Pathogenic Review: The Most Infectious Game of 2026?

I’ll admit, playing as a parasite trying to take over someone’s body wasn’t particularly high on my gaming bucket list. Then Pathogenic was recommended to me. Instead of fighting off an infection, you ARE the infection, travelling through different parts of the human body while its immune system does everything it can to get rid of you.

Now there’s been a LOT of praise for this one. People have even gone as far as to say it’s the game of the year. After playing it, I can definitely see why so many people have fallen in love with it. It looks fantastic, there’s a ridiculous amount you can do with your builds, and it has some of the smartest enemies I think I’ve ever encountered.

Did I love it quite as much as everyone else seems to?

Not quite. I wouldn’t say it’s the best game of the year, but I did enjoy it.

Let’s get infected…

Taking Over the Body One Cell at a Time

Developed by Aberrant Labs, Pathogenic is a roguelike twin-stick shooter that puts you in control of a parasite trying to take over a human host. Naturally, the immune system isn’t particularly happy about this.

You’ll travel through different parts of the body, fighting things like T cells and macrophages, while collecting upgrades and trying to make it through each area without being wiped out.

Combat is fast. Very fast. You’re constantly moving, shooting, dodging attacks, watching your stamina, and trying to avoid whatever else the game has decided to throw at you. Then there are the organelles.

These are essentially your upgrades, and you can slot them into different parts of your pathogen to change how it fights. You could add fire or electrical damage to an attack, pick up a completely new weapon, or find something that works particularly well with an upgrade you already have.

There’s a LOT you can do with them.

Enemies also drop DNA, which lets you level up and choose mutations, and eventually you can evolve into new versions of your pathogen with even more room for upgrades.

Basically, if you’re someone who loves putting builds together and figuring out how different upgrades can work with each other, you’re going to have a field day.

Hang On…Did That Enemy Just Cut Me Off?

I need to talk about the enemies here for a second, because this was probably the thing that impressed me most. They’re potentially the most intelligent enemies I’ve ever come across in a game.

I played mostly on Normal difficulty, and I’m used to enemies chasing me around while I desperately try to get away from them. However, Pathogenic’s enemies were in a whole different league. There were times when I’d have something chasing me, change direction to try and escape, and watch it turn around and head the other way to cut me off.

Excuse me?!

It makes the combat much more interesting because you can’t always rely on running around and keeping everything behind you. Sometimes the thing chasing you seems to have a pretty good idea of where you’re planning to go next.

I’ve played a LOT of games over the years, and these are some of the smartest enemies I’ve come across. I was impressed. Slightly annoyed when they killed me, but impressed all the same.

There’s A LOT You Can Do With Your Builds

If you love experimenting with builds, this is probably where Pathogenic is going to win you over. There are loads of different organelles to find, and you can move them around and experiment with how they work together.

Some upgrades affect the things attached to them, while others can be overcharged when you meet certain requirements. Then you’ve got different weapons, passive effects, mutations, active abilities, and different pathogens to unlock. There’s a lot to get your head around and I can see people losing hours to this side of the game alone.

Between runs, you’ve also got permanent progression to work towards. Resources earned while playing can be spent on skill trees, and each pathogen has its own progression to unlock.

Add in daily challenges and mod support, and there’s a huge amount here for anyone who wants a roguelike they can keep coming back to.

Being Inside a Human Body Looks Surprisingly Good

I never thought I’d describe the inside of a human body as pretty, but Pathogenic looks great. It’s bright, colorful, squishy, and slightly disgusting all at the same time.

Everything wobbles and jiggles around as you fight, and the different parts of the body actually feel different from each other rather than simply being the same rooms with a new background.

The environments can cause problems of their own too. Head into the lungs and you’ll have airflow to deal with. Make your way into the stomach and, unsurprisingly, there’s acid waiting for you, because fighting an intelligent immune system clearly wasn’t enough.

The different environments really help when you’re doing run after run because there’s enough variety to stop everything blending into one.

