Theme Hospital

32 Simulation games like Theme Hospital that you should try

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We filtered the 50 games similar to Theme Hospital down to the 32 that fit the “Simulation” category. Medieval II: Total War, Rome: Total War and Majesty Gold HD top the list, ranked by affinity and similarity score to Theme Hospital.

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GenreStrategySubgenreRTS

Tags

SoloMultiplayer

Year 1997Dev Bullfrog Productions

Stores

Quick answer

Within the “Simulation” category, the closest game to Theme Hospital is Medieval II: Total War — scoring 92/100 on our similarity scale. Rome: Total War and Majesty Gold HD follow close behind.

#1Medieval II: Total War92 #2Rome: Total War92 #3Majesty Gold HD92 #4Stellaris92 #5Impossible Creatures Steam Edition92

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The best simulation games like Theme Hospital

32 similar games foundUpdated July 2026

Handpicked by our similarity algorithm, these are the titles with the highest gameplay match to Theme Hospital. Each one has been evaluated across 5 real attributes — from combat style and progression mechanics to world structure and visual perspective — so every recommendation is based on how the game actually plays, not just its genre label.

#1Medieval II: Total War

92

Medieval II: Total War

GenreStrategySubgenreRTS

SoloMultiplayerIsometricTacticalMelee

Steam👍 96%· 36KIGDB90· 3

Year 2006Dev The Creative Assembly · SegaOn Linux · PC · Mac

✓ Both are real-time strategy games — sharing real-time strategy, deep simulation and single-player focus

≠ Where it differs: brings turn-based strategy, combat tactical and melee combat

#2Rome: Total War

92

Rome: Total War

GenreStrategySubgenreRTS

SoloMultiplayerIsometricTacticalMelee

Steam👍 95%· 17KIGDB91· 3

Year 2004Dev The Creative Assembly · SegaOn Android · PC · iOS

✓ Both are real-time strategy games — sharing real-time strategy, deep simulation and single-player focus

≠ Its own twist: turn-based strategy, combat tactical and melee combat

#3Majesty Gold HD

92

Majesty Gold HD

GenreStrategySubgenreRTS

SoloMultiplayerIsometricFantasyMedieval

Steam👍 93%· 589RAWG👍 87%· 101IGDB65· 1

Year 2001Dev Cyberlore Studios · Paradox InteractivePlaytime ~1hOn PC

✓ Fits the real-time strategy games cluster, with real-time strategy, deep simulation and single-player focus

≠ Stands apart with fantasy world, setting medieval and base building

92

Stellaris

GenreStrategySubgenreRTS

SoloMultiplayerIsometricTacticalNarrative

Steam👍 86%· 194KRAWG👍 84%· 693MC78IGDB79· 11OC81· 42

Year 2016Dev Paradox Development Studio · Paradox InteractivePlaytime ~10hOn PC · Apple Macintosh · Linux

✓ Same family of real-time strategy games: real-time strategy, deep simulation and single-player focus

≠ Stands apart with turn-based strategy, sandbox freedom and strong narrative focus

#5Impossible Creatures Steam Edition

92

Impossible Creatures Steam Edition

GenreStrategySubgenreRTS

SoloMultiplayerIsometricMeleeTactical

Steam👍 96%· 1.8KRAWG👍 75%· 32MC72IGDB73· 3

Year 2003Dev THQ NordicPlaytime ~1hOn PC

✓ Fits the real-time strategy games cluster, with real-time strategy, deep simulation and single-player focus

≠ Where it differs: brings melee combat, combat tactical and historical setting

#6Europa Universalis III

92

Europa Universalis III

GenreStrategySubgenreRTS

SoloMultiplayerIsometricSandbox WorldHistorical

Steam👍 83%· 2.0KIGDB70· 1

Year 2007Dev Paradox InteractiveOn PC · Mac

✓ Fits the real-time strategy games cluster, with real-time strategy, deep simulation and single-player focus

≠ Stands apart with turn-based strategy, sandbox freedom and sandbox world

#7Dawn of Discovery

92

Dawn of Discovery

GenreStrategySubgenreRTS

SoloMultiplayerIsometricFantasyHistorical

IGDB72· 2

Year 2009Dev Related Designs · Ubisoft EntertainmentPlaytime ~1hOn PC · Nintendo

✓ Same family of real-time strategy games: real-time strategy, deep simulation and single-player focus

≠ Its own twist: adventure storytelling, fantasy world and historical setting

#8Knights and Merchants

92

Knights and Merchants

GenreStrategySubgenreRTS

SoloMultiplayerIsometric

Steam👍 85%· 4.9KRAWG👍 40%· 166

Year 2013Dev Runesoft · TopWare InteractivePlaytime ~3hOn PC · Apple Macintosh · Linux

✓ Nearly identical: real-time strategy, deep simulation and single-player focus.

