Top similar games like Vital Decisions:

1-4 player co-op surgery game where you are aliens assigned to operate on a human. None of you has ever seen a human before. Extract the right organs, brew the right compounds, contain the mutations and DO NOT let the human be reborn aboard the ship.

A Co(s)mic Medical Simulator where healing humanity is just your cover. Treat patients, secretly harvest DNA, experiment with bizarre alien technology, and keep your true identity hidden.

Manage your own sushi restaurant, cook Japanese specialties, serve customers, manage inventory, hire staff, upgrade your equipment, and build the sushi restaurant of your dreams.

Run your dream pizzeria solo or with up to 6 players in chaotic online co-op multiplayer. Cook authentic pizzas, automate your kitchen, customize your restaurant, survive disasters, invest in stocks, gamble and build the ultimate Italian restaurant empire.

A chaotic co-op job sim for up to 4 players about night-shift doctors. Handle a bizarre stream of patients, diagnose illnesses, and assign people to the correct treatment zones. Work as a team, get through nightly crises, and try your best not to get fired!

You are clumsy cat doctors in a chaotic co-op hospital — a vet clinic in reverse, where the patients are human. Grab and haul ragdoll patients, X-ray, transplant and stitch against the clock, drive the claw-machine bed. For 1-4 online. Your patients don't have nine lives.

Run your own car wash business with realistic management and intense cleaning mechanics! Operate pressure washers and foam guns, drive customer cars, hire staff, set prices, manage supplies, upgrade gear, and polish every car to perfection. Go solo or co-op with up to 4 players!

The world's least qualified paramedics – now hiring 1-4 players. Answer the call, botch the treatment, and survive scenes no textbook prepared you for, from suburban living rooms to full-on bank heists. Chaotic co-op comedy, ambulance included.

Mowing lawns has never been this much fun! Relax with your friends in online co-op, upgrade your equipment, shape beautiful gardens, and enjoy the experience. Join the fun with 1-4 player co-op!

Build your café, brew perfect coffee, and sabotage your rivals in this chaotic multiplayer café simulator. Start small… and learn how far you’re willing to go.

Run your own game store, by yourself or with your friends! Stock shelves, sell games, and serve customers in this 1-4 player co-op simulator.

Welcome to the world's most chaotic place! Play solo or co-op with up to 6 players. Run a fast-food restaurant, and work with your friends to expand your business. Take orders, make burgers, and increase your earnings by dealing with customers.

Prison Pocket Patrol is a co-op prison guard simulator. Search, scrub, and sort incoming inmates according to the warden's strict orders. Deal with brawls, turn a blind eye for a bribe, and pocket confiscated contraband to fund shiny new checkpoint upgrades!

Team up in thrilling 3v3 café battles, build the ultimate café, and sabotage your rivals in chaotic co-op! Coffee's hot, competition's hotter!

Diner Together VR is a multiplayer co-op diner management simulator!

Brew & Bloom is a barista sim where every detail matters - from pulling the perfect espresso shot to designing the cozy corners of your dream café. You’re not just making coffee - you’re crafting a space with soul.

DISASTERS is a chaotic multiplayer survival game where you must outlast devastating natural disasters in fully destructible environments. Work together or sabotage your friends with items and proximity voice chat to survive the ultimate game of physics.

An ultimate 1-8 player Co-op Simulation game where you build and manage your gas station completely from scratch. Team up with your friends, provide exceptional service and grow your business! Collaboration (and some chaos!) is the key to success—fuel up, have your fun and rise to the top!

Dumpster Divers is an online co-op scavenging game where rejected puppets turn trash into treasure. Dive into alleys and dumpsters with up to 4 friends, outsmart bumbling cops, and haul your loot home to sell. Use scraps to craft helpful tools and climb the ranks of society one dumpster at a time.

Build a supermarket empire solo or with up to 4 friends. Stock the shelves, set your own prices, work the register by hand, chase down shoplifters and hire a crew — and grow one empty room into the busiest store in town.

Start digging with your grandpa’s map! In this stylized co-op digging game (up to 4 players), dig, upgrade, and reach the treasure together. Work as a team or compete! Fun, chaos, and rivalry await deep underground.

Play as one of Santa’s elves to create, gift-wrap, and deliver toys. This 1-4 cooperative toy-making game can be completed at your own pace in easy difficulty (1 star). But if you really want to impress Santa or test how well your group works together, you can attempt the harder timed difficulties.

In Car Wash Together, build your dream cleaning business - solo or in co-op! Tackle the challenge of detailing vehicles inside and out, gaining new skills and tools to satisfy even the most demanding customers.

BURGER, NO PLEASE! — a trashy co-op for up to 4 players where you work in fast food and get ingredients in absurd ways: fish from toilets, cola from rusty taps, cheese from rats. Cook, sabotage, and laugh until you cry!

Move fast in this 1-4 player moving game. Haul furniture, set off explosions, and sabotage your friends before they sabotage you.

Run the world's most chaotic fast food joint! Play solo or with up to 8 friends as you take orders, make burgers, and hustle to keep customers happy. Grow your business with every shift.

Clean up the aftermath of epic Kaiju battles in this brutal first-person simulator for 1-4 players. Carve up giant monster corpses, extract rare organs, operate heavy machinery, and wash away the blood and toxins polluting the city streets!

Shark Mart is a crazy co-op simulator about sharks undercover disguised as friendly dolphins. Run the shop, and scrub whales to secretly kidnap unsuspecting fish and cook up tasty delicacies! But beware - the Fish Police are out to expose your toothy secret...

Join forces online with friends or go solo in this immersive restaurant simulator! Transform an empty restaurant into a bustling hotspot, upgrade your kitchen and serve a variety of delicious dishes. Can you handle the heat and satisfy every hungry customer?

KITMAN is a 1-4 player job simulator set in the backrooms of a soccer stadium. Run the team by running the locker room. Clean the team’s boots, patch jerseys, mop floors, and when no-one is looking… sneak into the gaffer’s office and fix the game plan!

Start as an unknown artist. Record your own songs using your real voice, release them online, grow your fanbase and build your music career.

Rule over a town of customizable characters in this cozy simulation game. Dress up, feed, and play games with your townsfolk, build and break relationships as you please… But remember only the Best of Friends can handle the infamous Best Friend Quest! 

Totally Secure Airport is a chaotic co-op sim where you play as an airport security guard. Search through weird luggage and decide who flies and who cries. Documents? Check. Suitcases? Shuffle. Find troublemakers with your friends, but be quick - the airplane is taking off soon!