Modern medicine has come a long way. There was a time when turning up to the doctor with a headache could end with somebody draining your blood, drilling a hole into your skull, or trying another treatment that had a fairly questionable relationship with the word “healing.” Bloodletter has made that the perfect basis for a roguelike deckbuilder.
Developed by ALDAMAMI GAMES, Bloodletter puts you in the extremely reassuring hands of a medieval barber surgeon tasked with treating a village that has much bigger problems than whatever you’re about to do to it. Ancient entities are spreading corruption among the villagers, and somehow you’re the person responsible for keeping everyone alive long enough to stop them.
The game left Early Access and launched in full on August 17th, 2026, and currently holds a Mostly Positive rating on Steam.
Please Hold Still, This Will Probably Hurt
Rather than fighting monsters directly, Bloodletter turns medieval medicine into your deck. Villagers arrive at your bathhouse looking for treatment, and you play cards to deal with whatever is wrong with them. The treatments themselves are inspired by the sort of practices that once passed for legitimate healthcare, including bloodletting and trepanation, so this isn’t exactly a relaxing trip to the local doctor.
There are more than 80 cards to work with, alongside blessings and curses capable of changing how a run unfolds. Transmuters complicate things further by altering how cards can be used, which means building a strong deck isn’t simply about finding the same handful of good treatments every time.
Successfully treating someone also earns you a little gratitude. Once treatment is over, you can choose a villager to help you in return, gaining a new card for your deck and access to their unique ability. There are 11 villager abilities in total, giving the people you’re desperately trying not to kill a useful role in keeping everyone else alive.
Unfortunately, Your Patients Aren’t the Biggest Problem
Keeping the villagers healthy would be difficult enough if medieval medical knowledge was the only thing working against you. It isn’t.
Once night falls, the ancient entity haunting the village gets its turn. It can spread sickness and reduce the villagers’ Purity, undoing some of your hard work before another day of questionable healthcare begins. The cycle then repeats as patients return and you attempt to push things back in the opposite direction.
There are four different entities to face, each bringing its own design and win condition, and every one can be challenged across three difficulty levels. Winning a cleanse unlocks additional content for future attempts, so successfully saving the village gives you more to play with the next time something unspeakable decides to move in.
Medieval Medicine Was Already Horrifying Enough
The Lovecraftian horrors may technically be the villains here, but Bloodletter doesn’t exactly make the human side of medieval life look comforting either.
Its hand-drawn artwork leans heavily into the unsettling side of historical medicine, with cards depicting treatments that are considerably easier to appreciate when you’re safely separated from them by several hundred years. Around that sits more than 100 story snippets digging into a world built from medieval myth, superstition, sickness, and whatever ancient nightmare is currently ruining everybody’s week.
It makes for a roguelike deckbuilder with a very different idea of what needs saving. You’re not climbing a tower or clearing rooms full of monsters. You’re trying to keep a collection of increasingly unfortunate villagers alive while an ancient evil corrupts them from one side and your own medical qualifications remain slightly concerning from the other.