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Ranking The Old Ones (Pandemic: Reign of Cthulhu)

Cthulhu and the Lovecraftian mythos have been a staple in the gaming hobby for decades. Rich with history and lore, the world created by HP Lovecraft is unique, fantastical, and offers itself up for all kinds of games that are present across all genres. Those games include RPGs, such as the acclaimed tabletop roleplaying game Call of Cthulhu, deck building games like Arkham Horror, and cooperative nightmares like Pandemic: Reign of Cthulhu – the latter of which we will be talking about today.

Pandemic: Reign of Cthulhu is a cooperative point-to-point movement collaborative experience that walks in the same footsteps as games like Pandemic and Pandemic: Iberia. In Pandemic: Reign of Cthulhu, players play the parts of various different character archetypes in the Lovecraft universe, working to seal four gates (instead of curing diseases, like in the base Pandemic game) across four towns. Those are the towns of Arkham, Kingsport, Dunwich, and Innsmouth.

Leaving aside the obvious theme change there are a few core differences within the game. Firstly, Sanity is introduced, giving players lifelines and affecting their abilities when they turn insane. Secondly, instead of breakouts there are Shaggoths that can enter the game, causing much irk and angst amongst the players. Three Shaggoths and it is game over. There are also, and this is something I really like, Old Ones. At the start of the game there are seven Old Ones randomly selected (bar Cthulhu, who is always last, and whose reveal means the end of the game), and placed face down at the top of the board. Throughout the game they can get revealed for various different reasons and they cause permanent in-game effects that can change the way that the game plays.

Well, dear reader, it’s been a long while since we’ve looked at specific components to any game in detail. Today we are going to look at the Old Ones in Pandemic: Reign of Cthulhu and judge them in order to figure out which are the best and which are the worst.


The Old Ones in Pandemic: Reign of Cthulhu

Before we begin, let’s take a look at who the Old Ones are in Pandemic: Reign of Cthulhu and what it is that makes them so nasty.

In no particular order, the Old Ones are:

  • Yog-Sothoth – Ongoing effect – Playing Relic cards can only be done by the active player.
  • Tsathoggua – One off effect – All players collectively discard 2/3/4 cards (with 2/3/4 players)
  • Shudde M’ell – One off effect – All players collectively discard 3/4/5 sanity (with 2/3/4 players)
  • Nyarlathotep – Ongoing effect – Investigators may no longer do the Use a Gate action.
  • Shub-Niggurath – One off effect – Draw 4 cards from the bottom of the Summoning deck and add one cultist to each of these locations. Discard these cards to the Summoning discard pile.
  • Cthulhu – You lose – The world is plunged into an age of madness, chaos, and destruction. You have lost.
  • Azathoth – Ongoing effect – Remove 3 cultists from the unused supply.
  • Atlach-Nacha – One off effect – Each investigator puts one cultist on their location unless they choose to lose one sanity. An investigator may not lose their last sanity token to prevent this cultist placement.
  • Ithaqua – Ongoing effect – To walk out of a location with two or more cultists a player must first defeat a cultist at that location.
  • Yig – Ongoing effect – Sealing gates requires one additional clue card from a connected town.
  • Dagon – One off effect – Place one cultist on each gate location.
  • Hastur – One off effect – Draw the bottom card from the summoning deck. Place one Shoggoth at that location. Discard that card to the summoning discard pile. Then move each Shoggoth one location closer to the nearest open gate.

As you can see, the list of potential effects and actions are varied. As you can also see, there are twelve Old Ones in total. Since you will only ever play with seven, this means there will be quite a lot of variety every time you play.

Through the rest of this article we are going to go through which are the worst and best Old Ones (in our opinion) and what their effect can mean for the game.

Shoggoth Attacks

Which Old Ones are the best or worst in Pandemic: Reign of Cthulhu?

Myself and my partner are both avid gamers, and for the past thirty minutes we’ve been discussing the Old Ones in Pandemic: Reign of Cthulhu. With that in mind, we think we have hashed out which are the worst and which are the best, so – let’s take a walk through the logic.

Before we begin, this is just opinion, so please feel free to disagree. Whether you agree or disagree it will be interesting to hear your opinions in the comments below.

For this list, we will start off with the worst Old Ones that can be pulled in the game, and work our way through to those that are less harmful.

The Worst: Cthulhu

Cthulhu is the one Old One in Pandemic: Reign of Cthulhu who you are guaranteed to come across if the odds are not on your side. Cthulhu is always the 7th slot on the board, and his coming signals the end of the game. You draw him and you lose – so with that in mind, it’s pretty easy to see why he is worst.

