- #1 Two Point Campus
97% matchVery Positive88% of 7,953 reviews2022
Dev: Two Point StudiosPub: SEGA
Windows · Mac · Linux
Median: 5.5 hrsMean: 19.7 hrs≥1hr: 84%
Build the university of your dreams with Two Point Campus, the sim with a twist from the makers of Two Point Hospital. Build, hire staff and run an academic institution packed with wild courses.
Why similar: Management 29.4%, Building 20.2%, Simulation 13.5%, Sandbox 7.3%, City Builder 7.3%
Why You'll Like It: It is the closest match overall, taking the same room-building, staff-management, and comedic scenario structure from Two Point Hospital and applying it to a university.
- #2 Two Point Museum
96% matchOverwhelmingly Positive95% of 12,347 reviews2025
Dev: Two Point StudiosPub: SEGA
Windows · Mac · Linux
Median: 9.0 hrsMean: 25.8 hrs≥1hr: 88%
Curate and manage incredible museums! Explore to discover amazing artifacts. Design and refine the layout, keep staff happy, guests entertained, donations plentiful… and children off the exhibits
Why similar: Building 23.6%, Management 20%, Simulation 16.3%, City Builder 9.2%, Sandbox 9.1%
Why You'll Like It: From the same series, it keeps the same accessible management formula of specialized rooms, quirky visitors, and objective-driven expansion in a new setting.
- #3 Project Hospital
96% matchVery Positive89% of 9,182 reviews2018
Dev: Oxymoron Games
Windows · Mac · Linux
Median: 4.4 hrsMean: 24.4 hrs≥1hr: 80%
Become an ace doctor, an aspiring architect and a successful manager at the same time. Design your very own hospital, tweak every detail or choose one of the prebuilt scenarios and just jump to the doctor’s duty.
Why similar: Medical Sim 54.2% ★, Management 15.4%, Building 9.6%, Simulation 7.1%, City Builder 5.4%
Why You'll Like It: This is the best serious hospital-management counterpart, with deep department planning, diagnosis chains, and staff scheduling that mirror the core hospital sim appeal.
- #4 Planet Coaster
94% matchVery Positive91% of 71,870 reviews2016
Dev: Frontier Developments
Windows · Mac
Median: 4.2 hrsMean: 22.1 hrs≥1hr: 77%
Planet Coaster® - the future of coaster park simulation games has arrived! Surprise, delight and thrill incredible crowds as you build your coaster park empire - let your imagination run wild, and share your success with the world.
Why similar: Building 28.3%, Management 27.3%, Simulation 18%, Sandbox 10%, Funny 5.1%
Why You'll Like It: It shares the same satisfying pattern of building attractive facilities, managing employees, and optimizing guest flow in a polished, cheerful sim.
- #5 Galacticare
94% matchVery Positive87% of 639 reviews2024
Dev: Brightrock GamesPub: Mythwright
Windows
Median: 6.0 hrsMean: 12.6 hrs≥1hr: 95%
Build, manage and optimise intergalactic hospitals! Recruit staff to satisfy the whims of various alien species, and cure their bizarre illnesses - for money! Save the (literal) Galaxy in story mode, or head into sandbox to design the hospital of your dreams.
Why similar: Medical Sim 54.9% ★, Management 15.4%, Building 13.4%, Simulation 7.8%, Funny 4.7%
Why You'll Like It: It delivers a similarly humorous hospital-management loop with room placement, staff oversight, and strange patients, just in a sci-fi setting.
- #6 Planet Zoo
93% matchVery Positive91% of 95,209 reviews2019
Dev: Frontier Developments
Windows
Median: 6.4 hrsMean: 34.5 hrs≥1hr: 84%
Build a world for wildlife in Planet Zoo. From the developers of Planet Coaster and Zoo Tycoon comes the ultimate zoo sim. Construct detailed habitats, manage your zoo, and meet authentic living animals who think, feel and explore the world you create around them.
Why similar: Management 34.5%, Building 24.4%, Simulation 16.8%, Sandbox 9.9%, City Builder 7.5%
Why You'll Like It: Its blend of detailed building, staff logistics, and visitor satisfaction makes it a great fit if you love Two Point Hospital's management rhythm but want a new theme.
