Games like Pianistic
Games like Pianistic include A Dance of Fire and Ice, Geometry Dash, Beat Saber, Rhythm Doctor, and Intralism. We matched them by the tags players give Pianistic on Steam (Rhythm, Difficult, Atmospheric, Music, and Singleplayer): closest matches first, and among equally close ones the better-known games.

A Dance of Fire and Ice
Shared: Rhythm · Difficult · Level Editor

Geometry Dash
Shared: Difficult · Level Editor · Music

Beat Saber
Shared: Rhythm · Music · Moddable

Rhythm Doctor
Shared: Rhythm · Music · Level Editor

Intralism
Shared: Rhythm · Music · Level Editor

Muse Dash
Shared: Rhythm · Music · Singleplayer

DJMAX RESPECT V
Shared: Rhythm · Music · Casual

Just Shapes & Beats
Shared: Rhythm · Difficult · Music

Super Hexagon
Shared: Difficult · Rhythm · Singleplayer

Rift of the NecroDancer
Shared: Rhythm · Difficult · Music

Beatblock
Shared: Rhythm · Level Editor · Music

Audiosurf 2
Shared: Rhythm · Music · Moddable

Hollow Knight
Shared: Difficult · Singleplayer · Atmospheric

Spin Rhythm XD
Shared: Rhythm · Difficult · Music

Hollow Knight: Silksong
Shared: Difficult · Singleplayer · 2D

Neon Beats
Shared: Rhythm · Music · Singleplayer

EZ2ON REBOOT : R
Shared: Rhythm · Music · Difficult

Incredibox
Shared: Rhythm · Music · Casual

Music Racer
Shared: Rhythm · Music · Singleplayer

Thumper
Shared: Rhythm · Difficult · Music

140
Shared: Rhythm · Difficult · Music

Metal: Hellsinger
Shared: Rhythm · Atmospheric · Music

Soundodger+
Shared: Rhythm · Music · Level Editor

Neon Drive
Shared: Rhythm · Difficult · Atmospheric