I’ve always loved underground films and experimental short stories. That’s why Pathologic 2 immediately caught my attention with its auteur approach, oppressive atmosphere, and unsettling music. From the very first hours, it became clear: this game is not for everyone. And that’s what makes it brilliant. Here is my Pathologic 2 Review, originally written in 2019.

They’re Waiting for Me… Or Are They?

This review is about why you need to change your usual expectations and embrace the conditions the game imposes on you. Pathologic 2 isn’t a game you “play” — it’s a game that plays you.

A City in Agony

You play as Artemy Burakh, aka the Haruspex, who receives a desperate letter from his father asking for help to treat the sick. But upon arrival, you find your father dead and the townsfolk suspect you of murder. As the plague consumes the city, you hunt for the real killer, gather evidence, and try to survive in a society collapsing under fear.

This is just the first chapter of a planned trilogy, with each part introducing a new protagonist and perspective on the same doomed city.

Genre? Try Art-House Survival Horror

Pathologic 2 defies easy classification. It’s an arthouse thriller fused with immersive sim mechanics and survival elements. The experience mirrors the five stages of grief: denial, anger, bargaining, depression, acceptance.

Thoughts Become Your Compass

From the opening frames, nothing makes sense — surreal dreams, frantic screams, lifeless bodies, and children playing as if nothing happened. Your hunger and exhaustion soon become just as pressing as the central mystery. At times, survival overshadows story.

You’ll reload saves, replay days, and question every decision. Over time, you start thinking differently: planning routes, rationing energy, and calculating consequences. That’s when you realize — the game has changed you.

A Stage Set in Madness

This is not a realistic world. Ice-Pick Lodge reminds you of that in every frame: absurd architecture, theatrical performances, and dreamlike physics. Some structures look more like modern art installations than buildings. And that’s the point.

Playing by Its Rules

Pathologic 2 challenges the very idea of player agency. Here’s what defines the experience:

• Maps Are Your Lifeline: The city is a maze. Shortcuts rarely exist, and blocked paths are common. Planning every step matters.
• Survival Is Everything: Hunger, thirst, and exhaustion hit harder than any enemy. Sometimes you’ll steal or trade organs to survive.
• The Thought Map: A brilliant system that organizes your fragmented objectives and revelations.
• Ethics on Trial: You will kill. You will feel guilty. And you’ll keep asking yourself if there was another way.
• Saves Are Gameplay: Limited save points and penalties for death force you to live with your choices.

This is a game where “Game Over” is never the end — just another scar.

It’s Not You Playing Pathologic 2. It’s Pathologic 2 Playing You.

This isn’t about winning. It’s about enduring a cruel simulation of life, death, and moral compromise. Pathologic 2 is a labyrinth of survival wrapped in poetry and despair.

Is It a Remake?

Not exactly. Pathologic 2 is a reimagining of the 2005 cult classic. It’s bolder, darker, and more immersive, with fresh characters, new mechanics (like the autopsy system), and deeper narrative beats. Personally, I wish the reboot started from the Bachelor’s perspective instead of the Haruspex, as that arc is easier for newcomers.

Pros and Cons

+ Atmosphere of dread without cheap jump scares
+ Ethnic-inspired score by Theodor Bastard, perfectly framing the bleak steppe
+ Narrative that fuses morality, politics, and survival
+ Emotional manipulation through mechanics, not cutscenes

– Occasional stutters and technical hiccups
– Clunky combat (though it fits the game’s philosophy)

Final Thoughts: More Than a Game — A Statement

Pathologic 2 is the quintessence of Russian arthouse in gaming. It’s harsh, surreal, and unapologetically original — a rare gem in a market obsessed with convenience.

This isn’t comfort food gaming. It’s a bitter, raw dish meant to provoke, frustrate, and change you. Most players will walk away. The rest? They’ll call it a masterpiece.

If you love indie projects that challenge conventions, Pathologic 2 is art you must accept.