosphere.

Why similar: Horror 25.5%, Survival 12.9%, Dark 10.8%, Atmospheric 10.4%, First-Person 8.6%

Plague: London 1665 is an RPG with pixel art graphics set in 1665's during the Bubonic Plague outbreak in overcrowded and polluted London. As a body collector, graveyard keeper, and family provider, avoid the disease while clearing the streets. Will you survive the outbreak or become another victim?

Why similar: RPG 27.3%, Story Rich 22.9%, Choices Matter 20%, Atmospheric 16.9%, Adventure 7%

1924. Private Investigator Pierce is sent to look into the tragic death of the Hawkins family. Plunge into a world of creeping madness and cosmic horror. Cryptic clues, shadowy figures, and pure terror bar your way as you fight to retain your sanity and solve an otherworldly mystery.

Why similar: Psychological Horror 19.9%, Horror 16.3%, Story Rich 15.5%, Atmospheric 14.9%, First-Person 7.1%

Smuggle contraband VHS tapes across the border. Discover the remnants of illicit industry. Prepare for an assassination. This is Paratopic, an atmospheric retro-3D horror adventure through a cursed fever dream.

Why similar: Horror 18.1%, Great Soundtrack 17.9%, Atmospheric 16.4%, Psychological Horror 14.5%, Dark 8.4%

Visage is a first-person psychological horror game. Explore a mysterious ever-changing house in a slow-paced, atmospheric world that combines both uncannily comforting and horrifyingly realistic environments, and enjoy a genuinely terrifying experience.

Why similar: Psychological Horror 28.1%, Horror 26.2%, Dark 13%, Atmospheric 9%, First-Person 7.5%

Mind-altering sandbox game that can be described as a racing role-playing adventure game with a complicated storyline. You’ll find a unique atmosphere, complete freedom and lots of gameplay hours to figure out what’s the game is all about.

Why similar: Classic 23.6% ★, Atmospheric 13.8%, Great Soundtrack 12.9%, Story Rich 11%, Psychological Horror 10.1%

Fran Bow is a creepy adventure game that tells the story of Fran, a young girl struggling with a mental disorder and an unfair destiny.

Why similar: Psychological Horror 28.7%, Story Rich 19.2%, Horror 12.9%, Dark 12.4%, Atmospheric 9.7%

One-Eyed Likho is a grim first-person horror adventure set in a world inspired by a dark, Slavic fairy tale. Explore an unsettling and twisted land set in 19th-century Russia in your endeavor to escape your own evil fate.

Why similar: Psychological Horror 19.5%, Atmospheric 19.1%, Horror 18%, Walking Simulator 17.2%, Story Rich 16.2%

The Last Plague: Blight is an authentic survival experience rooted in realism and immersion. Endure the hazards of a brutal open world and uncover the origins of a mysterious disease. You are humanity’s final hope in ending the Blight

Why similar: Survival 37.9%, Difficult 19.1%, Dark 18.6%, Atmospheric 16.1%, Adventure 3.5%

Psychological single-player first-person horror. Explore dark environments, fight with melee and guns, and solve puzzles in this retro 2000s-inspired nightmare where the truth is more terrifying than the monsters.

Why similar: Psychological Horror 19.4%, Atmospheric 14.7%, Dark 13.6%, Story Rich 12.5%, Horror 11.4%

Delve into a role-playing game of horror, loss and madness set in the strange worlds of HP Lovecraft. Stygian: Reign of the Old Ones offers a mix of rich role-playing and turn-based tactical combat, represented in an illustrative visual style. Can you find salvation in a dead world?

Why similar: RPG 22.2%, Horror 20.4%, Atmospheric 15.1%, Story Rich 12.6%, Great Soundtrack 12.5%

A 1–4 player co-op horror game. Cleanse cursed lands, perform forbidden rituals, and survive a spreading plague. Fear is not scripted. It emerges from your choices, your mistakes, and your team.

Why similar: Psychological Horror 23.9%, Atmospheric 20.2%, Dark 17.5%, Horror 17.5%, Story Rich 13%

A 3rd person, fixed-camera survival horror adventure. Fear the Presence, a mysterious entity you cannot fight: stay alert, hide, breathe slowly... Explore cursed places where unseen spirits and lost souls linger in a true horror story for the ages.

Why similar: Psychological Horror 19.3%, Dark 16.7%, Atmospheric 14.9%, Horror 13.4%, Story Rich 11.2%

In this original and adult psychological survival horror, the masked protagonist must escape from a city ravaged by disease, by any means necessary.

Why similar: Horror 24.3%, Atmospheric 16.4%, Great Soundtrack 14.1%, Psychological Horror 11.2%, Dark 9%