Games like Shikhondo: Blue Pieta
Games like Shikhondo: Blue Pieta include ICEY, Bit Blaster XL, Planes, Bullets and Vodka, Vampire Survivors, and TouHou Makuka Sai ~ Fantastic Danmaku Festival. We matched them by the tags players give Shikhondo: Blue Pieta on Steam (Action, Casual, Adventure, Arcade, and 2D): closest matches first, and among equally close ones the better-known games.

ICEY
Shared: Action · Adventure · Side Scroller

Bit Blaster XL
Shared: Bullet Hell · Arcade · Action

Planes, Bullets and Vodka
Shared: Action · Casual · Arcade

Vampire Survivors
Shared: Bullet Hell · 2D · Casual

TouHou Makuka Sai ~ Fantastic Danmaku Festival
Shared: Action · Adventure · Casual

Cyberhunt
Shared: Action · Casual · Adventure

The Vagrant
Shared: Action · 2D · Adventure

Exit the Gungeon
Shared: Action · Arcade · Adventure

Bladed fury
Shared: Action · Adventure · Casual

DRAINUS
Shared: Action · Shoot 'Em Up · 2D

Rabi-Ribi
Shared: Bullet Hell · Anime · Female Protagonist

BALL x PIT
Shared: Action · Arcade · Bullet Hell

LUFTRAUSERS
Shared: Action · Arcade · Bullet Hell

METAL SLUG
Shared: Action · Arcade · 2D

Broforce
Shared: Action · 2D · Side Scroller

Revolution Ace
Shared: Action · Shoot 'Em Up · Bullet Hell

Nova Drift
Shared: Arcade · Bullet Hell · Shoot 'Em Up

Bloodstained: Ritual of the Night
Shared: Action · Adventure · Female Protagonist

TouHou Makuka Sai ~ Fantastic Danmaku Festival Part II
Shared: Bullet Hell · Action · Shoot 'Em Up

Zombotron
Shared: Action · Adventure · 2D

Muse Dash
Shared: Casual · Anime · 2D

DJMAX RESPECT V
Shared: Casual · Action · 2D

RADical ROACH Remastered
Shared: Action · Casual · Adventure

Touhou Kinjoukyou ~ Fossilized Wonders.
Shared: Action · Bullet Hell · Arcade