Ghouls are former humans who have become horribly irradiated by the radioactive fallout covering the wasteland from the Great War. Many ghouls are pre-War humans who survived the initial nuclear bombardment during the Great War. Becoming permanently irradiated, they were horribly disfigured and their lifespans were increased virtually indefinitely. In most case's exposure to radiation and the FEV in the post-War Commonwealth wastes degenerated their brains, causing them to lose their higher cognitive functions, turning them into mindless, radiation-resistant cannibals.
The brain structure of a feral ghoul indicates that the regenerative ability of the neurological system that affords "normal" necrotic post-humans their longevity does not extend into the higher reasoning functions of the brain itself. This condition is referred to as "ferocious post-necrotic dystrophy," according to the ghoul physician Barrows. Despite the apparent lack of the higher reasoning they once had as humans, some are capable of semi-intelligible speech, as the Vault 34 security officers will occasionally growl out understandable phrases similar to the trogs of The Pitt, indicating that their vocal chords and their brain's speech centers are still relatively intact.
As the reasoning and critical thinking portions of a ghoul's brain deteriorate, the ghoul subject becomes increasingly hostile, giving in to a carnal need to feed. It remains unclear exactly what precipitates this change in neurobiology and psychology, but anecdotal evidence seems to indicate that non-social ghouls, or those in isolation, are more prone to the condition.
It is possible that this is a gradual process, meaning that eventually all ghouls will succumb to this condition. However, considering the existence of ghouls that have been born prior to the Great War two centuries ago, it is quite possible that this theory is inaccurate, or that the rate of degeneration is dependent on the individual affected and surrounding environmental factors.
As with normal ghouls, ferals are not only extremely resistant to radiation, they are actually healed by it, as can be seen when a glowing one uses its radiation blast nearby other ghouls. M.A.R.Go.T. also states that feral ghouls have no internal body heat.
It is now possible to dismember ghouls, however they will continue to chase and bite the Sole Survivor even if they lose both of their arms. When losing a leg, however, they will become docile and will no longer try to attack, allowing the player to quickly dispatch them and handle any uninjured ghouls. Rarely, a feral ghoul will still attack after its head is decapitated. It is unknown if this is a bug.
A notable difference between the Massachusetts feral ghouls and feral ghouls seen throughout New California, the Mojave Wasteland, and the Capital Wasteland, is that they have glowing yellow eyes. Sometimes feral ghouls will lie on the ground, either to rest or play dead. Once the player character gets close enough or they are otherwise alerted, they get up and attack. These ghouls can sometimes be targeted in V.A.T.S. and if spotted, attacked before they rise. They also show up as living actors on the HUD if the Sole Survivor is wearing power armor with a targeting HUD-equipped helmet or aims at them with any kind of Recon Scope.
Occasionally, they will start to run faster at the player moving erratically to dodge incoming attacks, suggesting some form of intelligence, and will eventually lunge at their attacker once they're close enough. A gurgling roar is heard when a ghoul charges at the Sole Survivor. This attack can sometimes be difficult to dodge without sprinting, but it can however be blocked or interrupted with a melee strike. Additionally, when feral ghouls lunge at the player, they often fall down beside or behind their target, giving the player a brief chance to strike while the ghoul is getting back to its feet. In some locations, particularly indoors, ghouls will also emerge from windows, ductwork, etc, to attack when a victim comes close. Ghouls hiding in this sort of ambush cannot be detected even by V.A.T.S. before they begin emerging - however while they are emerging they are helpless while climbing into the room and can be freely attacked if one is quick.
They very rarely travel alone, and it is quite unusual to encounter a single ghoul. This behavior has lead to groups of ferals often being called "packs" or "hordes" by wastelanders.
Another notable difference from previous versions of ferals is that they inflict radiation damage as well as physical damage.
Stalkers are a variant of feral ghouls that can easily be distinguished by their bloody mouths and paler skin. They often pretend to be dead or hide amid rubble until an enemy is detected, where they then attempt to quietly ambush their prey without revealing themselves, usually in success. There are generally at least a few stalkers mixed into larger groups of weaker ferals. As they wear the same tattered clothing as roamers and normal ferals, they can be difficult to spot until they're damaged. They will also sometimes serve as a "boss" in locations populated by ferals. If the player is of a high enough level, the boss may instead be a glowing one, which the stalker will still accompany.
Reavers usually have pieces of post-war metal armor attached to them as in Fallout 3 and New Vegas, possibly implying these are rather recent victims of ghoulification. As in New Vegas, they lack a projectile attack, and are generally the ones in a pack to reach better-equipped targets thanks to their respectable amount of HP. They are much easier to deal with than past versions. Unlike the ones in Fallout 3 and New Vegas, their corpses do not emit green fumes.
Withered feral ghouls are slightly skinnier, with a yellowish leathery-looking skin, and wear no clothes. These ghouls are likely fairly old compared to others, as their clothing has rotted away and they appear to be severely sun-damaged.
A withered feral ghoul can be found inside the power armor storage in the national guard armory. Their eyes and mouth also appear severely damaged and shriveled.
Gangrenous feral ghouls are considerably rarer and stronger than the previous variants, with torn rags like common variants, and yellow skin. They can be hard to defeat even for some mid/high level player due to their aggressive attacks and high health. A gangrenous feral ghoul can be found inside Croup Manor's basement guarding a chest with some expensive loot. One also exists within O'Neill Family Manufacturing in the Glowing Sea.
Rotting feral ghouls have a bloated appearance, indicating that their bodies have begun decomposing, also suggested by the name. Although their offensive capabilities are on par with gangrenous feral ghouls, they have almost twice the amount of health.
A highly irradiated version of a feral ghoul, they glow with green light emitting from within, and just being near them causes radiation damage. They can perform an area of effect radiation attack indicated by the raising of their arms which releases radiation around them. This radiation also heals nearby feral ghouls, and glowing ones can even sometimes revive recently killed allies. They are potentially more dangerous than past iterations, especially against low-level players, due in part to their radiation-fueled healing, although their passive radiation radius is smaller and thus they are easier to dispatch without taking any radiation.
A higher level version of glowing one, covered in glowing green blisters of radiation. It gives off radiation the closer one is, even more so when hit by it. This is the strongest type of feral ghoul in the game, damage wise.
A higher level version of glowing ones. Its body is bloated and swollen with radioactive material. It gives off more radiation than its counterparts and the melee attack is a little weaker, compared to a putrid glowing one. However, it does have the highest health of all feral ghouls.
A variant only found on the Island and mutated by the island's radioactive fog. Fog ghouls are much paler than ghouls found in the Commonwealth, with black burns on certain parts of their skin and fishing nets draped over their chest. Their eye sockets are quite large, with the eyes sunken in, and their teeth permanently gritted, exposing the gums, which seem inflamed, and the teeth sunk in as well. Black soot is smeared across their faces, as well.
Feral ghouls are not hostile towards cats. This might be due to the game's data which does not allow the Sole Survivor to interact with cats and, as a consequence, also does not allow other characters to do so as well.
Feral ghouls' limbs are severed when broken compared to other creatures. Against a crowd, they can be safely incapacitated with less effort by severing their legs first, and only disposing them when it's safe to do so.
Feral ghouls can continue to survive, even if (the top part of) their head has been blown off (However this is extremely rare).
Feral ghouls will randomly become friendly if you have the Ghoulish perk.
The Children of Atom believe that feral ghouls were originally ghouls but rejected Atom and became feral.
Feral ghouls can be found in most graveyards in game.