- #7 Parkitect
92% matchVery Positive94% of 8,067 reviews2018
Dev: Texel Raptor
Windows · Mac · Linux
Median: 4.8 hrsMean: 18.2 hrs≥1hr: 86%
Parkitect is a business simulation game that charges you with the construction and management of theme parks! Bringing back the best of classic theme park games with many new features and content on top. Now supports online co-op with up to 8 players!
Why similar: Management 28.1%, Building 24%, Simulation 14.6%, Sandbox 8.3%, City Builder 7.8%
Why You'll Like It: It emphasizes smart layout design, behind-the-scenes logistics, and efficient visitor flow much like optimizing wards and treatment rooms in a hospital.
- #8 Let's School
91% matchVery Positive93% of 7,275 reviews2023
Dev: Pathea Games
Windows
Median: 4.4 hrsMean: 14.6 hrs≥1hr: 83%
Dive into the exhilarating role of a headmaster entrusted to revive your alma mater! Beyond just bricks and mortar, train teachers, recruit students. Sculpt your school into a unique educational haven! Let's School!
Why similar: Medical Sim 41.6% ★, Management 16.2%, Building 11.4%, Simulation 7.5%, Sandbox 5.6%
Why You'll Like It: Its room-based campus construction, staff hiring, and student-need management feel very close to Two Point's clear, objective-led design.
- #9 Prison Architect
91% matchVery Positive89% of 73,449 reviews2015
Dev: Introversion SoftwarePub: Paradox Interactive
Windows · Mac · Linux
Median: 6.0 hrsMean: 30.3 hrs≥1hr: 87%
Only the world’s most ruthless Warden can contain the world’s most ruthless inmates. Design and develop your personalized penitentiary in Prison Architect.
Why similar: Management 26.4%, Building 25.1%, Simulation 15.6%, Sandbox 10.9%, City Builder 8.8%
Why You'll Like It: Its room placement, staff deployment, and constant logistics troubleshooting create a similarly readable and addictive management sandbox.
- #10 Megaquarium
90% matchOverwhelmingly Positive95% of 3,709 reviews2018
Dev: Twice Circled
Windows · Mac · Linux
Median: 2.5 hrsMean: 15.1 hrs≥1hr: 67%
The public aquarium simulator. Design your displays, look after your fish, manage your staff and keep your guests happy! It's all in a day's work as the curator of your very own Megaquarium.
Why similar: Management 31.6%, Building 28.9%, Simulation 17.8%, Sandbox 12.6%, Strategy 2.7%
Why You'll Like It: Building specialized exhibits, hiring staff, and balancing guest needs gives it a very similar scenario-based management feel.
- #11 Rescue HQ - The Tycoon
89% matchMostly Positive79% of 922 reviews2019
Dev: stillalive studiosPub: Aerosoft GmbH
Windows
Median: 3.9 hrsMean: 15.3 hrs≥1hr: 86%
Build up your headquarters from scratch and design your own masterpiece. In Rescue HQ you build, organize and manage a joint station for firefighters, police and ambulance. Manage your resources wisely and master challenging emergencies to keep your city safe! Are you up to the challenge?
Why similar: Management 23.7%, Building 17.8%, Simulation 14.1%, Sandbox 7.8%, Comedy 7.7%
Why You'll Like It: Running a police, fire, and ambulance headquarters offers the same kind of modular building, staffing, and service-efficiency gameplay.
- #12 Project Highrise
89% matchVery Positive85% of 4,778 reviews2016
Dev: SomaSimPub: Kasedo Games
Windows · Mac
Median: 8.7 hrsMean: 32.1 hrs≥1hr: 85%
Project Highrise is a skyscraper construction and management sim...
Why similar: Management 37.6%, Building 27.4%, Simulation 19.2%, Sandbox 5.6%, Strategy 5.5%
Why You'll Like It: It scratches the same design-and-operate itch through floorplan planning, service routing, and keeping a complex building running smoothly.
- #13 Jurassic World Evolution 2
86% matchVery Positive90% of 46,323 reviews2021
Dev: Frontier Developments
Windows
Median: 4.9 hrsMean: 22.6 hrs≥1hr: 83%
Jurassic World Evolution 2 is the much-anticipated sequel to Frontier’s highly successful Jurassic World Evolution. This bold new era in the Jurassic World Evolution game franchise builds upon the ground-breaking and immersive 2018 management simulation.
Why similar: Management 30.3%, Building 29.3%, Simulation 15.4%, Sandbox 11.3%, City Builder 7.1%
Why You'll Like It: This combines attractive facility building, specialist staff, and crisis management in a polished, objective-driven tycoon structure.
