Pathologic 3 is an RPG developed by Ice-Pick Lodge and published by HypeTrain Digital. The title was previously released on 9 January 2026 on Steam and then published on Xbox Series X|S on 23 January 2026. We had the opportunity to review the game on our Xbox Series S.
Pathologic 3, a narrative odyssey
The game begins with the arrival in town of Daniil Dankovsky, a doctor tasked with finding out more about a disease that is claiming many victims. His arrival in the city does not go well, as his luggage is stolen by children and no one is willing to help him. However, this is not the strangest thing we encounter, as we also have to deal with followers of a dark cult and strange visions. Meanwhile, we try to get in touch with someone who seems to know a lot about our obsession with finding eternal life.
The title immediately throws us into a spiral of long dialogue with a lot of choices of answers that require the player to work hard to deal with everything that is happening. Furthermore, those unfamiliar with the previous titles may find it challenging to grasp the game’s narrative.
A complicated game to play… and review
Usually, when we review a game, we already have an idea of what we will write and what rating we will give it. There are good games, bad games, and then there’s Pathologic 3. We personally have to admit that we didn’t like it. Playing it to get an idea of what to write in this review took an incredible effort, and even now we still have doubts about what to write.
We don’t like all the games we review, but we try to be impartial and base our judgement on technical and artistic aspects. Often, some games make our lives easy because they have obvious flaws or engage us enough to analyse every detail of the game.
In this case, however, we don’t think we will be able to give an impartial opinion on Pathologic 3.
It is a title with a vast narrative, a non-linear story, and an absurdly huge amount of dialogue. It is never clear whether the dialogue is relevant to the plot. Added to this are the behavioural mechanics of the protagonist. Depending on how we behave in certain situations or how we respond to our interlocutors, we can switch from a state of Mania to Apathy.
The narrative is accompanied by superb environmental design, placing us in a detailed, populated city. The gothic and steampunk atmosphere ties in very well with the plot of the game. However, on Xbox Series S, the graphics are significantly inferior, with colours lacking brightness and contrast. This makes all scenes appear flat, as if there were a constant haze, even where there shouldn’t be one. Furthermore, the 3D models appear to be from a previous generation.
Not only does the Xbox port suffer graphically, but the controls are also less than ideal. The behaviour of the left analogue stick is strange, especially when strafing left or right. Even when the stick is moved all the way to the right, the character sometimes moves quickly and at other times very slowly, depending on whether the stick is also slightly forwards or backwards. This behaviour is truly bizarre. Additionally, the menu navigation is slightly complicated and mouse and keyboard support would have been a useful addition to the Xbox version.
One aspect that particularly disappointed us was the lack of accessibility features. For example, there is no option to activate subtitles, which we would have preferred, especially during the initial cutscene. There is also no option to increase the font size. Console games should be designed to be played while sitting comfortably on a sofa. With small fonts and dense dialogue, it becomes really difficult to follow the plot without getting tired.
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