2nd Worst: Hastur

Hastur has two abilities, both of which make him a nasty piece of work to uncover. First, he generates a Shaggoth, which is bad in and of itself. Shaggoths either take 3 actions to destroy, in a game where actions are a commodity, or they keep moving towards an Open Gate. If they reach the gate and travel through it they trigger and Evil Stirs action – the Reign of Cthulhu version of an outbreak. Evil Stirs cause the Old Ones to reveal (Awaken) and take you one step closer to losing the game.

Secondly, Hastur moves all Shaggoths one step closer to an open gate. So, why is this bad.

Well, if you have no Shaggoths on the board and you summon one near a gate then you may only have one or two actions to stop it passing through.

If you summon one on a gate, then Hastur making the Shaggoth move will push it through the gate, causing another Evil Stirs and another Awakened Old One. This can then cause the player who revealed Hastur to take more sanity damage, potentially pushing them over the edge of Sanity. What is more, you’d be surprised how often this happens. In our last game a Shaggoth got spawned on a gate by Hastur and it started a cascade of events that we didn’t recover from.

If there is one or two Shaggoths on the board already, then, depending on their placement, Hastur can force them through gates, causing more than one Evil Stirs to occur, and more than one Awakening.

Finally, if there are three Shaggoths already on the board when Hastur is revealed then no fourth Shaggoth can be placed. Needing to place a Shaggoth and not being able to is one of the loss conditions for Pandemic: Reign of Cthulhu. In such a situation then the game is lost instantly.

Hastur is not a nice card to come out.

The Driver vs The Shoggoth

3rd Worst: Azathoth

After Hastur, anything looks good; however, Azathoth can also end the game. Azathoth causes you to remove three cultists from the unused supply, making the pool of cultists smaller. Since one of the loss conditions of the game is that you run out of cultists and, when you need to place a cultists, can’t, then this can be pretty devastating.

So, best case scenario, Azathoth makes the game slightly harder. Worst case scenario, you only have two cultists left in the supply when Azathoth is revealed, losing the game instantly.

4th Worst: Shudde M’ell

If all characters go insane in Pandemic: Reign of Cthulhu then the game is over, and insanity is what Shudde M’ell specialises in.

Shudde M’ell makes all players collectively lose sanity. At the start of the game, this isn’t so bad – however, later on it can really hurt. It is even possible for the players to lose their last sanity this way, and that can end the game prematurely as all characters go insane. He isn’t the worst Old One, but he is pretty bad.

5th Worst: Yig

Finally an Old One with a name that is easy to spell, Yig doesn’t have the potential to end the game like the first four Old Ones on our list; however, his ability can make the game a lot harder.

Yig makes it so the players permanently need six cards to seal a gate instead of five (unless the Detective is in play, in which case it is five cards instead of four for him). This is difficult, and makes the game harder, since the hand limit is only seven (or eight for the Magician). It means you really need to manage your hand carefully.

Yig can also combo pretty devastatingly with one of the other Old Ones, Tsathoggua, who can force players to discard cards. Those two can cause some serious damage if Tsathoggua is pulled after Yig.

6th Worst: Ithaqua

Ithaqua is more of a nuisance than anything else, and it can burn up actions where actions are a real commodity. Ithaqua makes it so, in order to leave a space that has two or more cultists you need to defeat a cultists at that location first.

This means that moving two spaces can take four actions, and it can really slow gameplay down, as well as make it harder for a player to get where they need to be. In most cases it won’t instantly end the game (although it may signal the end game if you really need to be somewhere fast), but it will make the game a lot harder.

7th Worst: Tsathoggua

Interestingly, Tsathoggua won’t end the game, but he can make it near impossible to win. By forcing the players to discard cards collectively, depending on the number of players, Tsathoggua forces players to closely manage their hands in order to survive. Most of the time, players will have a few spare cards they can lose, but on rare occasions, they won’t and it can set an entire plan back a few turns. You may have just what you need to seal a gate and Tsathoggua forces you to discard it. In very rare occasions you may have the final cards of any given type, and Tsathoggua can force you to discard them, potentially making it impossible to win. We haven’t seen it happen, but it is technically possible.

Either way Tsathoggua is a pain.

Cultists Everywhere

8th Worst: Shub-Niggurath

Shub-Niggurath essentially spawns four cultists, using locations that are less likely to have been spawned before, and then places those locations in the Summoning discard pile, ready for them to re-enter the fold at the next Evil Stirs.