- #14 Little Big Workshop
87% matchVery Positive84% of 3,377 reviews2019
Dev: Mirage Game StudiosPub: HandyGames
Windows · Mac
Median: 4.3 hrsMean: 8.1 hrs≥1hr: 88%
Manage your workers, stations, machines and create awesome stuff as your little big workshop grows into your dream factory!
Why similar: Management 28.8%, Simulation 27%, Building 21.3%, Strategy 8.2%, Sandbox 6.9%
Why You'll Like It: This focuses on arranging workspaces, managing employees, and optimizing production in a charming, accessible management format.
- #15 Big Pharma
88% matchMostly Positive77% of 1,931 reviews2015
Dev: Twice CircledPub: Positech Games
Windows · Mac · Linux
Median: 5.8 hrsMean: 9.5 hrs≥1hr: 85%
What if you had it in your power to rid the world of disease, to improve the lives of millions, to ease suffering and cure the sick… and earn a tidy profit? As the head of your own Pharmaceutical Conglomerate you have this power resting in your hands. Will you use it for good?
Why similar: Medical Sim 55.7% ★, Management 19.1%, Simulation 8.5%, Building 6.6%, Sandbox 3.4%
Why You'll Like It: It keeps the medical theme and replaces hospital rooms with production-chain optimization, making it a strong fit for players who liked the management side most.
- #16 Planet Coaster 2
84% matchMostly Positive73% of 13,500 reviews2024
Dev: Frontier Developments
Windows
Median: 6.1 hrsMean: 32.8 hrs≥1hr: 86%
Build and customise thrilling roller coasters and incredible water slides, manage the ultimate theme park experience, and share your epic creations. Are you ready to ride the wave?
Why similar: Building 27.6%, Simulation 21.4%, Management 16.7%, Sandbox 13%, City Builder 9.8%
Why You'll Like It: It expands the same polished park-management formula with even more building tools while keeping the strong build-manage-optimize loop.
- #17 Evil Genius 2: World Domination
86% matchMixed69% of 13,142 reviews2021
Dev: Rebellion
Windows
Median: 4.9 hrsMean: 20.1 hrs≥1hr: 86%
A satirical spy-fi lair builder where YOU are the criminal mastermind! Construct your base, train your minions, defend your operations from the Forces of Justice, and achieve global domination!
Why similar: Management 30.2%, Building 27.7%, Simulation 19.8%, Strategy 9.5%, Sandbox 7.1%
Why You'll Like It: It mixes playful presentation with specialized rooms, worker management, and balancing a busy facility full of bottlenecks.
- #18 Academia : School Simulator
85% matchVery Positive86% of 3,034 reviews2021
Dev: Squeaky Wheel Studio IncPub: Paradox Interactive
Windows · Mac
Median: 7.2 hrsMean: 12.0 hrs≥1hr: 85%
Design, build, and manage a high school with terrific teachers and fantastic facilities or simply let your students poop in the bushes? Academia : School Simulator is a management/tycoon game where you get to decide!
Why similar: Management 31.1%, Building 22.8%, Simulation 13.7%, City Builder 10.4%, Sandbox 9.4%
Why You'll Like It: Designing a school around room placement, staff needs, and student flow gives it a very similar institutional-management appeal.
- #19 Game Dev Tycoon
83% matchOverwhelmingly Positive95% of 44,908 reviews2013
Dev: Greenheart Games 💚
Windows · Mac · Linux
Median: 8.0 hrsMean: 15.4 hrs≥1hr: 94%
In Game Dev Tycoon you replay the history of the gaming industry by starting your own video game development company in the 80s. Create best selling games. Research new technologies and invent new game types. Become the leader of the market and gain worldwide fans.
Why similar: Management 56.9%, Simulation 27.4%, Strategy 4.7%, Sandbox 3%, Indie 2.1%
Why You'll Like It: It captures a similar accessible management cadence of balancing staff, research, and growth across a structured campaign.
- #20 Parkasaurus
82% matchVery Positive93% of 3,105 reviews2020
Dev: Washbear Studio
Windows
Median: 3.2 hrsMean: 6.1 hrs≥1hr: 80%
Parkasaurus is a dinosaur tycoon management simulation where you take care of your dinosaurs by constructing well-designed exhibits, researching specialized technologies, and maximizing profits to expand into the ultimate dinosaur theme park. Do you favor development for guests or your dinosaurs?
