Games like Elder Hills
Games like Elder Hills include Megabonk, Vampire Survivors, Dead Cells, Halls of Torment, and BALL x PIT. We matched them by the tags players give Elder Hills on Steam (Bullet Heaven, Rhythm, Action, Adventure, and Roguelike): closest matches first, and among equally close ones the better-known games.

Megabonk
Shared: Bullet Heaven · Roguelike · Roguelite

Vampire Survivors
Shared: Roguelite · Roguelike · Pixel Graphics

Dead Cells
Shared: Adventure · Roguelike · Roguelite

Halls of Torment
Shared: Roguelite · Roguelike · Action

BALL x PIT
Shared: Action · Roguelike · Arcade

A Dance of Fire and Ice
Shared: Rhythm · Arcade · Action

Skul: The Hero Slayer
Shared: Action · Roguelike · Pixel Graphics

Sayonara Wild Hearts
Shared: Rhythm · Action · Casual

Death Must Die
Shared: Bullet Heaven · Action · Roguelite

BPM: BULLETS PER MINUTE
Shared: Rhythm · Action · Roguelike

The Spell Brigade
Shared: Bullet Heaven · Roguelite · Roguelike

Soulstone Survivors
Shared: Bullet Heaven · Roguelike · Roguelite

Atomicrops
Shared: Action · Roguelike · Bullet Heaven

Rogue Legacy 2
Shared: Action · Arcade · Adventure

Astro Prospector
Shared: Roguelike · Bullet Heaven · Casual

Neon Abyss
Shared: Bullet Heaven · Roguelike · Adventure

Streets of Rogue
Shared: Roguelite · Action · Roguelike

Crypt of the NecroDancer
Shared: Rhythm · Roguelike · Pixel Graphics

DJMAX RESPECT V
Shared: Rhythm · Action · Casual

Wizard of Legend
Shared: Roguelike · Action · Pixel Graphics

Boneraiser Minions
Shared: Bullet Heaven · Roguelite · Pixel Graphics

Noobs Want to Live
Shared: Action · Roguelike · Casual

Rhythm Doctor
Shared: Rhythm · Action · Pixel Graphics

Brotato
Shared: Roguelike · Bullet Heaven · Roguelite