92

Majesty 2

GenreStrategySubgenreRTS

SoloMultiplayerIsometricMagicRanged

Steam👍 69%· 1.3KRAWG👍 73%· 63MC72IGDB50· 2

Year 2009Dev 1C:InoCo · Paradox InteractivePlaytime ~2hOn PC

✓ Both are real-time strategy games — sharing real-time strategy, deep simulation and single-player focus

≠ Where it differs: brings punishing difficulty, combat magic and ranged combat

#10Black & White

92

Black & White

GenreStrategySubgenreRTS

SoloMultiplayerIsometricMagicSandbox World

Year 2001Dev Lionhead Studios · Electronic ArtsOn PC · Mac

✓ Same family of real-time strategy games: real-time strategy, deep simulation and single-player focus

≠ Its own twist: puzzle design, sandbox freedom and sandbox world

#11Anno 1602: Creation of a New World

92

Anno 1602: Creation of a New World

GenreStrategySubgenreRTS

SoloMultiplayerIsometricHistoricalExploration

Year 1998Dev Max Design · SunflowersOn PC

✓ Same family of real-time strategy games: real-time strategy, deep simulation and single-player focus

≠ Stands apart with historical setting, exploration and discovery and base building

#12The Settlers III

92

The Settlers III

GenreStrategySubgenreRTS

SoloMultiplayerIsometricTacticalHistorical

Year 1998Dev Blue Byte SoftwareOn PC

✓ Fits the real-time strategy games cluster, with real-time strategy, deep simulation and single-player focus

≠ Stands apart with combat tactical, historical setting and setting mythology

#13Dungeon Keeper

92

Dungeon Keeper

GenreStrategySubgenreRTS

SoloMultiplayerIsometricMagicRanged

IGDB10

Year 1997Dev Bullfrog Productions · Electronic ArtsOn PC · Mac

✓ Both are real-time strategy games — sharing real-time strategy, deep simulation and single-player focus

≠ Its own twist: dark, oppressive atmosphere, combat magic and ranged combat

#14Star Wars: Galactic Battlegrounds

92

Star Wars: Galactic Battlegrounds

GenreStrategySubgenreRTS

SoloMultiplayerIsometricMeleeSci-Fi

Steam👍 91%· 4.6K

Year 2001Dev LucasArtsOn PC · Mac

✓ Same family of real-time strategy games: real-time strategy, deep simulation and single-player focus

≠ Its own twist: melee combat, setting scifi and base building

#15RollerCoaster Tycoon 2

92

RollerCoaster Tycoon 2

GenreStrategySubgenreRTS

SoloMultiplayerIsometricCasualSandbox World

Steam👍 90%· 5.8KIGDB60· 1

Year 2002Dev Chris Sawyer Productions · InfogramesOn PC

✓ Same family of real-time strategy games: real-time strategy, deep simulation and single-player focus

≠ Stands apart with sandbox freedom, vibe casual and sandbox world

Complete list of simulation games like Theme Hospital

The full catalog of games sharing gameplay DNA with Theme Hospital, ordered from highest to lowest similarity score. Use the filters above to narrow down by genre, setting or game mode and find the alternative that best fits your playstyle.

The Guild II

The Guild II

RTS · Simulation

Stronghold 2

Stronghold 2

RTS · Simulation

Stronghold 2: Steam Edition

Stronghold 2: Steam Edition

RTS · Simulation

Grand Ages: Rome

Grand Ages: Rome

RTS · Simulation

Football Club Simulator - FCS #21

Football Club Simulator - FCS #21

RTS · Sports

Victoria II

Victoria II

RTS · Turn-Based Strat

The Guild II Renaissance

The Guild II Renaissance

RTS · Simulation

Commander: Conquest of the Americas

Commander: Conquest of the Americas

RTS · Simulation

East India Company

East India Company

RTS · Simulation

Stronghold 3 Gold

Stronghold 3 Gold

RTS · Simulation

Total War: Shogun 2

Total War: Shogun 2

RTS · Turn-Based Strat

Plague Inc: Evolved

Plague Inc: Evolved

RTS · Simulation

Age of Mythology: Extended Edition

Age of Mythology: Extended Edition

RTS · Simulation

Anno 2070

Anno 2070

RTS · Simulation

DETOUR

DETOUR

RTS · Puzzle

Startopia

Startopia

RTS · Simulation

Company of Heroes 2

Company of Heroes 2

RTS · Simulation

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