Games like OTTTD
Games like OTTTD include Thronefall, Orcs Must Die! 2, Bloons TD 6, Orcs Must Die!, and Age of Darkness: Final Stand. We matched them by the tags players give OTTTD on Steam (Tower Defense, Action RTS, Indie, Strategy, and Gore): closest matches first, and among equally close ones the better-known games.

Thronefall
Shared: Tower Defense · Strategy · Action RTS

Orcs Must Die! 2
Shared: Tower Defense · Strategy · Indie

Bloons TD 6
Shared: Tower Defense · Strategy · Singleplayer

Orcs Must Die!
Shared: Tower Defense · Strategy · Indie

Age of Darkness: Final Stand
Shared: Tower Defense · Action RTS · Strategy

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

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

Infested Planet
Shared: Tower Defense · Strategy · Indie

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

Kingdom Rush 6: Genesis TD
Shared: Tower Defense · Strategy · Action RTS

People Playground
Shared: Gore · Violent · Indie

Party Hard
Shared: Strategy · Indie · Violent

Creeper World 3: Arc Eternal
Shared: Tower Defense · Indie · Strategy

Hotline Miami
Shared: Indie · Violent · Gore

Bee Island
Shared: Tower Defense · Strategy · Action RTS

My Friend Pedro
Shared: Indie · Gore · Violent

Deathtrap
Shared: Tower Defense · Strategy · Indie

Touhou Monster TD ~ 幻想乡妖怪塔防
Shared: Tower Defense · Action RTS · RPG

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

Kindergarten
Shared: Gore · Violent · Indie

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

Happy Room
Shared: Gore · Violent · Indie

Defense Grid: The Awakening
Shared: Tower Defense · Strategy · Indie

Bloons TD 5
Shared: Tower Defense · Strategy · Action