Games like Last Saintess
Games like Last Saintess include Bloons TD 6, Crusader Kings III, Rogue Tower, Mount & Blade II: Bannerlord, and Thronefall. We matched them by the tags players give Last Saintess on Steam (Simulation, Strategy, Tower Defense, 3D, and Female Protagonist): closest matches first, and among equally close ones the better-known games.

Bloons TD 6
Shared: Strategy · Tower Defense · 3D

Crusader Kings III
Shared: Strategy · Simulation · Medieval

Rogue Tower
Shared: Strategy · Tower Defense · 3D

Mount & Blade II: Bannerlord
Shared: Strategy · Medieval · Simulation

Thronefall
Shared: Strategy · Tower Defense · Medieval

We Who Are About To Die
Shared: Strategy · Simulation · Roguelite

Totally Accurate Battle Simulator
Shared: Simulation · Strategy · Singleplayer

Crusader Kings II
Shared: Strategy · Simulation · Medieval

Emberward
Shared: Tower Defense · Strategy · Roguelite

CloverPit
Shared: Strategy · Roguelite · 3D

Lessaria: Fantasy Kingdom Sim
Shared: Strategy · Simulation · Tower Defense

Kingdom Two Crowns
Shared: Tower Defense · Strategy · Medieval

Book of Yog Idle RPG
Shared: Simulation · Sexual Content · Strategy

Planet Coaster 2
Shared: Simulation · Strategy · 3D

Soul Dossier
Shared: Sexual Content · 3D · Female Protagonist

Kingdom Rush Vengeance - Tower Defense
Shared: Strategy · Tower Defense · Singleplayer

Buckshot Roulette
Shared: Strategy · Dark · 3D

Plants vs. Zombies GOTY Edition
Shared: Tower Defense · Strategy · Singleplayer

Banished
Shared: Strategy · Simulation · Medieval

Kingdom Rush 5: Alliance TD
Shared: Strategy · Tower Defense · Singleplayer

Action Taimanin
Shared: Sexual Content · Female Protagonist · 3D

Kingdom Rush - Tower Defense
Shared: Strategy · Tower Defense · Singleplayer

Cities: Skylines
Shared: Simulation · Strategy · Singleplayer

Plague Inc: Evolved
Shared: Simulation · Strategy · Singleplayer