Why similar: Management 28.2%, Building 21.9%, Simulation 12.7%, City Builder 9.7%, Sandbox 8.4%
Why You'll Like It: Its bright tone, exhibit design, and guest-service management make it a strong tonal and mechanical cousin to Two Point's playful sim style.
- #21 Tavern Master
82% matchVery Positive92% of 13,034 reviews2021
Dev: Untitled Studio
Windows · Mac · Linux
Median: 7.9 hrsMean: 11.7 hrs≥1hr: 86%
Tavern Master is all about managing your medieval tavern. You start with a very small room, couple of benches and tables and build your way up to a huge successful tavern with a kitchen, rooms for guests, group of loyal staff and much more!
Why similar: Management 41.7%, Building 28.8%, Simulation 18.3%, City Builder 5.2%, Strategy 3.8%
Why You'll Like It: Expanding rooms, hiring staff, and keeping customers moving efficiently gives it a similarly approachable management loop.
- #22 Spacebase Startopia
84% matchMixed56% of 652 reviews2021
Dev: Realmforge StudiosPub: Kalypso Media
Windows · Mac · Linux
Median: 3.4 hrsMean: 5.9 hrs≥1hr: 88%
Spacebase Startopia captivates with its original mixture of economic simulation and empire building strategy paired with classic RTS skirmishes and a good dose of humor.
Why similar: Management 23.7%, Simulation 20.6%, Building 16.9%, City Builder 8.9%, Sandbox 8.8%
Why You'll Like It: Its comedic tone, layered departments, and constant juggling of visitor needs and operational efficiency feel very compatible with Two Point Hospital fans.
- #23 Mind Over Magic
79% matchVery Positive87% of 4,397 reviews2025
Dev: SparkypantsPub: Klei Publishing
Windows
Median: 4.6 hrsMean: 20.6 hrs≥1hr: 78%
Mind Over Magic is a colony sim set at the site of a cursed magic school. Build and optimize your own magical academy, train powerful Mages, and master mighty relics in order to battle through the Underschool, a mysterious underground dungeon that holds the key to liberation from a deadly curse.
Why similar: Management 40.3%, Building 36%, Simulation 19.6%, Singleplayer 2.3%, Indie 1.8%
Why You'll Like It: Its magical school-building, room synergies, and personnel management feel like a darker but still highly compatible spin on the same formula.
- #24 SimAirport
81% matchMostly Positive79% of 4,027 reviews2020
Dev: LVGameDev LLC
Windows · Mac · Linux
Median: 5.5 hrsMean: 21.2 hrs≥1hr: 85%
Build & Manage Your Airport. An International Hub or a Regional Masterpiece -- it's up to you. Buy more land to scale out, or escalators to scale up with MULTIPLE FLOORS. You're in full control in this modern business management tycoon!
Why similar: Management 30.2%, Building 25.1%, Simulation 13.3%, City Builder 11.2%, Sandbox 10.8%
Why You'll Like It: Like Two Point Hospital, it turns building design and service bottlenecks into a satisfying optimization puzzle centered on people flow.
- #25 Spellcaster University
81% matchVery Positive83% of 4,264 reviews2021
Dev: Sneaky Yak Studio
Windows · Mac
Median: 4.5 hrsMean: 7.5 hrs≥1hr: 86%
Develop a prestigious university of mages. Build rooms, train your students, fight orcs, slay the bureaucrats, manage your budget... a director's life is not a quiet one.
Why similar: Management 47.9%, Simulation 27.2%, Funny 9.3%, Strategy 6.2%, Cartoony 4%
Why You'll Like It: Growing a whimsical school through room choices, staff management, and student needs captures a lot of the same light-strategy appeal.
- #26 Airport CEO
80% matchVery Positive83% of 8,240 reviews2021
Dev: Apog Labs
Windows · Mac
Median: 6.6 hrsMean: 26.6 hrs≥1hr: 72%
Build and manage an international airport!
Why similar: Management 32.2%, Building 25.3%, Simulation 15.8%, Sandbox 10.9%, City Builder 8.7%
Why You'll Like It: It is less comedic, but the emphasis on layout planning, traffic flow, staffing, and smooth operations makes it a strong mechanical match.
