The achievement/trophy is awarded for completing the game from start to finish in Hardcore mode. The mode is initially available just before the player character leaves Doc Mitchell's house for the first time and are given the achievement/trophy for keeping hardcore on continuously from this point until completing the main quest line. Switching off Hardcore mode at any time during the play-through will deny you this achievement/trophy.
Hardcore mode can be toggled off at any time through the options menu. It can still be turned back on, but the achievement/trophy will be unobtainable.
In this mode, stimpaks and other healing items heal over time instead of all at once, RadAway removes radiation over time in a similar manner, ammunition has weight, and the Courier must stay hydrated, eat periodically, and have a regular sleep cycle. Limbs can only be restored by a doctor's bag, hydra, weapon binding ritual, healing poultice, Auto-Doc, or by visiting an actual doctor. Sleeping does not heal health points or crippled limbs, unless it's in an owned bed or having the Roughin' It perk. In addition, recruited companions can die permanently.
|Stimpaks heal instantly.||Stimpaks heal over time.|
|Radaway heals radiation poisoning instantly.||Radaway heals radiation poisoning over time.|
|Doctor's bags heal all limbs fully.||Doctor's bags heal limbs partially.|
|Crippled limbs can be healed with stimpaks, or by sleeping in any bed or mattress.||Only a doctor, a doctor's bag, sleeping in certain beds, healing poultice, weapon binding ritual, Auto-Doc, or hydra can heal a crippled limb.|
|Ammunition is weightless.||Ammunition has weight.|
|Companions cannot die, instead getting knocked unconscious for a short time.||Companions can die. However, they still heal without needing or using any stimpaks after battle.|
|No Dehydration, Starvation, or Sleep deprivation.||The Courier must drink, eat, and have proper sleep cycles or will suffer increasingly negative effects, up to immediate death.|
|H2O||-1 END||-1 PER, -2 END||-2 PER, -1 INT, -3 END||-2 PER, -3 END, -2 AGL, -1 INT||DEATH|| ~12/h|
(1 every 10s)
|FOOD||-1 STR||-2 STR, -1 CHR||-3 STR, -1 PER, -2 CHR||-3 STR, -2 PER, -2 CHR||DEATH|| ~4.75/h|
(1 every 25s)
|SLEEP||-1 AGL||-1 INT, -2 AGL||-2 INT, -1 END, -3 AGL||-2 INT, -2 END, -3 AGL||DEATH|| ~2.4/h (1 every 50s)|
(~ -60/h Sleep)
- Note: the hours are for game time; the seconds for real time.
- Doctor's bags function similarly to stimpaks when healing limb damage. They can be used to heal all crippled limbs at once (but only healing each limb minimally) or used on specific limbs to heal much more. The other limb-healing items such as Healing poultice cannot be used to heal individual limbs since the interface only offers Doctor's bags.
- Sleeping in an owned bed and getting the Well Rested bonus causes you and your limbs to fully heal.
- Hydra heals all limbs over time, functioning the same as in Normal mode.
- In many cases foods created at a campfire will heal far more than stimpaks, particularly if the player character has a high Survival stat and a low Medicine stat.
- When beginning the Dead Money add-on while on Hardcore mode, the player will wake up in the Villa with all Hardcore meters at zero, proceeding at normal rate from that point, but the SLP meter will be stuck at zero unless the player finds a bed and sleeps.
- Drinking from a water source, such as a water fountain, will satisfy the player's H2O count.
- Hardcore mode not only penalizes players for not eating food, but also on eating raw meat. Cooking meat with the Campfire is the only way to remove the debuffs given by raw meat.
- When adjusting the Timescale variable, needs DO NOT scale with it. If it is set to 1 (1 game minute = 1 real minute), you will die of starvation or dehydration if you sleep more than a couple hours.
- PC Playstation 3 Xbox 360 For unknown reasons, sometimes one or more of the Hardcore needs (such as H2O, FOD, SLP) will disappear, and will not even indicate a 0 integer. One can fix this by going into the options then turning hardcore off/on again, which will reset all needs to 0. However, this seems to be a redundant problem once it happens the first time, and starts again upon loading a save. A way to fix it is to make a backup save, and delete the old file.[verified]
- Another fix for the above bug is to use an item that increases/decreases the meter of said needs (i.e. if 0 integer is missing in SLP then take a nap and the integer will reset to 0). This may need to be repeated before the fix takes effect.
- PC Playstation 3 Xbox 360 The unpatched version of the game sometimes glitches and stops players from leveling up though still registering experience.[verified]
- PC If one transfers their save game to a new computer and continues playing, the Hardcore achievement may not register upon completing the game, even if Hardcore mode was left on.[verified]
- PC Playstation 3 Xbox 360 The sleep meter will not go below 2.[verified]
- PC Playstation 3 Xbox 360 Hardcore meters may stop increasing in "real time." Sleeping, waiting, or fast traveling will still cause them to increase. Reloading a previous save can sometimes "unstick" the meters, but they become stuck again after after a few minutes of gameplay.[verified]
- PC Playstation 3 Xbox 360 When loading a game, the needs meters may be higher than they were when it was saved, causing the player character to be hungry, tired, or dehydrated even though they were fine at the point of saving.[verified]