The Appalachia of Fallout 76 today is quite different from the one players saw back in 2018. While things were very rocky, literally and figuratively, at the start, the game is now teeming with life in all sorts of forms, and Bethesda recently added a new but familiar face to the roster – that of the playable ghoul. No doubt inspired and/or fueled by the success of the Fallout TV show and the popularity of its character, Cooper Howard, aka The Ghoul, in March, Bethesda released Fallout 76’s newest content, which unleashed “The Ghoul Within.” Having been a longtime if waffling fan of the game, I couldn’t wait to give the “ghoulification” process a go myself. If you follow us over on YouTube, this month, you can watch how my “ghoulish” adventures unfolded in Appalachia. This, however, is my retrospective, with some minor spoilers to start, and further thoughts.

Becoming a ghoul in Fallout 76 begins with a quest that pops upon a character reaching level 50. It follows a rumor that someone has figured out how to purposefully turn humans into ghouls. The basic reasoning behind doing so is to “save” the critically ill, but there is, of course, the catch of simply being a ghoul, not to mention the prospect of going feral. The story that ensued was engaging, and indeed, its end point was having to make the choice to become a ghoul, or not. I picked my current main, shotgunner Karla, as the willing subject. After it was all said and done, she was ghoulified!

That was all well and good, but the question as to what top do next loomed. Bethesda claimed that new interactions in Appalachia came with the new content, so I first wanted to see how different factions would react Karla’s presence. Spoilers…no one batted so much as an eye her way! Well, almost no one. While Karla the Ghoul could walk into different settlement without any reactions from the populace whatsoever, she couldn’t enter any of the main hubs, such as the Brotherhood of Steel’s observatory or the boss’s digs at Crater, home of the Raiders. Well, she couldn’t enter them without a disguise, that is, one provided by a particular new character. Once disguised as a “human” Karla the Ghoul could go wherever she pleased, no one thought anything of it. I was disappointed, to say that least. There wasn’t even a suspicious there’s something different about you…from anyone. What was even the point of going ghoul then, anyway?

The perks! Yes, the new ghoul perks cards that were added, of course. I could redo Karla’s build to fit her new personality…that was the ticket to something different! Only…the ghoul cards were all LOCKED. And they remained locked no matter what I tried. Now, upon becoming a ghoul, certain existing cards become locked, because those perks were no longer relevant – I’m not talking about those. I’m talking about the ones that were made just for ghouls. The only one I could apply to Karla was a legendary perk that aided in not going feral. But the rest of the cards for regular building stayed locked tight the whole time. That was a pretty big bummer.

I abandoned worrying about the perks and decided that my last option for really getting into the ghoulish spirit was to go feral. When you become a ghoul, a feral meter replaces the food and drink meters (though you can still consume food, water, etc.). The feral meter depletes over time unless (1) you feed your character chems, or (2) you are able to apply that legendary perk card I mentioned. Being non-feral and fully healthy ghouls isn’t all bad, as they receive buffs to strength and endurance and gain extra HP. As one’s feral meter drains, those benefits begin to decrease – buffs become debuffs and HP and AP takes hits, too. By the time one is fully feral, some stats go down the tubes, except for melee damage, which gets an extraordinary boost. Nothing about the look of one’s ghoul changes however in feral mode, there’s no lurching and flailing and hissing. There’s just you, a ghoul, being feral and fine with it. Hmph.

If I haven’t expressed my feelings clearly enough, I’ll state it plainly – becoming a ghoul in Fallout 76 was boring. It was mildly intriguing at first and underwhelming at the end. It’s worth noting that had this experience on my own private server – just Karla, alone in Appalachia, being a ghoul. I can imagine that publically, being a ghoul might be quite different, especially among role-players. (There is, after all, plenty of lore behind the presence of ghouls and their relationships (if that) with humans.) So, I might hop into a public world with Karla the Ghoul to see what happens. Or, more likely, I may turn her back into a human (a one-way option if ghoul-dom isn’t for you), because my role-playing wheels have started turning…

Though I was unimpressed with turning an established character into a ghoul, I am wondering about what a playthrough might look like if I had a character that was a ghoul from the start. That’s a rough prospect considering that the needed quest doesn’t kick off until level 50. But, with some in-game currency burning a hole in my pocket, I could pay for a level 50 character, become a ghoul, and take on the game’s various stories from there. It’s an idea…and with a few months left on my year-long sub, maybe one that’ll become a reality.

All images, including lede, were captured by author during PS5 gameplay of Fallout 76 © Bethesda Game Studios, Bethesda Game Studios Austin (2018-2025).