- #27 Honey, I Joined a Cult
79% matchMostly Positive73% of 1,907 reviews2022
Dev: Sole Survivor GamesPub: Team17
Windows
Median: 2.6 hrsMean: 5.8 hrs≥1hr: 79%
It's time to start working towards that ultimate goal of enlightenment, faith and money…lots and lots of money! Become the ultimate tycoon - create, customise, and manage your own cult whilst listening to funky music. Welcome to Honey, I Joined a Cult!
Why similar: Management 31.1%, Building 20.5%, Simulation 16.7%, Sandbox 10.8%, Funny 7.6%
Why You'll Like It: This offers quirky humor, room-based base building, and staff/visitor management in a very playful tycoon package.
- #28 Cat Cafe Manager
78% matchVery Positive88% of 3,151 reviews2022
Dev: Roost GamesPub: indie.io
Windows
Median: 4.9 hrsMean: 16.3 hrs≥1hr: 76%
Travel to the sleepy village of Caterwaul Way and rebuild your grandmother's cat cafe. Renovate your restaurant, befriend the local cats and townsfolk, forge lasting friendships, unravel catty mysteries, and build a home for dozens of unique felines!
Why similar: Management 38.4%, Building 29.4%, Simulation 20.1%, Strategy 6.9%, Cartoony 3.3%
Why You'll Like It: Smaller in scale but still rewarding, it revolves around arranging spaces, hiring workers, and meeting varied customer needs with a cozy charm.
- #29 Fable Hospital
77% matchMostly Positive74% of 88 reviews2025
Dev: AMGames TC
Windows
Fable Hospital is a medieval hospital management simulator with a touch of fantasy and humor. Cure hilarious diseases, manage an eccentric team, and gather resources in a world full of satire and fun.
Why similar: Medical Sim 54% ★, Management 14.2%, Simulation 8.7%, Building 7.6%, Sandbox 5.5%
- #30 Hotel Architect
75% matchVery Positive94% of 1,906 reviews2026
Dev: Pathos InteractivePub: Wired Productions
Windows
Median: 7.2 hrsMean: 14.7 hrs≥1hr: 80%
Step into the shoes of a hotel owner as you design, build, and manage grand hotels around the world. Juggle demanding guests, frantic logistics, and plenty of unexpected surprises in Hotel Architect; the ultimate hotel construction and tycoon management game!
Why similar: Management 25.8%, Building 21.9%, Simulation 13.7%, Sandbox 9.9%, City Builder 9.4%
- #31 Recipe for Disaster
78% matchMostly Positive71% of 719 reviews2022
Dev: Dapper Penguin StudiosPub: Kasedo Games
Windows
Median: 1.5 hrsMean: 6.9 hrs≥1hr: 61%
Recipe for Disaster is a management sim that captures the fast-paced, drama-filled environment of a professional kitchen and dining room. Build your dream restaurant, create recipes, design menus and manage your staff, all while contending with demanding customers and disastrous situations!
Why similar: Management 40%, Building 25.8%, Simulation 18%, Sandbox 5.8%, Strategy 4%
Why You'll Like It: Its focus on layout, staff traits, and service-chain bottlenecks mirrors the same kind of systems-driven chaos that makes Two Point Hospital fun.
- #32 Cities: Skylines
76% matchVery Positive93% of 289,591 reviews2015
Dev: Colossal OrderPub: Paradox Interactive
Windows · Mac · Linux
Median: 10.0 hrsMean: 65.5 hrs≥1hr: 87%
Cities: Skylines is a modern take on the classic city simulation. The game introduces new game play elements to realize the thrill and hardships of creating and maintaining a real city whilst expanding on some well-established tropes of the city building experience.
Why similar: Building 25.3%, Management 24.2%, Simulation 17.7%, City Builder 17.5%, Sandbox 8.1%
- #33 The Tenants
76% matchMostly Positive79% of 7,729 reviews2022
Dev: EndGameLoop Games
Windows
Median: 3.7 hrsMean: 11.2 hrs≥1hr: 84%
Become a landlord and deal with problematic tenants as you build your rental property empire. Decide how to react to annoyed neighbors or police interventions. Will you design your apartment for a group of gamer friends or an aspiring musician looking for a new home?
