The Fallout franchise has some elements that are just iconic: Power Armor, Super Mutants, Deathclaws, and, of course, ghouls. Although most ghouls were once human, they have been altered by the radiation ever present in their post-apocalyptic world, changing their biology in significant and seemingly permanent ways. With ghouls making appearances in every major Fallout installment, as well as one of the main characters of Amazon Prime’s Fallout series being a pre-war ghoul, knowing what they are and where they came from is important.

Throughout the Fallout games, there have been some fantastic examples of ghoul characters that have helped show what life is like for non-humans in the post-apocalyptic United States. In a series that has never shied away from showing the horrors and consequences of war, ghouls in Fallout manage to be both terrifying and sympathetic. However, until Fallout 76 added playable ghouls via a recent update, there wasn't an option to be a ghoul in any of the main Fallout games, and this is most likely due to their unique physiology and abilities.

What Makes Ghouls In Fallout

Ghouls Are A Product Of Intense Radiation

The answer to what makes a ghoul is, on the surface, a simple one: radiation, and plenty of it. Ghouls are the result of the intense gamma radiation from the Great War mutating the cells of a living creature — usually humans, but in some cases bears, dogs, and gorillas. At first, this exposure would present just like radiation poisoning, with a loss of hair and radiation burns covering their skin.

However, due to a genetic quirk, instead of dying from the radiation, some people transform into ghouls. This allows them to survive the attack on their cells from radiation that would usually be fatal, but it leaves them with distinct physical appearances. Ghouls usually have very damaged skin from the burns, which in turn can cause many to lose their noses and, in some extreme cases, their ears.

While most ghouls were created in the immediate aftermath of the Great War, some were transformed both before and after, usually due to specific drugs being used. These cases are unusual, but examples can be seen in Fallout 3's Desmond Lockheart, Fallout 4's Eddie Winter, who transformed himself prior to the bombs falling, and an unnamed Fallout 4 test subject whose sad story is found on holotapes. Meanwhile, Hancock in Fallout 4 is an example of a person turning into a ghoul post-war due to taking experimental drugs.

Do Ghouls Have Human Rights In Fallout?

The Subject Of Ghoul Rights Is A Complex One

Despite ghouls being among the first survivors of the Great War to start the rebuilding effort, they are often mistreated by those around them. More often than not, this leads to ghouls setting up isolated communities for themselves in order to feel safe. Examples of these can be seen in many games, such as the Necropolis in Fallout, Underworld in Fallout 3, the S Fallout 4, and Valley Galleria in Fallout 76.

Although laws were ed in the New California Republic to offer legal rights to all mutated individuals, including ghouls, this was not always enforced. Places in California, such as Vault City, actively discriminated against ghouls and had an official policy to shoot all ghouls on sight, whether they were feral or not. This was also the strategy for the East Coast Brotherhood of Steel under Elder Lyons, which added to tensions in the area.

With their appearance often resembling rotting flesh, many ghouls face discrimination based purely on their physical mutation alone. However, even those who know and have good relationships with ghouls will acknowledge that it is the fear of feralization that prevents many communities from opening their doors to ghouls. This was the platform on which the Synth Major McDonough ran when seeking to take office in Diamond City. Unfortunately, he was elected, and the city's ghoul population was exiled as a result, costing the lives of many.

Feral Ghouls & Ghoul Stages Explained

Not All Ghouls Are Dangerous, But Feral Ghouls Are Terrifying

Being feral is a real fear for many ghouls and is, unfortunately, one of the stages of ghoulification. While being a ghoul does grant many benefits, there are also complications that can ultimately result in a loss of sanity. This means there are two distinct stages to being a ghoul: intelligent ghouls and feral ghouls.

Intelligent ghouls are those who have retained most of their humanity and are able to live more or less as they did when they were human. Ghouls in this stage can take advantage of the benefits of their mutation, and many enjoy significantly longer lifespans, with many individuals born pre-war still alive over 200 years later. Ghouls are also able to heal themselves far more quickly than humans, so many of them are able to survive injuries that would be fatal otherwise.

Ghouls can even reattach severed fingers, toes, or even limbs.

Due to the high concentration of radiation that transformed them, ghouls are also immune to radiation, although some speculate that repeated exposure could increase the risk of feralization. There have also been recorded examples of ghouls needing significantly less food and water than humans, with some ghouls able to almost hibernate, most likely due to their regenerative abilities. The Ghoul is seen in the first season of Fallout being dug up after many years, while in Fallout 4, a ghoul child named Billy survived 210 years in a fridge.

However, the second stage of being a ghoul is one that causes a lot of fear, both from humans and within the ghoul community. Feralization is the loss of the ghouls' mental stability and is described by Doctor Barrows in Fallout 3 as the irreversible degeneration of all the higher mental functions. Sometimes this can happen over time, although it can also happen immediately, with many feral ghouls seen in the games being those who were transformed shortly after the bombs fell.

There are different varieties of ghouls, such as glowing ones, who contain higher concentrations of radiation that cause them to become bioluminescent and possess the ability to heal other ghouls close to them by emitting bursts of radiation.

Immediate feralization can be seen in Fallout 4, as the Sole Survivor's neighbors can be met as a group of feral ghouls. Speaking with Codsworth and the Vault-Tec Rep hints that the people became feral in the Sanctuary Hills settlement, a conclusion ed by clues in Sanctuary, Another example of people transforming into ghouls and immediately becoming feral is in New Vegas' Camp Searchlight, where an incursion from Caesar's Legion caused many NCR soldiers to become feral ghouls.

How Feralization Can Be Caused & Inhibited

Slightly More Than A One-Way Path

Many factors may contribute to a ghoul becoming feral over an extended period of time. These include mental trauma, PTSD, exposure to intense radiation, and social isolation. However, there is no clear-cut reason, with some ghouls retaining their faculties in the same situations that cause others to become feral. This, in turn, feeds the fear of feralization, with its unpredictability being more frightening than the issue itself.

Although many claim that feral ghouls cannot be cured, there are examples in Fallout of drugs that help stave off the effects of feralization. The Fix is a drug used in Fallout 76 to help clear a ghoul player's feral meter; meanwhile, Walton Goggins' Ghoul is seen frequently taking an inhaler-type drug to prevent him from turning feral. Interestingly, the conversion mod Fallout London features a quest that involves curing the feral ghoul Queen of England, but that's not considered canon despite its intriguing ramifications.