The game is a follow-up to 2019's Pathologic 2, which itself is a reboot of the original 2005 game, Pathologic.

Six years after deciding to split Pathologic 2 into multiple separate chapters so it could actually get the game finished and released, Ice-Pick Lodge has chucked that plan into the creepy medical incinerator and decided to go full steam ahead with Pathologic 3 instead.

The original Pathologic tells three stories from three very different points of view: the Bachelor, the Haruspex, and the Changeling. Pathologic 2 was an expanded and far more accessible re-telling of the game from the point of view of the Haruspex,