The worst case scenario with Shub-Niggurath is where you only have three or fewer cultists left as then he can end the game. In a rarer occasion you have made it through the entire Summoning deck twice or the Occultist has moved cultists to those locations, in which case you could cause an Evil Stirs. Those are both exceedingly rare though, and weirdly no where near as bad as the threat of Azathoth who reduces the pool of Cultists you have to play with. It’s the difference between there being a one off threat and there being a continuous threat present.

If you have at least five cultists in the pool, Shub-Niggurath is a manageable threat.

9th Worst: Yog-Sothoth

Now, don’t get me wrong – relics can be a useful addition to the game in Pandemic: Reign of Cthulhu, and they can really get you out of a sticky situation or make the game easier – that being said, Yog-Sothoth’s curse isn’t the end of the world.

In Pandemic: Reign of Cthulhu, it is usually the case that Relics can be played on any player’s turn. Yog-Sothoth limits that use by making it so only the active player can play relics. It’s a bit limiting, but since most relics have a one off use, and Yog-Sothoth makes they slightly more restrictive but not hugely so. Even when only playable by the active player, Relics are still nice to have.

The Magician at Work

10th Worst: Dagon

Dagon places a cultist at each gate location. This means he will place four cultists. For reasons explored with Shub-Niggurath, there are times when this could end the game, but it is highly unlikely. Instead, this is just four additional cultists.

Since you don’t need to clear cultists to close a gate, it doesn’t restrict gameplay all that much. If the gate locations haven’t yet been pulled in the Summoning deck then it may be a while before those gate locations become a real threat.

11th Worst: Atlach-Nacha

Coming in as the 11th Worst, or 2nd Best, Old One we have Atlach-Nacha, who forces all players to have one cultist played on their location or they can choose to lose one sanity. You can’t lose your last sanity this way. Okay, so let’s dissect this –

In the best case scenario, this is two cultists in a two player game. Simple, easy, done and dusted, unless there are less than two cultists left – in which case it could be game over if the players are on their last sanity.

In a four player game, it is four cultists. This may push a location over the limit of cultists causing another Evil Stirs. If there are four locations each with three cultists then this could, in theory, cause four Evil Stirs. Alternatively, if there are not enough cultists, then it will end the game.

Those situations are highly unlikely however. In the majority of cases, it will just be the same number of cultists as players. Easy and simple.

12th Worst/The Best: Nyarlathotep

Finally, we get to the best Old One to enter the field, and one that is essentially harmless – Nyarlathotep. So, what does Nyarlathotep do? Nyarlathotep makes it so you can no longer do the Use a Gate action.

Players can use gates to transport between towns in Pandemic: Reign of Cthulhu by rolling the sanity dice and potentially paying a sanity or cultist price. That being said, you can also easily play the game without using gates. There are busses that allow you to do the same thing for Clue cards from the Player deck – something that is even easier with the Reporter. Alternatively, the Driver can move fast anyway. Gates are optional, so much so we often forget that we can use them when we play, making Nyarlathotep the least threatening Old One to hit the table.

The Whole Board Midgame

So there we have it – a longer than expected exploration of the Old Ones in Pandemic: Reign of Cthulhu – putting them into a list from worst to best. Of course, they come out randomly, so all you can hope for is that the odds play to your advantage and you end up with Nyarlathotep rather than Hastur.

So, what are your thoughts? Do you like Pandemic: Reign of Cthulhu? What are your opinions of the Old Ones and what do you think of our list? Let us know in the comments below.

Other articles about the Lovecraft mythos in gaming:
A Beginner’s Guide to the Cthulhu Mythos
What is the difference between Pandemic and Pandemic: Reign of Cthulhu?
Call of Cthulhu – Basic Rules Impressions
Cthulhu Board Games – The (Almost) Definitive Guide


  1. Nice to see a new post! I have this game and rather like it. I think your taxonomy and evaluation is about right. I haven’t been able to play with all of the Old Ones yet to confirm, but Hastur and Cthulhu are definitely a pain. I do find this slightly easier to beat as a cooperative game than Pandemic itself and I’m good with that.

    Liked by 1 person

    • Thanks Bill! Oh yeah, Hastur and Cthulhu are definitely bad news.

      I think you may be right – it might be slightly easier than the base game of Pandemic. Any thoughts as to why?


