Games like Touhou Dystopian
Games like Touhou Dystopian include Hades II, Hades, Megabonk, Skul: The Hero Slayer, and Sephiria. We matched them by the tags players give Touhou Dystopian on Steam (Action Roguelike, Female Protagonist, Action, Roguelite, and 3D): closest matches first, and among equally close ones the better-known games.

Hades II
Shared: Action · Roguelite · Action Roguelike

Hades
Shared: Action Roguelike · Roguelite · Action

Megabonk
Shared: Action Roguelike · Roguelite · Roguelike

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

Sephiria
Shared: Action Roguelike · Roguelite · Action

Risk of Rain 2
Shared: Action Roguelike · Roguelite · Action

Vampire Survivors
Shared: Action Roguelike · Roguelite · Action

Gunfire Reborn
Shared: Roguelite · Roguelike · Action Roguelike

Streets of Rogue
Shared: Action Roguelike · Roguelite · Action

Taboo Trial
Shared: Female Protagonist · Action Roguelike · Action

Metal Unit
Shared: Action · Female Protagonist · Action Roguelike

AI LIMIT
Shared: Female Protagonist · Action · Anime

Little Witch Nobeta
Shared: Female Protagonist · Cute · Action

Stellar Blade™
Shared: Female Protagonist · Action · Third Person

Tower Hunter: Erza's Trial
Shared: Action Roguelike · Female Protagonist · Roguelite

Neon Echo
Shared: Action Roguelike · Action · Roguelite

Dreamscaper
Shared: Action Roguelike · Action · Roguelite

Realm of Ink
Shared: Action Roguelike · Roguelite · Female Protagonist

Dead Cells
Shared: Action Roguelike · Roguelike · Roguelite

The Binding of Isaac
Shared: Action Roguelike · Roguelike · Action

Ravenswatch
Shared: Action Roguelike · Action · Roguelike

Halls of Torment
Shared: Action Roguelike · Roguelite · Action

Rogue Legacy
Shared: Action Roguelike · Action · Roguelike

Shape of Dreams
Shared: Action Roguelike · Roguelite · Action