Why similar: Management 34.6%, Building 26.3%, City Builder 11.3%, Simulation 11.2%, Sandbox 10.4%
- #34 Fun Hospital
77% matchMixed64% of 600 reviews2018
Dev: OrangesGame Technology Limited
Windows · Mac
Median: 1.2 hrsMean: 32.8 hrs≥1hr: 52%
Build your own theme hospital! Here, you might meet patients with a lot of hair, or no hair; strange aliens, evil guy, super hero…
Why similar: Medical Sim 74.4% ★, Simulation 16.3%, Strategy 5.8%, Indie 1.8%, Casual 1.7%
- #35 Tropico 6
74% matchVery Positive88% of 29,117 reviews2019
Dev: Limbic EntertainmentPub: Kalypso Media
Windows · Mac · Linux
Median: 5.6 hrsMean: 27.0 hrs≥1hr: 88%
El Presidente is back! Prove yourself once again as a feared dictator or peace-loving statesman on the island state of Tropico and shape the fate of your very own banana republic through four distinctive eras.
Why similar: Management 29.9%, Simulation 18.3%, City Builder 16.3%, Building 13.6%, Sandbox 8.1%
- #36 PC Building Simulator
74% matchVery Positive94% of 52,550 reviews2019
Dev: Claudiu KissPub: The Irregular Corporation
Windows
Median: 4.8 hrsMean: 38.5 hrs≥1hr: 86%
Build and grow your very own computer repair enterprise as you learn to diagnose, fix and build PCs. With real-world licensed components and comprehensive hardware and software simulation, you can plan and bring your ultimate PC to life.
Why similar: Building 27.3%, Simulation 26.7%, Management 26.4%, Sandbox 9.7%, Funny 6%
- #37 Arcade Tycoon ™ : Simulation Game
73% matchVery Positive82% of 542 reviews2021
Dev: Squidpunch StudiosPub: Vincent Ltd
Windows
Median: 1.5 hrsMean: 4.9 hrs≥1hr: 62%
Build stunning Arcade Centre’s, purchase a range of arcades machines, manage troublesome staff in this colourful and humorous simulation management game. Inspired by Two Point Hospital, Let's Build A Zoo and Megaquarium.
Why similar: Management 26.5%, Building 21.3%, Simulation 13.3%, Sandbox 9.2%, City Builder 9.1%
- #38 Doctor Dash ASMR Hospital
72% matchVery Positive89% of 95 reviews2024
Dev: Friedegggames OUPub: Brightika, Inc.
Windows
💊 Your dream hospital awaits! 🏥❤️ Addictive levels and unique locations ✈️ Hours of entertainment in the time-management genre ⏰
Why similar: Medical Sim 68.1% ★, Management 15%, Simulation 13.8%, Casual 1.6%, Singleplayer 0.9%
- #39 Jurassic World Evolution
73% matchVery Positive87% of 55,085 reviews2018
Dev: Frontier Developments
Windows
Median: 7.3 hrsMean: 28.4 hrs≥1hr: 89%
Place yourself at the heart of the Jurassic franchise and build your own Jurassic World. Bioengineer dinosaurs that think, feel and react intelligently to the world around them and face threats posed by espionage, breakouts and devastating tropical storms in an uncertain world where life always finds a way.
Why similar: Building 31.7%, Management 30.3%, Simulation 16.6%, Sandbox 9%, City Builder 5.4%
- #40 Hospital Manager
75% matchMixed46% of 255 reviews2015
Dev: CCCPPub: Microids Indie
Windows · Mac
Median: 1.1 hrsMean: 9.5 hrs≥1hr: 56%
Experience something novel, bursting with extraordinary phenomena and strange situations in your hospital! Only you have the power to make the best decisions and to make your hospital the most popular one! But beware: Several events will add some spice to your life! Embark on the career of your life!
Why similar: Medical Sim 66.7% ★, Management 23.9%, Simulation 9.4%
- #41 Healing Spree
73% matchMixed55% of 106 reviews2021
Dev: ParoPub: Milk Bottle Studio
Windows
Healing Spree is a tongue-in-cheek hospital simulator featuring co-op for up to 4 players. Play as doctors on call to diagnose, help, and treat as many patients as humanly possible while maintaining your sanity AND friendships!
Why similar: Medical Sim 73.8% ★, Simulation 8.9%, Funny 5.8%, Comedy 4.8%, Strategy 4.4%
- #42 CURE - A Hospital Simulator
68% matchVery Positive87% of 824 reviews2025
Dev: Sentinel Games
Windows
Median: 4.7 hrsMean: 8.3 hrs≥1hr: 84%
Manage the night shift of an ER during the apocalypse, solo or with friends online: Diagnose patients. Design and grow your hospital, and defend against the undead while treating the living. If you're a creator, connect the game to Twitch and make the audience your patients for even more fun!
