You know that feeling when a game finally breaks you? I'm talking about that "Ground Zero" chapter in Seattle. Abby is just trying to find some medical supplies for Yara, and then—boom. You're face-to-face with a multi-limbed, pulsating wall of flesh that sounds like a chorus of people screaming underwater. Honestly, the rat king last of us 2 is probably the most effective piece of body horror Naughty Dog has ever pulled off. It isn't just a big zombie. It's twenty-five years of trauma and fungal growth fused into a single, agonizing entity.
What Actually Is the Rat King?
Basically, it's a super-organism. Think of it as a biological pile-up. Back in 2013, when the outbreak hit Seattle, the city's first patients were brought to Lakehill Hospital. They didn't know how to treat them, so they locked them in the basement. Then the world ended. For over two decades, those infected people—Stalkers, Clickers, and a Bloater—were trapped in a dark, damp trauma center. They didn't just stay there; they grew together. The Cordyceps fungus acted like a glue, stitching their limbs and torsos into one giant mass.
It gets its name from a real (and super gross) phenomenon where a bunch of rats get their tails tangled together with hair and filth until they become one stuck unit. In the game, it's people.
How Naughty Dog Built the Nightmare
The developers didn't just draw a big monster and call it a day. They actually looked at some pretty wild sources for inspiration. Kurt Margenau and Anthony Newman, the co-game directors, have mentioned that Neil Blomkamp’s short film Zygote was a huge influence. If you’ve seen it, you know exactly why: it’s all about a creature made of human limbs. They also pulled from Inside (that creepy ball of bodies at the end) and even the Magni and Modi fight in God of War.
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The sound design is where it gets really unsettling. The audio team recorded actual human screams and layered them with distorted animal noises to make sure you felt the "multi-person" aspect of the creature. It doesn't roar like a lion. It wails like a crowd.
Surviving the Hospital Basement
If you're playing this for the first time, or maybe trying a Grounded run, you've probably realized that you can't just "John Wick" your way through this. The rat king last of us 2 fight is a test of your kiting skills. You have to keep moving. If it catches you, it's an instant death animation that involves Abby’s head being quite literally ripped apart.
Fire is your best friend here.
The creature is incredibly weak to flames.
Use the Flamethrower you found earlier in the descent.
Pipe bombs are also essential for staggering it.
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The Mid-Fight Twist
Just when you think you’re getting the hang of it, the thing literally splits in half. A specialized "super-stalker" tears itself out of the main body's back. Now you’re dealing with a tank that can crush you and a fast, agile pest that throws toxic spores. Most people make the mistake of trying to kill the Stalker first. Don't. Focus everything you have on the big guy. Once the main body goes down, the Stalker retreats, and you’ll have a separate, much more personal showdown with it in the hospital’s morgue later.
A quick tip for the final phase: The smaller Stalker is fast, but it’s susceptible to the hunting pistol. Wait for it to peak out from the vents or behind the desks. One or two well-placed shots will end the nightmare for good.
Why We’re Still Talking About It
The reason the rat king last of us 2 works so well isn't just the jump scare. It's the environmental storytelling. You spend the whole level reading notes about the "first patients" and the chaos of the early outbreak. By the time you reach the basement, the atmosphere is so thick you can practically smell the rot through the screen. It’s the ultimate "Patient Zero" payoff.
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It also highlights how much the Cordyceps can evolve when left undisturbed for decades. If one hospital basement can create that, imagine what's brewing in other cities that haven't been touched since the 2013 collapse.
Actionable Strategy for Your Next Run
- Stockpile Beforehand: Don't waste your incendiary shells or pipe bombs on the lower levels of the hospital. Save every single one for the basement.
- The "Loop" Strategy: The arena is basically a series of interconnected rooms. Run in a large circle. Never hide in a corner; the Rat King will just smash through the walls to get to you.
- Double Damage: If you hit it with the flamethrower first, your following bullets actually do more damage while it's stunned by the heat.
- Distance is Life: Use the "quick turn" (down on the stick + X) to constantly check how close it is. If you hear the scurrying of the Stalker, keep sprinting until you find a clear line of sight.
Getting through this section is a rite of passage for any fan. It’s grueling, it’s disgusting, and it’s arguably the peak of the game's tension. Just remember to breathe, keep your finger on the sprint button, and for the love of everything, don't let it corner you in the laundry room.
Check your inventory right now. If you don't have at least three pipe bombs and a half-tank of fuel, go back and scavenge the upper floors of the hospital before you take that elevator down. You’ll thank yourself when the screaming starts.