Pathogenic Review - The Most Creative Roguelike of 2026?

Ole Gamer Joe
3 hours ago
5 min read

https://www.youtube.com/watch?v=GTeeFPY2cEg

Wouldn’t Biology class have been far more entertaining if everything in the lab was getting launched toward your face? Ok, that came out wrong, fuck, that also came out wrong. I’m going to stop now and instead talk about Pathogenic, a brand-new twin-stick roguelike shooter created by Aberrant Labs and published by Slug Disco. This genre of games is far from constipated, with releases leaking out faster than a bad bout of diarrhea; however, it’s fair to say not all of them have been… shall we say, fully flushed-out hits.

In Pathogenic, you’ll control a lone disease attempting to hijack the human body. This means traversing its many components, including the skin, stomach, liver, and beyond, yummy! Unfortunately, we don’t get to explore the anus, so you’ll have to do that on your own time. It plays very much like a traditional twin-stick shooter from a mechanical perspective; however, Pathogenic is anything but, and yes, if you are reading this review on our website instead of watching the video version, I spelled butt with two t’s intentionally.

It turns out playing as an infection is more fun than it sounds, as through each new run you’ll be collecting an assortment of biological parts, strengthening your disease in a variety of different customizable ways. Yes, the game is run-based in traditional roguelike fashion, with players unlocking new parasites that each come with unique biological quirks. As for the controls themselves, all you really need to be concerned with is a small handful of them: there’s a dodge, you move with the left stick and aim with the right stick, shoot your loads, and that’s about it.

While that sounds simple enough, it's those different components that are clipped onto your parasite, earned through defeating foes and via exploration, that really spice things up in the same way that last burrito infected your bowels. There’s a massive assortment of projectile weapons, shields, and beyond that can turn your tiny parasite into a full-blown biological disaster. How you stack your virus is entirely up to you, with a large assortment of customizable options available. You might lay things out so that you’re spewing bullets, blasting laser beams, and crop-dusting enemies with noxious gases and flames. Sometimes you’ll sacrifice speed for strength, and vice versa. It can all feel a bit overwhelming at first, but much like that last mole that appeared on my ass, I grew to accept and love it like the rest of my body. There are lots of different types to be strapped on too, including flagella which will help with your overall movement, mitochondria which offer powerful boosts if aligned correctly, ranged attacks, and even some close melee options. Not everything can be snapped together like a simple jigsaw puzzle either, as certain mitochondria have to be placed on specific locations of your virus to work at all.

The human host which you’ll be exploring, as I mentioned, is broken up into sections which can be considered their own individual levels. As you would expect, each area is procedurally generated, hosting a wide assortment of enemies ranging from immune to T cells. A tapeworm was something I never wanted to encounter in life, but this game has now ensured that I have. Enemies will blast out bullets which you’ll naturally need to dodge, carefully eyeing your stamina so that you don’t run out of steam. Controls are fast and, pun intended, fluid, gently massaged by excellent controller support, which is the recommended way to play. These levels are also beautifully laid out on a map, with light exploration encouraged. This is because you can find awesome new upgrades and spend earned currency for even more upgrades that will help you fight another day. Do know that some perks come with downsides, adding an additional layer of strategy. Fast travel is also available, making getting around a breeze, with each area culminating in a disgustingly fun boss battle.

With so many different synergies, there’s rarely a dull moment in Pathogenic. This isn’t even including plasmid fragments that allow for permanent upgrades to parasites, with players unlocking new parasites through gameplay. Each of these characters comes with its own skill tree, extending playtime significantly. Pathogenic also features some really fantastic physics that will have both you and your enemies wobbling about, stretching, and reacting impressively to each hit. I also loved how each area of the host body offered unique traps suited to the theme of the level. Lungs feature plenty of airflow hazards, there are barnacles to be hung up on, and naturally pools of acid in the stomach. Each area offers dangers of its own outside of the many cells you’ll be fighting against.

The further into the body you get, the more challenging Pathogenic becomes, so grabbing the right upgrades will be paramount to your success. While I played the vast majority of the game on the default normal setting, those who struggle with the genre will appreciate that two easier options are available. This means that players who aren’t the best at twin-stick shooters can still enjoy playing while paying more attention to the many different ways parts can interact with one another.

For as gross and unappealing as it may seem thematically, the visuals are actually quite lovely in Pathogenic. Each location pulses and feels alive, filled with bright, vivid colors and just about everything on screen jiggling about like Jell-O. Areas feel distinctly their own, and I wasn’t hit with the usual sense of roguelike burnout that can come with trudging through the same locations time and time again due to the variety of creativity packed within this tiny indie. It’s an awesome-looking game, with an exceptional electronic soundtrack that eases off into the background during exploration, cranking up tenfold during combat encounters. Pulsing electronic beats will have you bobbing your head as you duck and weave through bullets and hazards.

In terms of performance, I did sadly hit a few random framerate snags throughout gameplay which seized up the screen entirely. These were rare thankfully and can hopefully be ironed out in time for release. Steam Deck support is mostly excellent for those looking to play on Valve’s handheld, offering a solid 60fps experience that still looks great on the smaller screen.

Between the vast array of unlockable content, customizable builds, mod support, and daily challenges, Pathogenic is the kind of game that burrows itself deep inside you and refuses to pull out. I loved the smooth controls, tough but fair challenge, and unique setting and atmosphere. Toss in that fantastic soundtrack and great overall sound design, and you’ve got yourself one of the biggest surprises of 2026. As someone who loves twin-stick shooters, I was endlessly impressed with what the game offers, feeling fresh, fun, and innovative in the most disgustingly satisfying of ways. If you're looking for something a bit different out of the genre that looks, plays, and sounds great, this is one virus you won’t mind infecting you. I am awarding Pathogenic the elusive Golden Genie Lamp of Approval.

PROS

Great soft‑body physics

Tons of build variety

Distinct organ biomes

Fast, fluid controls

Strong replay value (mods + challenges)

Excellent visuals and soundtrack

CONS

Occasional framerate freezes

Early-game overwhelm

Organelle placement can confuse

Visual chaos during heavy fights