Pathologic 2

About Pathologic 2

Pathologic 2 is Ice-Pick Lodge's reimagining of its 2005 game Pathologic. It came out on PC in May 2019, later on Xbox One, and on PlayStation 4 in March 2020; it also plays on Xbox Series X|S and PS5. You play Artemy Burakh, a surgeon known as the Haruspex, who comes home to a town on the Gorkhon River after his father asks him to return. He is attacked as soon as he steps off the train, his father is dead, and the town suspects him of the killing, just as an old plague returns.

Time is the main pressure. The town runs on a clock that does not wait for you, and events happen whether or not you are there. You must eat, drink and sleep; thirst also works as your stamina. At night shops close and bandits roam. Districts fall to the Sand Pest one by one, and their water becomes infected. Medicine is scarce, the sick are everywhere and you will not be able to save everyone.

You get what you need from shops, from containers in homes and streets, by burglary, or by bartering, where every item has a barter value. Tinctures brewed from steppe herbs help with healing, and a scalpel lets you take organs from the dead, though too many autopsies cost you the town's trust. A thought map keeps track of leads and questions. Fights are short and dangerous, and firearms are rare and expensive.

The horror is slow despair and strangeness rather than jumpscares. Masked plague doctors walk the infected streets, a gang of children plays by its own rules, and each night the town theatre rehearses a strange play that hints at what is to come. The whole story is framed as a performance, with spotlights, scene changes and a disembodied stagehand voice.

It is demanding and deliberately uncomfortable. Critics praised its atmosphere and criticised its unforgiving survival systems and clumsy combat, and the developers later added difficulty sliders for individual settings. It suits patient players who want survival horror about a whole society collapsing. A sequel, Pathologic 3, followed in January 2026.

How to play Pathologic 2

1. Talk to the town's people to learn what each day asks of you, and watch the clock.
2. Keep hunger, thirst, exhaustion and immunity in check by eating, drinking, sleeping and taking medicine.
3. Scavenge, trade and barter for food, money and the herbs and tools you need for cures.
4. Check the thought map to see your open leads and decide which ones to follow today.
5. Visit the sick and the people who matter to the story, and decide where to spend scarce medicine and time.
6. Avoid infected districts and fights when you can; they cost health and supplies you cannot spare.

Tips

• Do not try to do everything; pick the most important tasks of each day.
• Shops close at night and bandits come out, so plan to be indoors or finished with errands by dark.
• Barter with children and townsfolk; items you don't need are worth more as trades.
• Water becomes infected as districts fall, so keep clean water with you before it runs short.
• Autopsies give organs you can trade or use, but doing too many costs you the town's trust.
• If the survival needs are too punishing, the difficulty sliders let you ease specific settings.

Questions