Games like Touhou Fantasy
Games like Touhou Fantasy include Vampire Survivors, Minishoot' Adventures, 永远消失的幻想乡 ~ The Disappearing of Gensokyo, Touhou Hero of Ice Fairy, and 20 Minutes Till Dawn. We matched them by the tags players give Touhou Fantasy on Steam (RPG, Bullet Hell, Female Protagonist, Casual, and Top-Down Shooter): closest matches first, and among equally close ones the better-known games.

Vampire Survivors
Shared: Bullet Hell · Roguelite · Casual

Minishoot' Adventures
Shared: Bullet Hell · RPG · Adventure

永远消失的幻想乡 ~ The Disappearing of Gensokyo
Shared: Bullet Hell · Female Protagonist · RPG

Touhou Hero of Ice Fairy
Shared: Bullet Hell · Female Protagonist · Roguelite

20 Minutes Till Dawn
Shared: Bullet Hell · Top-Down Shooter · Roguelite

Melvor Idle
Shared: RPG · Casual · Adventure

Greyfox RPG
Shared: RPG · Adventure · Female Protagonist

Death Must Die
Shared: Bullet Hell · RPG · Roguelite

ICEY
Shared: Female Protagonist · Adventure · RPG

Brotato
Shared: Bullet Hell · RPG · Singleplayer

DAVE THE DIVER
Shared: Casual · Adventure · RPG

Nordic Ashes: Survivors of Ragnarok
Shared: Bullet Hell · RPG · Roguelite

Touhou Mystia's Izakaya
Shared: RPG · Casual · Female Protagonist

Home Behind
Shared: RPG · Adventure · Casual

Mirror 2: Project X
Shared: Female Protagonist · RPG · Casual

The Vagrant
Shared: Female Protagonist · RPG · Adventure

Asgard's Fall — Viking Survivors
Shared: Bullet Hell · Casual · Roguelite

Escape From Duckov
Shared: Adventure · Top-Down Shooter · Shooter

Tales of the Black Forest
Shared: RPG · Female Protagonist · Adventure

Tiny Rogues
Shared: Bullet Hell · Top-Down Shooter · Roguelite

Bladed fury
Shared: Female Protagonist · RPG · Adventure

Apocalypse Party
Shared: Casual · Bullet Hell · Top-Down Shooter

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

Touhou Endless Dream
Shared: Casual · Roguelite · Female Protagonist