Games like Pixel Survivors: Defense
Games like Pixel Survivors: Defense include Vampire Survivors, Megabonk, Death Must Die, Necrosmith, and Halls of Torment. We matched them by the tags players give Pixel Survivors: Defense on Steam (Tower Defense, Action Roguelike, Bullet Hell, Bullet Heaven, and Roguelite): closest matches first, and among equally close ones the better-known games.

Vampire Survivors
Shared: Action Roguelike · Bullet Hell · Roguelite

Megabonk
Shared: Action Roguelike · Bullet Heaven · Roguelite

Death Must Die
Shared: Action Roguelike · Bullet Hell · Roguelite

Necrosmith
Shared: Action Roguelike · Tower Defense · Bullet Hell

Halls of Torment
Shared: Action Roguelike · Bullet Hell · Roguelite

Brotato
Shared: Bullet Hell · Action Roguelike · Bullet Heaven

Boneraiser Minions
Shared: Action Roguelike · Bullet Hell · Roguelite

Rogue: Genesia
Shared: Action Roguelike · Bullet Hell · Bullet Heaven

Soulstone Survivors
Shared: Action Roguelike · Bullet Heaven · Bullet Hell

20 Minutes Till Dawn
Shared: Action Roguelike · Bullet Hell · Roguelite

Nomad Survival
Shared: Action Roguelike · Bullet Hell · Roguelite

Enter the Gungeon
Shared: Action Roguelike · Bullet Hell · Pixel Graphics

Tower of Babel: Survivors of Chaos
Shared: Action Roguelike · Bullet Heaven · Bullet Hell

Nordic Ashes: Survivors of Ragnarok
Shared: Action Roguelike · Bullet Heaven · Bullet Hell

Deep Rock Galactic: Survivor
Shared: Action Roguelike · Bullet Heaven · Bullet Hell

Astro Prospector
Shared: Action Roguelike · Roguelite · Bullet Hell

The Binding of Isaac: Rebirth
Shared: Action Roguelike · Roguelike · Pixel Graphics

BALL x PIT
Shared: Bullet Hell · Roguelite · Action Roguelike

The Spell Brigade
Shared: Bullet Heaven · Bullet Hell · Roguelite

Nuclear Throne
Shared: Action Roguelike · Bullet Hell · Pixel Graphics

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

Karate Survivor
Shared: Action Roguelike · Bullet Heaven · Bullet Hell

Be My Horde
Shared: Action Roguelike · Bullet Hell · Bullet Heaven

Dead Cells
Shared: Action Roguelike · Roguelike · Roguelite