      • Yes I do! I never thought about it expressly, however my gut instincts were always that it was easier. So I sat down with the boards and rules side by side and worked out some possible reasons. These are:

        Investigator Powers
        Number of Locations
        Number of Opponents
        Efficient Travel

        Both games share significant core mechanisms. Pandemic Cthulhu does add a new mechanic – Sanity – which is both thematically apropos and shifts the challenge from disease to horror. Sanity creates a random effect to either the character or the board – you lose Sanity or cultists appear. It also adds the Old Ones, who limit or change the board state. So the games will never perfectly compare however for discussion purposes they are close enough.

        Let’s look at these one at a time:

        Investigator Powers

        Characters in Pandemic Cthulhu start off a little more powerful than in the original Pandemic. When they lose enough Sanity to flip to Insane, they are reduced to approximately the same power level as a character in Pandemic. That’s a benefit right there.

        Additionally, Give Or Take 1 Clue/Relic Card allows you to hand off cards in the same location as long as they match the current town. Pandemic would be a lot easier you could use Share Knowledge in the same city to give any card that matches the color of the region instead of the just the city you share.

        Finally, the reward for defeating a Shoggoth is to get a Relic card. A Relic card is a boost to player action. There’s no reward in base Pandemic for any successful action other than slowing the spread of disease. In play, you may randomly draw Events from the City card deck, which are always useful, however it’s never guaranteed when and where you’ll draw one. The certainty of “I get a Relic” is slightly more powerful I think.

        Number of Locations

        I suggest that this is actually the number one factor in giving a higher success rate playing Pandemic Cthulhu. Base Pandemic has 48 locations, in the four colors, roughly divided into global regions. Pandemic Cthulhu has just 23 locations, also in the same four colors, divided up by the four towns. Pandemic has 88 connections (if I counted right) between locations where Pandemic Cthulhu has 30 connections.

        Because cultists can spawn in only half the number of locations, which you can move around with fewer Walk actions, you can be more efficient with Defeat a Cultist than with Treat Disease. With the exception of the Medic (and one other base Pandemic role I’m forgetting), until you Cure a disease, a Treat Disease action removes one cube. It’s good Pandemic strategy to keep moving between adjacent, about-to-outbreak cities, so that in four moves, for example, one character reduces two stacks of 3 cubes to 2 cubes apiece. Whereas in Pandemic Cthulhu, you can remove more cultists in any given location most of the time. Now, there is only one cultist pool, instead of four (or five) strains of disease, and the net pool depletion goes faster. So that is a partial offset that moves the difficulty back up since that pool runs the risk of depleting faster.

        Needing fewer of the four actions on any given turn to move about locations increases efficiency. Multiply that by number of players and it is almost a force multiplier, until countered by the increasing numbers of Old Ones restricting actions.

        Number of Opponents

        I must acknowledge that the change in opponents to cultists and horrors (shoggoths) instead of strains of disease is nicely flavorful. It also reduces the areas one has to focus on by shifting from curing diseases to closing Gates. In base Pandemic, you can get an outbreak that spills over from one region to another, creating different strains of disease in the same area, increasing the total number of possible outbreaks. In Pandemic Cthulhu, there is only one type of cultist, and if you are about to add a fourth cultist, instead you perform an Awakening Ritual, revealing an Old One.

        As the Old Ones are revealed, they restrict options for characters and increase the challenge. So this shifts from mounting numbers of potential outbreaks globally to more eldritch horrors. It generally increases the number of Shoggoths on the board. However, as noted previously, you can more easily reduce opponents from the board.

        Efficient Travel

        Here the big difference is Gates vs. Research Centers. Pandemic Cthulhu removes the ability to create a Research Station. Instead, Gates are fixed and already in play. You lose flexibility. However, with fewer locations, you do not need to travel as much. With the Use A Gate action, you can also instantly teleport just like having a Research Station. You don’t need to use a card for the Build a Research Station action either. That’s a savings of up to 6 card expenditures in the course of a game, along with up to 6 collective actions that need to be taken.

        Because locations are fewer, with lower total connections across the board, any movement to reach spaces to take down cultists or shoggoths is more efficient. The most remote Gate location is the Graveyard, which requires two moves to get to the rest of Kingsport. Compare that to building a Research Station in Santiago in Pandemic. Kingsport has six spaces, and is roughly equivalent to South America and Central America. Those have 8 spaces in Pandemic. And there are 4 yellow region spaces in Africa. Having to get to Santiago from Africa or Australia to deal with a 3 cube pile is one of the biggest challenges in Pandemic. Having an always accessible means of getting around the board simplifies that step, making the number of actions required less, increasing investigator efficiency.

