What are Ghouls in Fallout and how do they live so long?

Ghouls are some of the most iconic characters in all of Fallout – which makes it a little trouble that we don’t know much about them. 

Ghouls have been around since the very first game, and other wastelanders have pretty much always treated them as second-class citizens. Because of that ghouls tend to form their own settlements, like Necropolis in the original Fallout and the Underworld in Fallout 3. Though some ghouls decide to go it alone, in general, they tend to look out for each other because, as the Fallout show reveals, they’re going to be around for a long, long time. 

Something about becoming a ghoul stops your aging process entirely and essentially lets you live forever. In the games, ghouls can pretty easily live for centuries without any problems. Some ghouls lose their minds and become feral. They get violent and will eat anyone who comes near them, but at least in the games, it isn’t clear why some ghouls turn feral and others are just fine. 

The Fallout show introduced some changes to the lore surrounding ghouls. In the show, it seems like every ghoul is on the path to becoming the equivalent of a post-nuclear zombie. To survive, ghouls need to track down and take a mysterious serum that seemingly holds their mind together. We don’t know much more about that serum, and we also aren’t sure if the Fallout show is going to change how ghouls become ghouls in the first place. For now, we have to rely on what the games have to say. 

What makes someone become a ghoul? 

The Fallout lore becomes a little vague around the process known as “ghoulification.” We know that exposure to extreme radiation has a chance to transform someone into a ghoul, and that’s about it. At lower doses, the transformation will leave them looking burned and scarred, as the Ghoul does in the Fallout show. At higher doses, a person’s skin will tear and rot, like Roger’s in episode 3, and they might even turn feral instantly. 

Radiation is always involved, but not all ghouls are people who’ve been exposed to radioactive fallout. The Fallout 3 DLC Point Lookout introduced Desmond Lockheart, a man who exposed himself to radiation before the Great War in order to preemptively become a ghoul and survive the bombs. In Fallout 4 we meet Eddie Winter, who did the same thing, as well as John Hancock, who took a radioactive medication in the post-war days to transform himself into a ghoul for reasons that are entirely his own.

Though they won’t die of natural causes, ghouls can be pretty easily killed – in the games at least. Some ghouls can regenerate health when they’re exposed to radiation, but none of them exhibit the superhuman healing powers that Squire Thaddeus has after his apparent transformation. The Fallout series is clearly getting set up for a deeper exploration of how ghoulification works, and it seems like the show is going to take things in a new direction from what we’ve seen before.