Pathologic 2 is a weird game, a game that has you go from trading drugs with little kids to participating in a cult bull-cutting ritual. It’s oftentimes hard to tell what the game is trying to be, yet this is what makes the experience so interesting. Even after completing it, I’m still having a hard time comparing it to any game I’ve played in the past. It’s a truly unique experience, even if it does come with some problems.


Bizarre, yet oddly interesting storyline. Pathologic 2‘s storyline is akin to that of a David Lynch film: bizarre, yet somehow manages to maintain one’s interest throughout. Part of this is due to the story’s pacing: it never felt too fast nor too slow, striking a nice middleground. If you do find that it is too slow, you can always sleep through certain sections of the story, although this comes at a cost.

That is, because time is constantly moving in the game, sleeping can and will make you miss certain story opportunities. It is a very player-driven experience and one’s choices do actually have consequences. The game gives you a lot of power in this regard, letting you drive the story as you wish.

If you do actively engage in the story, you’ll be met with an incredibly depressing tale. You’re a doctor tasked with saving a town from a plague that will wipe it out in about 12 days. You cannot save everyone, but you can at least try to do so, even if such efforts may prove useless in the long run. Throughout this journey you’ll meet a lot of interesting characters, visit cool areas, and try to solve a mystery that really doesn’t make that much sense. It’s definitely the kind of story that is best experienced in-game and would be very hard to describe to someone else.

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Great art direction. To go along with the game’s incredibly depressing storyline, there’s also its incredibly depressing art direction. That’s not to say that it’s bad, but that it is perfect for the type of story being told here. You’re given a bleak game world, a murky color palette, and a town full of expressionless inhabitants to go along with the game’s story.

In fact, the game makes that last one pretty apparent. Whenever you talk with an NPC, the game presents you with an extreme close-up of said NPC’s face, lasting until the exchange is over. In doing so, emphasis is placed on their facial expressions, or rather, the lack thereof. This not only helps establish the town’s bleak nature, but it also serves to unnerve the player, further driving home the tone that the game goes for.

This is just one example of how the game makes use of its art direction to tell its story. The two really work in tandem with each other and it provides for a very cool storytelling experience.

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Dynamic game world. Further building on its storytelling, Pathologic 2 also provides a pretty dynamic game world to match what’s going on in the story. Throughout the course of the game, you will see the town shift from bleak, yet populated, to just desolate and full of bodies. It’s a slow transition, but one you will really start noticing once the plague sets in. Again, this is just another visual element the game uses to tell its story.

However, the dynamic game world benefits more than just the story — it also has some gameplay effects that can either help or hurt the player. For example, when a district gets ravaged by the plague, you can choose to go in and loot homes while the occupants are dying. You can also wait another day for the plague to leave the district and then loot it at that time, although with less overall loot and more thieves to deal with. It’s a nice way to get material for trading and crafting and is oftentimes necessary in order to survive.

There is a negative side to this though: that being that the story will continue regardless of the plague status in a given district. If you’re not equipped to go into a plagued district and a story event is taking place in one of them, you’ll have to either face the plague and deal with the consequences or give up on that event entirely. Of course, this may lead to the story developing in a different way, but that’s why it is such a cool mechanic.

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Clunky combat. While the game does well on the story-side, it unfortunately suffers when it comes to combat. Hitboxes are oftentimes much larger than they appear to be, staggering is unpredictable, and the overall feel to it is just clunky. This makes combat scenarios much more frustrating than they needed to be, especially so because you can easily get one or two-shot by certain attacks. I personally avoided many combat scenarios for this very reason. Granted, the combat is a very small part of the game, especially in comparison to its story elements, but it could still definitely use some patching up.

Tedious travel times. My biggest problem with Pathologic 2 is simply how annoying it is to get anywhere, or rather how much time is spent traveling instead of doing something interesting. As this is a story-driven game with a bunch of quests to complete, you will be traveling to and from different districts in the town, oftentimes back and forth between them several times per in-game day. This leads to a lot of wasted time running about, which definitely isn’t helped by the fact that there’s a limited stamina meter and you have to constantly keep your character hydrated and well-fed in order to keep going.

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There is an in-game fast travel system, but it is pretty lacking and actually costs the player to use. It takes the form of a river, in which an NPC will take you to one of his seven or so docks scattered throughout the town for the cost of a fingernail (one of the game’s currencies). However, some areas in the game are far from this river and some are even blocked off at times dependent on where the plague is. As such, this system is not entirely sufficient.

Granted, there is stuff to be seen when traveling around, but the long travel times proved to be more annoying than anything. The game could really benefit from a Bethesda-style fast-travel system (with the passing of time included of course).

Performance issues. Unfortunately, Pathologic 2 has quite a few performance issues that need to be noted. The first is an issue with how the game runs when displayed as a borderless window. I found that, when displayed as such, there would be constant lag spikes regardless of where I was in the game and what I had open on my computer. My FPS would be fine, then all of a sudden I’d get hit with a micro-freeze before returning to good FPS. Switching the game to fullscreen pretty much eliminates this problem, but comes at the cost of having to deal with slow alt-tabbing and the inability to interact with other monitors.

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However, even when running in fullscreen, the game has an issue with slowing down the longer it is open. During my play sessions, if I kept the game open for more than three or four hours at a time, a noticeable FPS loss would start and continue until it became almost unplayable. A game restart would completely eliminate this problem for the next few hours though, so I found myself restarting numerous times during my playthrough just to deal with it. I thought it may have been some sort of memory issue, but the game never appeared to use more than 40% of my 16GB of RAM.

Aside from that, there is still the occasional FPS drop in some areas, a stutter in others, and the slow loading of some game assets (even though I had it installed on an SSD). Hopefully these are some issues that can be patched with time, but as it stands, they are quite annoying to deal with.

Some bugs. On top of the performance issues, I also ran into a few bugs during my playthrough, some minor and a few major ones. The minor ones were pretty tame, with NPCs walking into walls, walking in place, or birds flying through structures. The few major ones I ran into consisted of a couple instances of the game locking up and one instance of a full crash to desktop. By “locking up”, I mean the game is still running, but does not accept any inputs, forcing me to restart it. Considering the scale of the game and the fact that I played it before release, I was actually surprised that I ran into only these few bugs. Regardless, they are bugs and need to be fixed in future patches, especially the major ones.

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Pathologic 2 is a very niche game. It does really well in the story and art departments, but does suffer elsewhere, most notably with its combat and travel times. It’s really the type of game that you won’t know if you like until you actually try it. I at least enjoyed it enough to give it a positive recommendation, but I can definitely see many not enjoying it for the same reasons that I liked it. For those that do like it, it is worth noting that this is only chapter one of the three planned, so we got that to look forward to at least.

Score: 6.5/10

You can buy Pathologic 2 on Steam here.

I was provided a review copy of the game in order to write this review. Read more about how I do my game reviews here.