Pandemic: Reign of Cthulhu

1 Overview

Pandemic: Reign of Cthulhu is a standalone game (not an expansion) that reimagines Pandemic in H.P. Lovecraft's Cthulhu Mythos. Instead of diseases and cures, you're sealing dimensional gates to stop Ancient Ones from awakening. The core cooperative loop is similar to Pandemic, but Shoggoths, Sanity loss, and Madness cards add a distinctly Lovecraftian flavor.

2 Setup

The board shows four towns across a New England-inspired map (Arkham, Dunwich, Innsmouth, Kingsport). Each has a gate. Cultist tokens seed starting locations. Each player chooses an Investigator with a unique ability and a full sanity track.

The Ancient One deck is shuffled face-down, one Ancient One will awaken if players lose, and the specific one changes the lose condition.

3 Cultists & Gates

Cultists replace disease cubes. They appear in towns during the Summon Cultists phase (equivalent to Infect Cities). Each town can hold 3 cultists before summoning a Shoggoth.

Gates replace Research Stations. Four gates (one per town) serve as the objectives. To seal a gate, an Investigator must be in that town and discard 5 matching Relic cards. Once sealed, that town's cultist limit increases (it's harder to overflow). Seal all 4 gates to win.

4 Sanity & Madness

Each Investigator starts with a full Sanity track (4–5 points depending on character). Certain events reduce sanity:

• Being in a town when a Shoggoth appears
• Encountering specific Cultist Event cards
• Failed gate sealing attempts (in some variants)

When Sanity reaches 0, the Investigator draws a Madness card, a permanent disadvantage (lose 1 action per turn, cannot share Relic cards, must discard a card each turn, etc.), and their Sanity resets to 1. If a Maddened Investigator loses all Sanity again, they are eliminated from the game.

5 Shoggoths

When a town overflows (would receive a 4th cultist token), a Shoggoth appears instead of triggering an outbreak chain. Shoggoths are monster tokens that move each turn.

At the end of each round, all Shoggoths move one town along the road network toward the nearest gate. If a Shoggoth reaches a sealed gate, the gate reopens, the seal is broken and must be re-sealed. If a Shoggoth reaches a town with the maximum cultist count, the players lose.

6 Ancient Ones

The Ancient One deck determines which entity awakens if players lose. Each Ancient One has different abilities that affect the lose condition and sometimes modify game rules. Players don't know which Ancient One is "in play" until a loss trigger occurs, discovering which entity you're fighting against is part of the game's tension.

7 Winning & Losing

Win: Seal all four gates before any loss condition triggers.

Lose if:

• The Cultist token supply runs out
• A Shoggoth reaches a town that's already at maximum cultists
• The Player deck runs out (like standard Pandemic)
• All Investigators are eliminated (too much Madness)

8 Strategy

Control Shoggoths Early

Shoggoths are the most dangerous unique mechanic. Prevent their appearance by keeping cultist counts low in towns, don't let any town approach 3 cultists without a plan for clearing them.

Protect Sealed Gates

Re-sealing a gate costs 5 Relic cards again, a massive setback. After sealing a gate, keep the town's cultist count low so Shoggoths don't march toward it.

Manage Sanity Like a Resource

Madness cards are permanent and compound. Protect Investigators with critical abilities from Sanity loss. If one Investigator is already Maddened, route them away from Shoggoth-heavy areas.