Games like Steam Veins
Games like Steam Veins include Skul: The Hero Slayer, Vampire Survivors, Celeste, Momodora: Reverie Under The Moonlight, and Blasphemous 2. We matched them by the tags players give Steam Veins on Steam (Action Roguelike, Side Scroller, Difficult, Vampires, and Pixel Graphics): closest matches first, and among equally close ones the better-known games.

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

Vampire Survivors
Shared: Action Roguelike · Vampires · Pixel Graphics

Celeste
Shared: Difficult · Pixel Graphics · 2D Platformer

Momodora: Reverie Under The Moonlight
Shared: Side Scroller · 2D Platformer · Pixel Graphics

Blasphemous 2
Shared: Difficult · Side Scroller · Pixel Graphics

SANABI
Shared: Pixel Graphics · 2D Platformer · Action

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

Dungreed
Shared: Action Roguelike · Pixel Graphics · Difficult

Super Meat Boy
Shared: Difficult · Pixel Graphics · 2D Platformer

Bloodstained: Curse of the Moon
Shared: Pixel Graphics · Side Scroller · Action

Downwell
Shared: Action Roguelike · Pixel Graphics · Difficult

30XX
Shared: Action Roguelike · Side Scroller · 2D Platformer

Enter the Gungeon
Shared: Action Roguelike · Difficult · Pixel Graphics

Dead Cells
Shared: Action Roguelike · Pixel Graphics · 2D

Anomaly Agent
Shared: Side Scroller · Action Roguelike · 2D Platformer

Risk of Rain (2013)
Shared: Action Roguelike · Pixel Graphics · Difficult

Katana ZERO
Shared: Pixel Graphics · Action · 2D Platformer

Blasphemous
Shared: Pixel Graphics · Dark Fantasy · Difficult

Noita
Shared: Difficult · Pixel Graphics · Action Roguelike

NINJA GAIDEN: Ragebound
Shared: Side Scroller · Pixel Graphics · Action

Shovel Knight: Treasure Trove
Shared: Pixel Graphics · Difficult · Side Scroller

20XX
Shared: Action Roguelike · 2D Platformer · Action

Touhou Luna Nights
Shared: Side Scroller · Difficult · Female Protagonist

BlazBlue Entropy Effect
Shared: Action Roguelike · Action · Pixel Graphics