It’s also easy to see why this one works so well on Steam Deck. Pathogenic is Steam Deck Verified, and the twin-stick controls feel made for a handheld. The bright colors should look especially good on an OLED screen too, so if you own a Deck, this feels like a really good way to play it.

Trust Me, Use a Controller

I play pretty much everything on PC with a mouse and keyboard. Pathogenic made me question that decision.

When you first load the game, the developers recommend playing with a controller. Naturally, I ignored that and carried on with my keyboard and mouse but I probably should have listened.

There’s nothing actually wrong with the keyboard controls. The problem is how quickly Pathogenic expects you to use them. When you’ve got enemies chasing you, projectiles coming from different directions, stamina to watch, and about half a second to get yourself out of the way, finding the right key quickly enough can be a challenge.

This is something I’ve noticed with other fast-paced games too, so it could very easily be a me thing. Players who regularly use a mouse and keyboard for twin-stick shooters will likely have absolutely no problem with it.

Personally, though, I’d use a controller if you have one. Both Xbox and PlayStation controllers are supported, and considering the developers recommend one anyway.

Don’t Worry, You Can Make Things Easier

If twin-stick shooters aren’t normally your thing, Pathogenic does give you a few ways to make life easier. There are several difficulty settings, including easier options for anyone who wants a little more time to get used to the combat. I really like that and after giving it a go I can confirm the easiest mode does make a huge difference if you’re like me and tend to get a little overwhelmed with twin stick shooters in the beginning.

There’s quite a lot happening when you first start playing. You’re learning how the organelles work while also trying to dodge attacks, shoot enemies, manage your stamina, and generally avoid being wiped out by the immune system.

Having the option to turn things down a little gives you a chance to actually figure out what you’re doing.

There are some useful accessibility options too. You can remove distracting foreground scenery, change the transparency of your attacks, and adjust how far the camera is zoomed in or out. You can also disable the live-action cutscenes.

That said, even on the easier settings, this is still a pretty fast game. So, if you really struggle with games where you need to react quickly and keep track of several things at once, Pathogenic might still be a bit much.

I Can See Why People Love It, But…

Now there isn’t anything I particularly dislike about Pathogenic. It just didn’t completely win me over in the same way it seems to have won a lot of other people over.

The enemies are brilliant. The environments look great. There’s a huge amount of build variety, and the whole idea of ripping upgrades from things inside a human body and using them to evolve your own parasite is wonderfully weird. I can absolutely see why people love it.

For me, though, I think there are two things that could potentially stop someone truly enjoying the game. The first is simply how fast and chaotic it can get. There are moments where you’ve got enemies, bullets, attacks, hazards, and effects all over the screen, and I sometimes found myself losing track of what was happening.

The second is all the tinkering. After Sephiria, I’ve learned that I’m really not an inventory-management kind of girl, and I think the same thing applies here.

If you give me a cool upgrade, I want to grab it and get back to killing things. Pathogenic wants you to think about where that upgrade goes, what it connects to, what else it might work with, and whether moving everything around could make your build even better. For some people, that’s going to be one of the best parts of the game.

For me? Just give me the upgrade and point me towards the next enemy.

My Verdict

Pathogenic is a really good game, it’s just not one of my favorite games. I loved how intelligent the enemies are, the different areas of the body are creative, and there’s a ridiculous amount of freedom when it comes to creating your own builds.

It looks fantastic too. Who knew being a parasite could be so colorful?

For players who love twin-stick shooters and really enjoy digging into builds, swapping upgrades around, and finding combinations that turn their character into something completely ridiculous, I think Pathogenic has a LOT to offer.

If you prefer your roguelikes a little less frantic and don’t particularly enjoy spending time working out where every upgrade should go, you might find it doesn’t quite click in the same way.

I can see why people love Pathogenic and I can see why it came recommended to me. I’d happily recommend it to the right person too, especially given it’s only $10 at the time of writing. That person just needs to enjoy considerably more organelle management than I do.

Oh, and use a controller. Trust me on that one.