Pathologic 3 is one of 2026's most ambitious reboots

5 days ago 10

The latest game in the franchise is actually a great jumping-off point for new players

An Herb Bride, a member of a local tribe who dances barefoot on the ground to encourage herbs to grow. She has a large dreadlocked beehive hairstyle, accented with small pink flowers, and a necklace made of bone.

As a long-time fan of Ice-Pick Lodge's Pathologic, I've been getting increasingly anxious as the release date for Pathologic 3 — the latest entry in the original 2005 game's reboot series — approaches. It's been a rocky couple of years for developer Ice-Pick Lodge, which released Pathologic 2 in 2019 with the intention of adding in what is now Pathologic 3 as a DLC expansion. But between the studio relocating from Russia to Kazakhstan amid the war in Ukraine, the controversial departure of long-time creative director and studio co-founder Nikolay Dybowski, multiple delays, and some surprising announcements regarding gameplay changes, I wasn't sure Ice-Pick Lodge could successfully execute another trip to the Town-on-Gorkhon, the memorably unnerving steppe village where the series takes place.

But after spending about 20 hours with an expanded demo of the game that consists of more than half of its content, I'm happy to report that Ice-Pick Lodge appears to have pulled off another miracle. Pathologic 3 is brilliant, beautiful, and most importantly, approachable for both new players and those like myself, who have been captivated by this world since the original game launched 20 years ago.

A group of sick beggars walk toward the player, the sky thick with miasma.

For the uninitiated, the original Pathologic (and its remaster, Pathologic Classic HD) contains three campaigns. Players start off as Daniil Dankovsky (aka the Bachelor), and after completing his campaign, can re-play the game as Artemy Burakh (aka the Haruspex). The game can then be played for a third time with Clara (aka the Changeling) as the protagonist. Pathologic 2 served as a reboot of the original game, and launched with the Haruspex's campaign, with Ice-Pick Lodge planning to add the Bachelor and Changeling campaigns as DLC. Now, the Bachelor's campaign has been reimagined as Pathologic 3. (No word yet on whether we'll see a Changeling campaign in Pathologic 3, if it will be released as Pathologic 4, or if it will be released at all.)

I had some serious reservations going into Pathologic 3. My first concern was the lack of an open world. In all previous iterations, players were allowed to freely roam around the Town-on-Gorkhon, a strange little steppe village steeped in mystery and bizarre local customs involving bull-worship. Pathologic 3 cuts the town into various zones, and there are more frequent loading screens compared to Pathologic 2 (though they're relatively quick). Historically, most of Pathologic's gameplay loop consisted of players getting from Point A to Point B without starving to death, getting attacked by random vagrants, or succumbing to the strange plague afflicting the town. Additionally, there's a jaw-dropping plot twist midway through that relates to the in-game map, and I feared that the lack of an open world would take some of the shock out of it. Thankfully, this isn't the case — Ice-Pick Lodge does a great job of making sure players familiarize themselves with the map, and the game's various NPCs frequently reference important areas of town. By the time you figure out what's going on with the map, it's still just as shocking as ever.

My other big concern was whether Pathologic 3 could appeal to newcomers without alienating seasoned veterans like myself. Based on my time with the expanded demo, Pathologic 3's biggest triumph is its ability to sink its claws into both types of players. Your first moments in the town are meant to be confusing, but previous iterations of the game have been a bit too disorienting in the opening hours, making it a difficult title to recommend to friends. (You can only say, "Don't worry, it'll all make sense later!" so many times before people start to get frustrated.) But Pathologic 3 gracefully sidesteps this issue entirely by giving players robust dialogue options. If you have no idea why creepy masked mimes and even creepier guys in bird costumes are posted up all over the town, you can express that during dialogue. If, like myself, you know exactly why these creeps are hanging around, and there are plenty of dialogue options to express that, too. Some characters, like the town's eccentric resident theatre troupe coordinator, Mark Immortel, will pick up on the fact that this isn't your first time playing, and comment on it. My first encounter with him in Pathologic 3 felt like bumping into an old friend, while I imagine anyone encountering him for the first time will walk away simultaneously baffled and intrigued. Pathologic 3 is, in many ways, a game that plays you, something Mark Immortel makes clear early on.

"Keep going; this is the beating heart of our play: the blur between reality and fiction," the ever-cryptic Mark told me as we parted ways. "You are free to go. But remember: The game doesn't end until I say so."