        Additionally, all Gates are in place at the start of the game. In Pandemic, you have to move to the locations and create Research Stations, which requires a number of actions and/or City card uses before you have a second fixed point to access. A Research Station that is placed away from common travel paths will increase overall global transfers however you pay for it with inefficient moves out from the Research Station.

        I should however acknowledge that there’s a drawback and possible consequence with Gate Use. You have to roll the Sanity dice. It is not without cost. However, when you’re only placing one or two cultists, that’s survivable. When a character becomes Insane, you’re down to the power level of a standard Pandemic character. The net benefit is significant.


        In Pandemic Cthulhu you start with a stronger character, who faces fewer types of opponents. Events will start to restrict both character abilities and actions as the game progresses, so there is still a building threat. (This is part of the flavor of impending eldritch horror too!) However, despite a buildup of opponents and reduced options due to emerging Old Ones, the board and number of spaces is smaller. Character efficiency increases while reducing card spend to take movement actions. Instead of uncertainty (where do we put Research Stations vs where are the outbreaks going to happen and will the Research Stations be placed correctly?), you have certainty (Gates), with no cost to place them, only a cost to use them (Sanity).

        Finally, I suggest that the game board itself reduces the cognitive load to mentally map out where to take actions, in turn easing the mental math to create highly efficient actions. Thus even if someone did a lengthier math exercise showing that I’m full of it, it feels easier when you play. Or so I think.

        Liked by 1 person

        • Oh wow Bill – this response is amazing and you raise so many good points. I can completely see where you are coming from. Initially my thoughts were around movement efficiency, which you definitely cover as well, but you have provided a lot of food for thought there!

          I didn’t actually realise how much smaller the board is, and where the Old Ones can vary the game and make it harder, with the board being smaller and with greater character powers/efficiency the game is potentially still easier even with the Old Ones in play.

          Thanks for putting so much thought and effort into your response, and for providing such an interesting read. The big question now – which version of Pandemic is your favourite?


          • You’re welcome! It was fun to think through. (Maybe I’ll repost this on my very neglected blog even.) I go back and forth between which one I like better. I forced to choose because, say, board games cease production or I had to go to Mars, I’d take Pandemic. Reason being that there’s more of a challenge and expansions will continue to be produced, I suspect.

            Liked by 1 person

  2. Luke,
    I am also named Luke. Intriguing. Let me know if you hear of any “Battle of Luke’s” coming up, similar to the recent “Josh War” that just occurred. It would be enjoyable to engage you in combat, or even greet you as a worthy competitor.
    I have a very specific question regarding the Old One Ithaqua. My wife and I played last night, and we have played many times before. However, classic us, we came across a scenario where we disagreed on the proper way the turn should play out. Here’s the set up:
    Ithaqua was in play. It was her turn. She was on Diner with 3 cultists. She removed one cultist and proceeded on with her movement away from that space. I contested that she needed to take away two cultists, not one, in order to walk away. Her reasoning being the verbatim instructions on Ithaqua, which says “To walk out of a location with 2 or more cultists a player must first defeat a cultist at that location”, she was focused on the words “A cultist.” A, singular, just one. So, she took that to mean that regardless if there are two or three cultists, she only needed to defeat one in order to move. I disagreed that per the rule of Ithaqua, defeating only one cultist still left two on the space, and therefore one more still needed to be defeated. I fully understood the implication of “a cultist” equaling just one cultist, but I feel that per the wording, and the fact that Ithaqua’s effect is constant, it means that in order to walk away, the space cannot have more than one cultist at it.
    Your thoughts?
    I appreciate your time. Keep upholding the honorable name of Luke with poise and integrity. Until next time we communicate, I wish you well.

    Liked by 1 person

    • Hi Luke!

      Interesting situation. My reading would be the former I think – in order to walk away you need to defeat a singular cultist, even if that means there are still two cultists left.

      The main reason I am thinking that is because it could be reworded the other way around as “You can’t leave a location if it has 2 or more cultists”.

      That said, I really like the twist on the rules and the fact you could read it as both ways depending on how difficult you want the game. Maybe house rule it? 🙂


      • May I kibbitz here? I pulled out the rules. If you look on p. 11 Old Ones – Fine Points under Ithaqua, there’s a further paragraph that I think important:

        “This restriction is lifted if you reduce the number of cultists to 1 by another means (such as using the Occultist’s special ability).”

        When read in conjunction with the card itself, that seems pretty clear to me. You have to get down to 1 Cultist.

        Liked by 1 person

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