Games like Ruina
Games like Ruina include Balatro, Slay the Spire, Slay the Spire 2, Luck be a Landlord, and Dicey Dungeons. We matched them by the tags players give Ruina on Steam (Roguelike Deckbuilder, Strategy, Roguelite, Deckbuilding, and Score Attack): closest matches first, and among equally close ones the better-known games.

Balatro
Shared: Roguelike Deckbuilder · Deckbuilding · Strategy

Slay the Spire
Shared: Roguelike Deckbuilder · Deckbuilding · Strategy

Slay the Spire 2
Shared: Deckbuilding · Strategy · Roguelike Deckbuilder

Luck be a Landlord
Shared: Roguelike Deckbuilder · Roguelite · Strategy

Dicey Dungeons
Shared: Roguelike Deckbuilder · Roguelite · Deckbuilding

RACCOIN: Coin Pusher Roguelike
Shared: Strategy · Roguelike Deckbuilder · Deckbuilding

Vampire Survivors
Shared: Roguelite · Pixel Graphics · Singleplayer

9 Kings
Shared: Strategy · Roguelike Deckbuilder · Deckbuilding

Dungeons & Degenerate Gamblers
Shared: Roguelike Deckbuilder · Strategy · Deckbuilding

Peglin
Shared: Deckbuilding · Roguelite · Strategy

Loop Hero
Shared: Deckbuilding · Roguelite · Pixel Graphics

Die in the Dungeon
Shared: Strategy · Roguelike Deckbuilder · Deckbuilding

Vampire Crawlers: The Turbo Wildcard from Vampire Survivors
Shared: Deckbuilding · Strategy · Pixel Graphics

Combolands: Roguelike Citybuilder
Shared: Strategy · Roguelite · Roguelike Deckbuilder

Into the Breach
Shared: Strategy · Pixel Graphics · Indie

Inscryption
Shared: Deckbuilding · Roguelite · Puzzle

Super Fantasy Kingdom
Shared: Strategy · Roguelite · Roguelike Deckbuilder

The Loopler
Shared: Roguelike Deckbuilder · Strategy · Roguelite

The Legend of Bum-Bo
Shared: Roguelite · Strategy · Indie

Nubby's Number Factory
Shared: Strategy · Singleplayer · Deckbuilding

Ratropolis
Shared: Deckbuilding · Roguelite · Strategy

Backpack Hero
Shared: Roguelike Deckbuilder · Deckbuilding · Strategy

Dicevaders
Shared: Roguelike Deckbuilder · Strategy · Deckbuilding

Roguebook
Shared: Deckbuilding · Strategy · Roguelite

