- Manual saving, quicksaving, and autosaving (with the exception of autosaving after sleeping) are disabled. The only way to save is to sleep in any bed for at least one hour.
- In Survival mode, the exit save is automatically inaccessible once it is loaded. System crashes will allow you to return to your last exit save.
- Fast travel is disabled.
- The Sole Survivor takes but also deals more damage.
- Most threats are not visible on the compass.
- Locations of interest are harder to detect.
- A new perk, Adrenaline, is automatically given to the Sole Survivor.
- The Sole Survivor must stay hydrated, eat periodically, and have a regular sleep cycle in order to survive.
- If the Sole Survivor is hungry, all foods lose their healing properties and do not regain them until enough is consumed to make the survivor "well-fed." The amount of food that must be eaten to do this is relative to its quality, i.e, ribeye steak removes hunger better than grilled radroach.
- Fatigue damage reduces Action points (AP).
- Sleeping in a bed for less than 7 hours does not heal Hit points (HP).
- Illness and antibiotics are introduced.
- The healing rates of RadAway, stimpaks, and other healing items are significantly reduced.
- RadAway and chems can negatively affect the immune system.
- Limbs no longer heal after combat and must be restored with a stimpak, sleeping in a bed until well rested, or by visiting a doctor.
- Ammunition has weight and total carry weight is significantly reduced for both the Sole Survivor and their companions.
- Companions will not get back up if downed in combat until healed. If left unattended, they will return home.
- Robotic companions created in the Automatron add-on, excluding NPC robots like Ada and Jezebel, will now be destroyed if not repaired after being downed in combat.
- Cleared locations (both those marked as "[Cleared]" or otherwise) take much longer to repopulate enemies and loot.
- Normally non-"[cleared]" locations take 7 in-game days and "[cleared]" locations take 20 in-game days to start respawning. In survival mode, these are increased to 35 in-game days and 80 in-game days, respectively.
- Perhaps as a consequence of fewer respawned enemies, enemies now yield twice as much experience. (This change is not explicitly mentioned by the help notes for survival mode.)
- Enemies that usually spawn at higher levels will now spawn with regularity.
- Ability to access the game console (the tilde key) and use console commands is disabled.
|Saving||Manual, quicksaving and autosaves are available.||Manual, quicksaving and almost all autosaves are disabled.|
|Fast travel||Fast travel is available.||Fast travel is disabled.|
|Locations of interest||Easy detection of locations of interest.||Detection of locations of interest are significantly reduced.|
|Location repopulation rate||Repopulate after 7 or 20 (for "[Cleared]") in-game days.||Repopulate after 35 or 80 in-game days.|
|Experience gain||Normal rate.||Enemies yield 2x experience.|
|Available perks||Adrenaline perk not readily available.||Adrenaline perk is given.|
|Wellness||Not subject to Exhaustion, Hunger, or Thirst deprivation.||The Sole survivor is challenged to stay hydrated, fed and rested.|
|Fatigue||Not subject to Fatigue.||Subject to Fatigue.|
|Illness & antibiotics||Not subject to illness.||Antibiotics are needed to heal illness.|
|Healing rates||Food, Stimpaks and Radaway heal instantly.||Restorative items recover Hit points at a significantly reduced rate.|
|Crippled limbs||Crippled limbs auto-heal after combat.||Crippled limbs do not auto-heal. Must be healed by a Stimpak, a doctor, or be slept off.|
|Companions||If knocked unconscious, Companions will get back up after combat.||If knocked unconscious, Companions will not get back up after combat. They must be healed first, or they will return to their designated settlement. Non-NPC robot companions will instead be destroyed rather than returning to a settlement.|
|Workshop||No limits on overall Workshop inventory capacity.||Workshop inventory capacity reduced. May affect availability of production items (food, water, etc).|
There are five stages in each category of wellness that span in-game hours. It doesn't appear that the thresholds are linear. For example, it takes about 6 hours to go from well-fed to peckish to hungry, then 12 hours to go from hungry to famished. The following table shows the approximate times that it takes for a character to go from completely satisfied to the listed condition in each area. In-game time is expressed in "hours" and real-time is expressed in "minutes". These effects can be sped up when using certain items. Stimpaks and other drugs inducing dehydration, Rad-Away causing hunger, etc.
|THIRST||Parched||Thirsty||Mildly Dehydrated||Dehydrated||Severely Dehydrated|
|Effects||-1 INT||-2 INT, -1 PER||-4 INT, -1 LCK, -3 PER||-8 INT, -2 LCK, -5 PER||-10 INT, -3 LCK, -7 PER, Periodic Damage|
|4 hours||9 hours||18 hours||30 hours||45 hours|
|12 mins||27 mins||54 mins||90 mins||135 mins|
|Effects||-1 END||-2 CHR, -1 END||-3 CHR, -4 END, -1 LCK||-5 CHR, -8 END, -2 LCK||-5 CHR, -10 END, -3 LCK, Periodic Damage|
|6 hours||12 hours||24 hours||36 hours||64 hours|
|18 mins||36 mins||72 mins||108 mins||192 mins|
|Effects||-5% AP Refresh|| -1 STR, |
-15% AP Refresh
| -1 AGI, -1 LCK, -2 STR |
-30% AP Refresh
| -2 AGI, -2 LCK, -4 STR, |
-50% AP Refresh, Can't Sprint
| -4 AGI, -3 LCK, -6 STR, |
-75% AP Refresh, Can't Run
|27 hours||40 hours||55 hours||69 hours||82 hours|
|81 mins||120 mins||165 mins||207 mins||246 mins|
Note: The In-game / real-time data in this table are approximations only. The time expressed is not truly accurate. This table may be incomplete.
