The Medium for Xbox Series X/S review: A compelling blend of innovation and nostalgia

A horror title that pulls inspiration from the past to build something new.

The Medium Marianne
(Image: © Windows Central)

The Medium has been one of my most anticipated games of the last few years. As a long-time fan of survival-horror games, especially classics like Silent Hill and Fatal Frame, I was excited to see a modern take on this iconic genre. But did this psychological horror title live up to my lofty expectations? In many ways, this ambitious project not only met but even challenged my assumptions of what it would be.

Suppose you're a horror fan looking for exciting new ways to experience storytelling through a video game. In that case, The Medium shines with a cast of captivating characters and innovative design decisions. Still, if you're someone looking for high-octane thrills and chills, the slower pacing of this title might not have enough action to keep you hooked.

The Medium: What I liked

The Medium Xbox Exterior

Source: Windows Central (Image credit: Source: Windows Central)
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TitleThe Medium
DeveloperBloober Team
PublisherBloober Team S.A.
GenrePsychological horror
Xbox VersionXbox Series X|S
Game Size24.47GB
Play Time6-8 hours
Xbox GamePassYes
Launch Price$50

The most important element of any good psychological horror game is the compelling story, preferably filled with nuanced characters and layered interactions. The Medium focuses heavily on Marianne, who tries to reconstruct the memories of her past. The slower, deliberate pacing of cutscenes and world exploration makes this descent into madness, grief, and unimaginable tragedy feel more like playing a devastating horror film in the vein of Hereditary or The Lodge than revisiting games like Silent Hill or Alone in the Dark. As a massive horror movie buff, this is one of the greatest compliments I can give to The Medium.

Not only did I find myself enthralled by the mystery of Marianne's strange supernatural history, but I was also captivated by the possibilities of an expanded Medium universe. I wanted to know everything there was to know about Marianne, her family, and the tortured souls you encounter along the way. The moment I finished my first playthrough, I immediately wanted to dive back in and do it all again. As someone who's completed two playthroughs of The Medium so far, I would highly recommend you do the same if you want to fully unpack all the subtleties of this haunting experience.

It's also worth noting that this game touches on some serious and incredibly heavy subject matter, so keep that in mind before playing. I won't go into any specifics because I genuinely believe how the story is unraveled and how it's presented through new and innovative gameplay mechanics is its biggest achievement. I wouldn't want to take those initial discoveries away from anyone jumping into this game for the first time. If you're a fan of cryptic character dissections as opposed to more in-your-face exposition, chances are you'll love the delicate examination of the darkest recesses of the human psyche uncovered in this title.

The Medium Cracow

Source: Windows Central (Image credit: Source: Windows Central)

The Medium masters world and atmosphere presentation throughout its 6-8-hour story. The environment design team at Bloober consistently delivers engaging locales for you to explore. High-quality textures and ray-tracing makes each of the distinct areas feel grounded and authentic. That goes a long way in supplying immersive, intricate backdrops to your foray into this world of faded nostalgia. Settings like the NIWA Resort, where a good chunk of the game takes place, were based on and modeled after real-world locations. A meticulous level of care is on display in every frame, and this attention to small details makes The Medium one of the most gorgeous horror games I've ever played.

To fully showcase the scope of The Medium's dark beauty, the entire game is presented through fixed camera angles. This will definitely be a bit jarring for some players, especially if you've never experienced the infamous tank controls of Resident Evil or Silent Hill. Still, I loved how cinematic this made every moment feel. You never miss a tense scare or subtle environment clue because your camera was facing the wrong direction. Thankfully, some modern enhancements and quality-of-life features for mobility keep things rather intuitive for those worried about how this makes controlling Marianne feel. Seeing this iconic perspective properly revisited in a contemporary horror game gives me hope for its big comeback.

The Medium: What I didn't like

The Medium Xbox Dual Reality

Source: Windows Central (Image credit: Source: Windows Central)

The Medium is undoubtedly a visual spectacle in many ways. Considering this is the first true Xbox Series X and S exclusive, and one of the first real showcases of what these next-gen consoles could do, there are a few areas I feel some players might be disappointed.

There are major differences between what Silent Hill is and what The Medium wants to be.

Let's start with the elephant in the room. The Medium is not 60FPS on Xbox Series X, and the official spec sheet for PC doesn't list anything above 30FPS. The game seems to hover around the 35-40FPS mark during most sequences from our performance analysis. The target here is definitely 30FPS, especially during the dual-reality sections of the game. With fixed camera angles and generally slower pacing, I ultimately think players will be able to look past this after the first few minutes, but it is worth mentioning for all the newfound 60FPS purists out there.

Many horror fans have been hyping up The Medium as the spiritual successor to Silent Hill. While it's clear the game pulls plenty of inspiration from that series, there are major differences between what Silent Hill is and what The Medium wants to be. The lack of dedicated combat will absolutely be a divisive design choice. While Marianne has some impressive supernatural powers at her disposal, there isn't much in the way of action outside of a few tense chase sequences. The pacing of The Medium is deliberately very slow and methodical. While I wouldn't go as far as to say that this was an issue I personally had with the game, the focus on story over combat will likely be a complaint for many players.

I've been very deliberate in my approach to avoid key story details in my review. I want players diving into The Medium for the first time to genuinely form and build their own character theories, as that was one of my favorite elements of the game. Without touching on any spoilers, the ending will be polarizing. I can't wait for more people to play this so that I can bounce ideas off other horror enthusiasts. After sitting on the grand finale for a few days now, I'm still not quite sure how I feel. There will certainly be some passionate discussions about the ending of The Medium.

The Medium: Should you buy?

As a huge horror fan and someone who's played basically every previous Bloober Team title, I can confidently say that The Medium is, hands down, this studio's biggest triumph. Innovative gameplay ideas like dual-reality puzzle-solving and immaculately designed environments elevate this above many other titles in the genre. Instead of replicating a formula from the past, The Medium blazes forward with bold new ideas and innovative mechanisms for character-focused storytelling.

Even though The Medium wears its Silent Hill inspirations on its sleeves through fixed camera angles, heady psychological horror, and themes of two distinct realities, The Medium is not Silent Hill. Players who go in wanting it to be will leave disappointed. But instead of critiquing a game for what you want it to be, I implore players to embrace The Medium for the genuinely captivating vessel of great horror game storytelling that it is.

The Medium is available from January 28, 2021, as part of Xbox Game Pass across Windows 10 PC and Xbox Series S/X consoles.

Miles Dompier

Miles Dompier is a Freelance Video Producer for Windows Central, focusing on video content for Windows Central Gaming. In addition to writing or producing news, reviews, and gaming guides, Miles delivers fun, community-focused videos for the Windows Central Gaming YouTube channel. Miles also hosts Xbox Chaturdays every Saturday, which serves as the Windows Central Gaming weekly podcast.