Pathologic 2

Game review by
Neilie Johnson, Common Sense Media
Pathologic 2 Game Poster Image
Violent survival horror game tests players' moral fiber.

Parents say

No reviews yetAdd your rating

Kids say

age 15+
Based on 1 review

Did this review miss something on diversity?

Research shows a connection between kids' healthy self-esteem and positive, diverse representations in books, TV shows, and movies. Want to help us help them? Suggest a diversity update

A lot or a little?

The parents' guide to what's in this game.

Positive Messages

Depending on the player's choices, the story can be bleak or hopeful. 

Positive Role Models & Representations

As the prodigal son of a murdered village doctor, players define their moral alignment through difficult choices. 

Ease of Play

Gameplay is challenging, but more accessible now thanks to the post-release addition of varying difficulty settings.


The player can be attacked and can kill other characters; he can also perform autopsies, steal human organs, and drain human blood. Cutscenes show people being shot and burned alive, and dead bodies lie all over the village. 


Some female characters appear topless or in revealing outfits. 


Infrequent swearing includes "s--t," "a--hole," and "bastard." 


Sequel to 2006's Pathologic.

Drinking, Drugs & Smoking

As the town medic, the player can make, take, and administer drugs. A tavern shows people drinking. 

What parents need to know

Parents need to know that Pathologic 2 is a downloadable single-player survival horror game for Windows PCs that's set in a small Russian town. The story involves a young doctor coming home to find his father murdered and the townspeople thinking he's the main suspect. The game features violence in the form of fistfights, knife-fights, shootings, and people being burned alive. The main character can also cut open human bodies and steal their organs and blood. An epidemic shows people starving, dying and suffering terrible pain, as well as being cruel to one another as conditions worsen. The storyline examines racism and superstition, and shows half-naked women who appear to have been beaten. There's some profanity in the form of “s--t,” “a--hole,” and “bastard,” and the main character can make, take, and administer morphine to others. 

User Reviews

  • Parents say
  • Kids say

There aren't any reviews yet. Be the first to review this title.

Teen, 15 years old Written byX._.X May 23, 2020

One of the best games I’ve seen in a long while

Such a great game to play if your 15+ and love anything horror related then this is the game for you. In my opinion this game is absolutely amazing I love this... Continue reading

What's it about?

PATHOLOGIC 2 is the spiritual sequel to 2006's Pathologic, a survival horror game set in a Russian village during a plague. In this version of the game, players become a young doctor called back to his home town by an urgent letter from his father. When he gets there, he finds the villagers short on food and long on suspicion, and his half-breed status as part villager, part Steppe nomad, make him an easy scapegoat for their fears. A murder mystery sets the story going, and a deadly epidemic helps it pick up steam. Players deal with both by getting acquainted with the local power players, earning the trust of the villagers, and getting reacquainted with old friends (and enemies.) In addition to exploring the village and the surrounding steppe, players have to make tools and medicine, diagnose and heal villagers, scavenge materials, trade for food, and figure out what the creepy local kids are up to—all while avoiding being killed by crazed villagers or catching the deadly Sand Plague.

Is it any good?

This adventure game is tough and not for the easily frustrated, because even with newly-added easier difficulty levels, the challenge and the likelihood frequent restarts is high. Still, if you're up for a challenge, Pathologic 2 is one of the most interesting games you'll play this year. Young Russian surgeon, Artemy Burakh returns to the small Russian town where he was born to find the place grim and dark and the townspeople—even his old friends—suspicious and hostile. Worse yet, a mysterious illness is on the rise and food and medicine are scarce. The situation is desperate and creates the perfect testing ground for a young doctor who's also an emotionally ambivalent native son. 

Of course, the hero's (and your) main emotion here is fear. The twilit village with its "orderlies" in plague doctor outfits, weird frog people who run the ferry system, scary kids, rampaging thugs, and witch women carrying cow skulls, is a nightmare in the making. Outright horror is everywhere, and fear colors your every decision. Do you use your limited medicine on a dying child or on yourself? Do you desecrate the dead if doing so means saving the living? Do you embrace the wisdom of your steppe ancestors or dismiss it as superstition? The mental anguish is tough to endure, but finding enough food, water, sleep, and medicine to keep yourself alive is the real challenge. Pathologic 2's depth of emotion is remarkable, mainly because it's not the sort of game you “win.” With limited time and resources, it's impossible to do everything, and you go in knowing some things (and some people) will be lost forever. On one hand, this is hard to accept. On the other, it's a great excuse for additional playthroughs. Mind you, it isn't meant for kids under 17. In spite of the game's meaningful themes, its nudity, drug use, profanity, and graphic violence make it one “thought buffet” that's meant for grown-ups only. 

Talk to your kids about ...

  • Families can talk about the opposition between science and superstition. Where have you seen this clash lately in the headlines? 

  • What does "the end justifies the means,"imply, and when is it true? 

  • Have you seen any movies or TV shows where disaster changes how people treat each other? Why does this happen? 

Game details

  • Platforms: Windows
  • Price: $34.99
  • Pricing structure: Paid
  • Available online? Available online
  • Developer: Ice-Pick Lodge
  • Release date: May 23, 2019
  • Genre: Action/Adventure
  • Topics: Adventures
  • ESRB rating: NR for No Descriptions
  • Last updated: June 27, 2019

Our editors recommend

For kids who love scares

Themes & Topics

Browse titles with similar subject matter.

Common Sense Media's unbiased ratings are created by expert reviewers and aren't influenced by the product's creators or by any of our funders, affiliates, or partners.

See how we rate

About these links

Common Sense Media, a nonprofit organization, earns a small affiliate fee from Amazon or iTunes when you use our links to make a purchase. Thank you for your support.

Read more

Our ratings are based on child development best practices. We display the minimum age for which content is developmentally appropriate. The star rating reflects overall quality and learning potential.

Learn how we rate