- If you toggle Survival mode on and then change the difficulty, you cannot opt back into Survival mode. In other words, you cannot turn it on, then off, and then on again.
- There is a high probability for contracting parasites during melee attacks on infected animals, in particular radroaches and mongrels.
- All illnesses can be cured by a doctor using the 15 cap "Cure Me" option in their dialogue. This is preferable over spending the caps on antibiotic supplies. It is therefore also recommended to have at least a level 1 clinic at your main settlement to use whenever you return.
- Purified water is harder to obtain. Consider building two water purifiers at Sanctuary Hills as production for purified water is considerably longer and in lesser quantities. Alternatively, build one water purifier for travel water and use a manual water pump when needing to hydrate at Sanctuary Hills. Save as many empty bottles as you can find. Fill the empty bottles with dirty water from lakes and streams to cook soups. Empty bottles can also be filled with purified water from manual water pumps, as well as Vault 111's and Vault 81's water fountains. It is also possible to drink directly from manual water pumps. Drinking from irradiated sources is not recommended, as each drink has the possibility of giving the player an illness.
- Bonuses granted by food are only given if eaten while you are not currently hungry, as stated on the game's loading screen. However, eating something that grants a bonus (e.g. the +1 agility of Deathclaw steak) while you are hungry will cause you to lose the bonus if you already have it active. For example, if you eat a Deathclaw Steak while not hungry to gain the bonus, then became Peckish, then ate a second Deathclaw Steak to become well-fed, you would lose the +1 agility bonus and would need to eat a third Deathclaw Steak to regain it.
- For at least the first 10 levels, you may need to broaden your food options due to limited sources of food, at least until you build up enough crops and water for cooking. Consider hunting radstags for immediate supply of food that both has little risk of injury, and a highly useful bonus of +25 carry weight from Grilled radstag that helps to mitigate the very low early-game carry weight if eaten while not currently hungry.
- Certain foods, such as soups and certain crops, satisfy both hunger and thirst. A good, renewable option is noodle cups because you can now fill any empty bottles you find with dirty water and use them with a farm of razorgrain.
- Sleeping seven hours in a full bed ensures being well rested and minimizes risk of illness. For a quick save at a key location, sleep for at least 3 hours. If you only sleep for one hour in any bed, even at a workshop settlement, there is still a high risk for illness, in particular parasites. Lethargy, insomnia, and weakness are also common with not sleeping well.
- Because a fusion core now weighs 4 lbs, carrying too many cores may not be advantageous. You may want to consider elevating Intelligence to 9 as early in the game as possible, to access the Nuclear Physicist perk. This perk will help extend the life of your fusion cores. At the very least, as early as possible, fight your way up the skyrails of the Corvega assembly plant to get the Repair bobblehead in order to permanently increase the duration of your fusion cores by 10%, whether you're on a faction quest or not.
- Because both you and your enemies are much weaker in terms of health, direct "guns blazin'" fighting will likely get you killed, especially in lower levels. The lowered health of your enemies does however make sneak builds incredibly advantageous, as it becomes much easier to kill an enemy in one hit, and it allows for you to fight one enemy at a time.
- Supply Lines allow workshops to share items used for crafting. Cooking stations therefore share the raw meat, crops, water, etc that are stored in a workshop's inventory, so long as the settlements are connected through the supply line. However, already-cooked food cannot be stored and then picked up anywhere along the supply chain, but rather only at the settlement in which it was stored. Storing uncooked food in any settlement will allow you to cook it on an as-needed basis at any settlement connected through the supply line, and reduce the necessary time needed to get supplies for an expedition
- Issue #9 of Wasteland Survival Guide doubles the meat dropped by most animals in the Commonwealth. This can significantly impact the amount of available food to you, so getting it early on in Sunshine Tidings co-op can be incredibly advantageous.
- Because fast travel is disabled, there are two methods to move more quickly around the Commonwealth. One option is the utilization of Vertibirds using a Vertibird signal grenade, which will allow you to "fast travel" using your map. An alternative is to teleport to The Institute, then to CIT ruins, which effectively places you around the middle of the Commonwealth and can significantly cut travel time. Legendary effects on armor which increase movement speed, decrease the AP cost of sprinting, increase AP regeneration, etc, also help with lowering travel time
- If you start in Survival mode and later change the game mode, your water production from Water Purifiers will not change.
- When you first join The Railroad, the message "You can now fast travel to and from Railroad HQ" still appears, despite the fact that fast travel is disabled in Survival mode.