The Rules

  • Location Cards: Place face-up in a random 5x5 grid. Decide which player will play as the Patients; others are Victims. One player wins each game: a single Victim or the Patients player. A fun rule: the last person to listen to a murder documentary plays as the Patients. They’re sick anyway.


    Cards: Place Camo/Sabo and Movement cards face down. Place Bloodlust cards with Patients player. Patients player utilizes a coin and die; Victim players get paper and pen.

    Note: If you do NOT have a coin on hand for movement. You may use the Dice. Odd = Move 1, Even = Move 2.

    Victims: Each player randomly picks a Victim card and shows it. Victim cards have positive and negative effects that should be visible and discussed before the game. (You are given one mulligan to re-draw your chosen Victim if desired.)


    Patient Player: Draw a Patient card and place it in its starting location.


    Victims: Choose starting rooms, write locations on paper, and keep them hidden. Locations are secret until caught or otherwise revealed.


    Draw Cards: Each Victim draws a Camo/Sabo card to start and you're ready to play.

    After this set-up phase, play starts with the Patients player and moves clockwise around the table.

  • Patients: Find and kill all Victims players.


    Victims: Betray other Victims, stay hidden, and escape the Asylum.



    1. Flip Coin: Heads: All Patients move 1 room. Tails: They move 2 rooms. They move up, down, left or right.


    1. Catch Victims: If a Patient moves through, or ends in a Victim's room, the Victim announces they were caught and which room they were caught in. Roll the die to determine if the Victim is killed using the stats in the top right of the Patient's card.

    • Success: The room where the Victim was killed is destroyed, the Patient moves to the room above. And the rooms collapse down in its place filling the new void in the Asylum's column, thus shrinking the amount of available rooms to hide in. (If this was a room in the top row, the Patient instead falls into the room below it, and if the column is destroyed you may pick the left or right room to move into and push the columns together.)  

    • If no Patients Kill a Victim on the turn: Draw a Bloodlust card and resolve it immediately.

    New Patients: At the start of the Patient player's 4th turn, add a new Patient. On the 7th turn, add a Special Patient. Destroy the room these Patients start in (in the same manner as catching a Victim). If their starting room is gone, choose a room of the same room-color to place them into. (If the same color is not available, choose any room you want.)

    Note: Some Patients have effects. These may only be used ONCE per game.



    1. Draw a Card (Only if desired): Each Victim may draw a single card (Camo/Sabo or Movement).

      • Camo/Sabo: Protect yourself or sabotage others. Camo cards are green and may be used whenever. Sabo cards are orange and can only be used on your turn unless specified otherwise.

      • Movement: Draw a movement card and use it immediately. You must move the full amount of spaces allocated, and write down your new location, but you may move back and forth to try to trick the Patient player. If you are forced to move through a Patient's room (IE: you are cornered), you are caught by them in their room and do not use any leftover movement. They then get a chance to kill you, much the same as if they'd entered YOUR room. Victims also move up, down, left, or right only. (Not diagonally)

  • Once all but one Victim have been killed, the game enters its final three rounds, starting with the last Victim.

    A.) The Victim takes their turn.

    B.) The Patients player takes their turn.

    C.) After the Patients have moved, but before the Bloodlust card is played, any rooms containing a Patient are destroyed, causing the rooms above to collapse as usual.

    D.) Resolve the bloodlust card.

    If the Victim survives these final three rounds of turns, they escape. If not, they die, joining the rest of their friends.

  • Notes:

    • Victims can hold up to 7 cards. To draw another, discard one.

    • Multiple Camo/Sabo cards can be used per turn.

    • If a Patient fails to kill a victim, the Victim immediately draws a free movement card to flee.

    • “Stumble into Nearest Patient” cards move a Victim to the nearest Patient's room.

    • Effects are resolved in the order they are played. A Victim can use a Camo to get away from a Patient but can’t retroactively use a card out of your hand after someone has made you discard it. 

    • Some Location cards have effects, used once or multiple times.

    • If 2 Patients are in the same room, they both catch any present Victims, subsequently they both get a chance to kill them.

    • All cards are discarded face-up when they are used.

    • Some cards are labeled "Hold". These cards are to be placed on the table and last forever unless destroyed. They also are not treated as cards in the players hand.