Mark Immortel sits next to a large stranger in an enourmous plague-doctor style bird costume

Like players who are new to Pathologic, protagonist Daniil Dankovsky is a fish out of water here in the Town-on-Gorkhon. He's an urbanite through-and-through; a well-educated, well-dressed doctor from the city, studying immortality. Daniil's only visiting this remote backwater village because he's heard rumors that a local man named Simon Kain has figured out a way to cheat death, and finding this Simon guy is his only real lead when it comes to the whole "figuring out immortality" thing.

It’s an intriguing setup on its own, and from the moment Daniil steps off the train, it's clear that something is off about this place. First, he discovers that his luggage — including some vital medical research equipment — has been stolen by a group of local children. Then, he's mocked by a nearby street-sweeper, who warns him that he'd better not harm the children who just robbed him. It's clear that his education and status hold no value here, and the local adults seem to defer to their children rather than vice-versa. Everything about the town seems backwards and unsettling, and as an outsider, Daniil is the perfect vessel for new players to discover the weird, wonderful world of Pathologic. This is an experience about atmosphere, and Ice-Pick Lodge manages to cultivate a truly unforgettable one here.

Herb Brides dance and pray near a sacred bull.

Every iteration of Pathologic has always told the same story, which takes place over the course of 12 days. Conditions in the town grow more grim with each passing hour as a strange, seemingly sentient plague begins destroying everything in its path. In previous games, time ticked along chronologically. In Pathologic 3, you'll often jump forward and back in time. While I didn't find this too confusing, I can imagine it being a potential pain point for other players. Still, I felt the game's mind map (which is tied to what day of the week it is) does a good job of letting you know exactly where (and when) you currently are.

Pathologic 3 is quite challenging, but it's also the friendliest the franchise has ever been. Combat is smooth, reactive, and better than ever, though the low amount of ammo lying around makes it clear that shooting your way through the town is meant as a last resort. The tutorial is detailed, the mind map is invaluable for keeping track of what's going on, and players have new tools in their arsenal to combat the plague. Unlike previous iterations of the story, players can actually clear sentient clouds of plague miasma using an odd little gizmo that disperses a cloud of antiseptic into the air, though it has a limited number of uses before it must be refilled. It’s a satisfying gimmick that makes survival feel like a matter of strategy rather than pure luck. Death, too, is interesting. Without spoiling anything, it's safe to say that Daniil's state of mind can easily impact his health.

Daniil examines a strange creature called an Odongh, as thoughts about the creature swirl in his line of sight.

When it comes to survival, you’ll need to maintain a balance between apathy and mania. Grow too apathetic or too manic, and you won't be able to successfully engage in conversations with NPCs or treat their ailments, but mania can have some benefits — you'll run faster when manic, for example. The game also features a sort of "detective vision" ability that allows Daniil to examine objects more closely, but this can also affect the Apathy/Mania gauge. While examining an object, thoughts will pop into his head, and clicking on them will cause him to think about the topic more deeply. But some thoughts can negatively affect Daniil's mental state. Most RPGs feature dialogue options that affect how NPCs see the player-character, but this is the first time I've seen a game allow a player to control how their character thinks and have that thought process affect actual gameplay.

Speaking of dialogue, Pathologic 3 has some of the best writing in the series. The English translation is phenomenal, and really gives you a feel for who each character is as a person, without constantly devolving into incomprehensible philosophical rambling, as previous iterations of the game often did. Pathologic 3 also features another unique dialogue mechanic I've never encountered in a game before: Occasionally, when speaking to an NPC, you will abruptly switch places with them, choosing how they reply to Daniil, instead of choosing what Daniil says to them. At one point early in my playthrough, I found myself several weeks into the future, being interrogated for something I hadn't yet done. Then I was suddenly put into the shoes of my interrogator, selecting which questions they asked Daniil. These moments never last too long, but they make for some absolutely fascinating (and very tense) dialogue exchanges, and also hint at the game's mindblowing hidden metanarrative, which is, to this day, my favorite plot twist in any game I've ever played.

a murderious steppe golem in the guise of a woman.

Based on my time with the extended demo, Pathologic 3 is a triumph in writing, telling its incredible story in a way that will please both long-time fans and uninitiated noobs alike. Ice-Pick Lodge has once again managed to transport players to the strange, atmospheric, and beautiful Town-on-Gorkhon. Yes, Pathologic 3 is a new take on the story, but for veteran players, this version of the town will still feel like home. For new players, it offers a wealth of secrets to be uncovered — and some of the most mind-boggling plot twists in the history of gaming.

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