Pathologic 2
A horror RPG set in a plague-ridden town where every choice wounds the world.
Pathologic 2 is a horror role-playing game from Ice-Pick Lodge and tinyBuild, released in 2019. What began as a planned remake of the studio’s 2005 game *Pathologic* expanded into something much larger, and the final product blends elements of a remake, a reboot, and a remaster. The game was originally intended to include three storylines, matching the Bachelor, Haruspex, and Changeling from the original. Only the Haruspex’s story was included at launch on 23 May 2019. In October 2024, the developers announced that the Bachelor’s route would become a separate sequel, *Pathologic 3*, with a very different style and scope; that game released on 9 January 2026.
A free playable demo called *The Marble Nest*, with its own short story, has been available online since 2 December 2016. An alpha build followed on 11 September 2018, and another demo appeared on 24 April 2019, one month before the full release. An updated version of *The Marble Nest* came out as Steam DLC on 28 October 2019, free for anyone who already owned the base game before that date.
**Gameplay**
Most of the game takes place in the Town on the Gorkhon River, with occasional detours for tutorials or one-off events. The town is split into districts named after body parts—like “The Gut” or “The Hindquarters”—which can become infected or abandoned as the plague spreads. The player’s choices directly influence which districts fall sick and which stay healthy. Traveling through infected areas, sometimes necessary for objectives or scavenging, greatly raises the risk of catching the plague.
Time passes in day cycles: a full day followed by a short night. During the day, most activities are available, shops are open, children play, and citizens go about their routines, provided the district isn’t infected. After midnight, the night phase begins. Many daytime events become locked off until the next day or permanently. Shops close, few citizens remain except night watchmen, and bandits may attack the player or rob anyone caught outside. Each night, a play is rehearsed at the central theater—bizarre, surreal scenes that cryptically hint at future events. After the play, the Dead Item Shop opens at a random location, where the player can trade normally useless “dead” items (like wrappers, broken bottles, or used bandages) for various goods, sometimes rare ones.
Quick Facts
- Title
- Pathologic 2
- Developer
- Ice-Pick Lodge
- Publisher
- tinyBuild
- Director
- Nikolay Dybowski
- Producer
- Alex Nichiporchik / Ivan Slovtsov
- Designer
- Ivan Slovtsov
- Artist
- Meethos / Anna Orlova / Elena Alt / Peter Potapov / Pavel Panfilov
- Writer
- Nikolay Dybowski / Alexandra Golubeva
- Composer
- Vasily Kashnikov / Theodor Bastard
- Engine
- Unity
- Platforms
- Microsoft Windows · PlayStation 4 · Xbox One
- Released
- Windows, Xbox One / 23 May 2019 / PlayStation 4 / 6 March 2020
Facts from the source article.
Lore & Background
Pathologic 2 takes place in the Town on the Gorkhon River, divided into districts named after body parts such as 'The Gut' or 'The Hindquarters.' The player's actions directly affect which districts become infected by the plague, and traveling through infected areas raises infection risk. The game operates on day cycles: during the day, townsfolk go about their routines; at night, shops close, bandits roam, and a surreal play is rehearsed at the town theater, cryptically predicting future events. After the play, the Dead Item Shop opens at a random location, allowing the player to exchange useless 'dead' items for rare goods.
The player manages hunger, thirst, exhaustion, health, immunity, and reputation. Hunger and thirst become harder to satisfy as the plague progresses. Exhaustion is relieved by sleep, which may trigger dream sequences that foreshadow events. Immunity drops in infected areas and must be maintained with medicine. If immunity reaches zero, the player becomes infected and must use antibiotics to survive. Reputation varies by district and is affected by actions such as healing, theft, or murder. Performing autopsies harms reputation until the player is declared a 'menkhu' by religious elders.
Upon death, the player is transported to the theater and criticized by director Mark Immortell, who states that each death 'wounds the world' and makes things worse for subsequent 'actors.' The player receives a permanent debuff affecting stats or actions. The game was designed so that the player cannot investigate every lead in a single day, forcing difficult choices with permanent consequences.
Reader's Guide
Pathologic 2 was released with only the Haruspex's storyline, though three storylines had been planned, mirroring the Bachelor, Haruspex, and Changeling from the original Pathologic. On 7 October 2024, it was announced that the Bachelor's route would instead be released as a standalone sequel, Pathologic 3, with dramatically different gameplay and scope; that game released on 9 January 2026. A playable demo called The Marble Nest, with its own short story, was released on 2 December 2016 and remains freely available online. An alpha build was released on 11 September 2018, and another playable demo appeared on 24 April 2019, one month before the full game. An updated version of The Marble Nest was released as DLC on Steam on 28 October 2019, free to players who owned the base game before that date. The game's significance lies in its uncompromising survival mechanics, narrative branching, and the permanent consequences of player death, which together create a tense, morally ambiguous experience that has been noted for its unique approach to storytelling and player agency.
Did You Know?
- Pathologic 2 was originally conceived as a remake of the 2005 game Pathologic but grew to encompass a much greater scope.
- The game was released with only the Haruspex's storyline; the Bachelor's route was later announced as a standalone sequel, Pathologic 3.
- Upon death, the player is transported to a theater and receives a permanent debuff from director Mark Immortell.
More in Role-Playing Games of the 2010s, Part 3 1-24
Spotted an error? Know more?
Reader corrections go straight into our review queue. Suggest an edit · How this site is sourced