Why similar: Medical Sim 69.9% ★, Management 19.4%, Simulation 9.3%, Multiplayer 1.4%
- #43 Prescribe and Pray
69% matchMostly Positive73% of 71 reviews2026
Dev: Nuclear Rabbits
Windows
Awaken the incompetent doctor within you! Diagnose strange patients, examine their absurd symptoms… and prescribe treatments that could change their lives… or cut them short. Your actions will have consequences.
Why similar: Medical Sim 68.8% ★, Management 13.4%, Simulation 9.6%, Comedy 6.9%, Singleplayer 1.2%
- #44 RollerCoaster Tycoon® 3: Platinum
72% matchVery Positive92% of 5,234 reviews2008
Dev: Frontier
Windows
Median: 2.2 hrsMean: 12.0 hrs≥1hr: 64%
Rollercoaster Tycoon 3 Platinum combines the excitement of rollercoasters with the fun of a great strategy simulation. RCT3 Platinum combines the roller coaster theme park fun of the Roller Coaster Tycoon 3 with included expansion packs Soaked! and Wild! Now enjoy more options than ever.
Why similar: Management 34.8%, Building 22.1%, Simulation 20.2%, Sandbox 10.7%, Strategy 3.3%
- #45 Let's Build a Zoo
70% matchVery Positive89% of 4,073 reviews2021
Dev: SpringloadedPub: No More Robots
Windows
Median: 4.5 hrsMean: 13.1 hrs≥1hr: 80%
It's time to Build a Zoo! Construct and decorate enclosures, buy and breed animals, hire zookeepers and vets... then try your hand at DNA splicing, and stitch together over 300,000 different types of animal. This can only go smoothly...
Why similar: Management 30.1%, Building 21.9%, Simulation 20%, Sandbox 11.1%, City Builder 10.8%
- #46 Another Brick in The Mall
71% matchVery Positive83% of 2,431 reviews2020
Dev: The Quadsphere
Windows
Median: 5.5 hrsMean: 12.8 hrs≥1hr: 87%
Design, build and manage a giant shopping center. Open shops, supermarkets, restaurants, movie theaters, bowling alleys and more. Hire and manage the best staff for the job and milk your customers for all they're worth!
Why similar: Management 36.3%, Building 25.9%, Simulation 16.7%, City Builder 8.1%, Sandbox 6.3%
- #47 Heart's Medicine - Time to Heal
70% matchVery Positive94% of 883 reviews2016
Dev: Blue GiraffePub: GameHouse
Windows · Mac
Median: 6.0 hrsMean: 12.1 hrs≥1hr: 92%
An intense, but also funny, medical drama that deals with a lot of life-changing decisions. Become an aspiring surgeon at Little Creek Hospital!
Why similar: Medical Sim 86.6% ★, Simulation 9.7%, Casual 1.6%, Indie 1.4%, Singleplayer 0.7%
- #48 Prison Tycoon®: Under New Management
71% matchMixed62% of 184 reviews2021
Dev: Abylight StudiosPub: Ziggurat
Windows
Build an intricate prison, hire the best staff, and pamper your prisoners to create the perfect rehabilitation facility in Prison Tycoon: Under New Management
Why similar: Medical Sim 40% ★, Management 20.9%, Building 16.4%, Simulation 8.5%, Sandbox 5.5%
- #49 RollerCoaster Tycoon® 3: Complete Edition
69% matchVery Positive87% of 2,889 reviews2020
Dev: Frontier DevelopmentsPub: Atari
Windows · Mac
Median: 48 minMean: 8.4 hrs≥1hr: 45%
Build the park of a lifetime and rediscover the critically acclaimed rollercoaster simulation bestseller. Feel the thrill of a genre-defining classic, complete with two huge expansion packs.
Why similar: Management 32.2%, Building 24.1%, Simulation 13.3%, Sandbox 8.7%, City Builder 8.7%
- #50 Game Corp DX
70% matchVery Positive88% of 3,083 reviews2015
Dev: Endless Loop Studios
Windows · Mac · Linux
Median: 4.6 hrsMean: 6.2 hrs≥1hr: 92%
Manage your Game Studio, earn big bucks, impress the critics, beat rival studios and clean up at the awards!
