Pathologic 2

Gameplay in Pathologic 2 takes place primarily in the Town on the Gorkhon River, with occasional diversions for tutorial sequences and other one-off events. The town is divided into a number of districts named after various body parts, such as "The Gut" or "The Hindquarters", which may become infected or abandoned throughout the game as a result of the plague. The player's actions often directly affect which districts become infected with the plague and which remain healthy, and travelling through infected districts (which the player must do for some objectives or to scavenge supplies) greatly raises the player's own infection risk.

Pathologic 2 takes place over day cycles, consisting of a day and a short night. During the day, most things will be available for the player to pursue and townsfolk will take part in their daily activities (as long as the district is not infected); shops will be open, children will be playing in parks and on streets and citizens will move around the city. After midnight, the night phase begins. Many events that could have occurred during the previous day will be locked off, either until the next day or sometimes permanently.

Pathologic 2 takes place in a small town on the steppe only referred to as the Town on the Gorkhon River, or simply "the town". The culture of the town is a fusion of 20th century technology and architecture with ancient steppe culture and traditions, which bring about customs that greatly affect the course of events in the town. Though the exact location and date are never mentioned, it is very heavily implied by character dialogue and environment clues that the game is set during the Russian Civil War.

The world of Pathologic 2 leans heavily into the surreal, meta-commentary and symbolism, frequently making discerning what is fiction and what is "reality" difficult. The events in the town are framed as a play in the style of Bertolt Brecht's "epic theatre", where the player is an "actor" "playing the part" of the player character. The player's "reality" often comes into contact with this framing, with theater-like elements such as spotlights, "scene changes" between day and night, and a disembodied stagehand-like voice appearing intermittently throughout the game. At certain points, such as during plays performed in the town's theater or after the player's death, the player encounters the mysterious and supernatural theater director Mark Immortell, who is often critical of the player's "acting" and frequently breaks the fourth wall, referring to the game's development, referencing the mechanics and inner workings of the game's systems, and referencing events or aspects from the original Pathologic, both contextually and literally.

In September 2014, Ice-Pick Lodge team launched a fundraising campaign on Kickstarter: according to the Kickstarter description, a remake was supposed to keep the overall plot and world of the original game, but with updated graphics and game mechanics as well as better AI and behavior model of the disease. According to the promises of developers, the duration of the game should exceed 70 hours. On 7 October 2014, the campaign ended with a total donation of $333,127. This money was enough to fulfill the first super goal—the expansion of the in-game town.

Initially, the release of the game was scheduled for autumn 2016. The developers claim that there are enough changes and innovations in the game to call it a separate game and not a remake. On 1 December 2016, those who donated a sufficient amount of money to the Kickstarter or the game site were granted a demo version of the game called Pathologic: The Marble Nest, which is essentially a separate game. Later the development was extended until autumn of 2017.

Pathologic 2 received "mixed or average reviews" according to review aggregator Metacritic, with a score of 70 based on 28 reviews. Critics praised the game's unique atmosphere, but criticized its unforgiving survival mechanics and clunky combat. In response to this, the game's developers added difficulty sliders to the game, allowing customization of specific parameters in addition to overall difficulty.