Why similar: Management 52.4%, Simulation 20.2%, Building 11%, Sandbox 4.6%, Strategy 3.3%
- #51 Doctor Life Simulator
67% matchMixed67% of 139 reviews2025
Dev: Bleeding Edge StudioPub: Blackburne Games Studio FZ LLC
Windows
Step into the shoes of a dedicated medical professional in Doctor Life Simulator. Experience the challenges and triumphs of running your own medical practice, from diagnosing complex illnesses to performing life-saving surgeries.
Why similar: Medical Sim 61.5% ★, Management 16.9%, Simulation 9.8%, Building 9.5%, Singleplayer 0.9%
- #52 Mini Motorways
67% matchOverwhelmingly Positive96% of 24,040 reviews2021
Dev: Dinosaur Polo Club
Windows · Mac
Median: 6.0 hrsMean: 16.7 hrs≥1hr: 89%
Mini Motorways is a strategy simulation game about designing the road map for a growing city. Build a traffic network, one road at a time, to create a bustling metropolis. Redesign your roads and place your motorways to get everyone where they need to go. How long can you keep the city moving?
Why similar: Management 35.4%, Simulation 24%, Building 18.4%, Strategy 9.7%, City Builder 5.9%
- #53 Town to City
63% matchOverwhelmingly Positive98% of 6,538 reviews2026
Dev: Galaxy GrovePub: Kwalee
Windows
Median: 4.0 hrsMean: 7.6 hrs≥1hr: 81%
Build an idyllic 19th century Mediterranean town and help it flourish into a prosperous city. Freely place and customise each element to create the perfect home for your growing population in this cozy city builder from the creators of Station to Station.
Why similar: Building 26.9%, Management 25.8%, City Builder 15.5%, Simulation 11.8%, Sandbox 9.6%
- #54 My Time at Portia
67% matchVery Positive92% of 44,162 reviews2019
Dev: Pathea GamesPub: Focus Entertainment
Windows · Mac
Median: 6.0 hrsMean: 36.0 hrs≥1hr: 88%
Start a new life in the enchanting town of Portia! Restore your Pa's neglected workshop to its former glory by fulfilling commissions, growing crops, raising animals, and befriending the quirky inhabitants of this charming post-apocalyptic land!
Why similar: Building 39.8%, Simulation 33.8%, Sandbox 15.5%, Singleplayer 3.3%, Casual 3%
- #55 Hospitalize
71% matchMostly Negative40% of 171 reviews2016
Dev: Illeris
Windows
Find the most effective way to construct and manage a hospital. Build your hospital smart and avoid excess time and resources consumed by examining your patients unnecessary. You can choose to micromanage your patients or hope that your doctors are able to identify the cause of their symptoms.
Why similar: Simulation 53%, Management 41.2%, Indie 5.8%
- #56 Heart's Medicine - Hospital Heat
68% matchVery Positive96% of 366 reviews2017
Dev: Blue GiraffePub: GameHouse
Windows · Mac
Median: 5.1 hrsMean: 8.7 hrs≥1hr: 93%
The long awaited sequel to "Heart's Medicine - Time to Heal". An intense, but also funny, medical drama that deals with a lot of life-changing decisions. Become an aspiring doctor at Little Creek Hospital!
Why similar: Medical Sim 83.2% ★, Simulation 13.8%, Indie 1.6%, Casual 1.5%
- #57 Mad Games Tycoon
67% matchVery Positive91% of 4,418 reviews2016
Dev: Eggcode
Windows · Mac
Median: 5.2 hrsMean: 20.3 hrs≥1hr: 67%
Form your own game studio set in the early 1980s in a small garage. Develop your own game ideas, create a team and develop megahit video games. Research new technologies, train your staff and upgrade your office space, going from a lowly garage to a huge building. Expand your business and dominate the world market for video games!
Why similar: Management 41.1%, Building 21.7%, Simulation 16.6%, Sandbox 8.8%, Strategy 4.9%
- #58 Rec Center Tycoon - Management Simulator
68% matchMostly Positive71% of 327 reviews2019
Dev: Jarrod Brown
Windows
Median: 1.3 hrsMean: 10.5 hrs≥1hr: 53%
Design, build and manage a recreation center! Host fitness classes, build swimming pools, arcade & entertainment areas, build event rooms to host parties & much more. With endless customisation, Rec Center Tycoon goes much more in-depth than your average business management simulator.
Why similar: Medical Sim 45.5% ★, Management 16.1%, Building 14.2%, Simulation 8.7%, Sandbox 6.2%