Animal Hospital Anomaly Tier List
Confirmed anomalies ranked by danger and how hard they are to spot. Learn the S-tier threats first.
Instant threats — recognize these immediately or lose the shift.
Dangerous but learnable with practice.
Moderate threat — noticeable once you know the signs.
Lower priority — easy to spot with baseline knowledge.
Why these rankings?
Both confirmed anomalies sit at S-tier right now because each one punishes a slow or careless call. The Monster-Mouth Rabbit is the game's signature threat — it can pass for a normal yellow rabbit until its fanged mouth shows. The Shadow Rabbit stands out visually but appears where patients should be seated, baiting a wrong move. As more anomalies are confirmed, lower tiers will fill in.
See exactly how to deal with each one on the anomaly list.
Tier list FAQ
How is this tier list ranked?
Anomalies are ranked by two factors: how dangerous they are if missed (danger rating), and how difficult they are to spot (detection difficulty). S-tier anomalies are the most dangerous AND hardest to detect — missing one can end your shift. C-tier anomalies are easier to spot or less punishing if missed. Rankings are based on community consensus and testing across all shifts.
Will the tiers change with updates?
Yes. As the developer adds new anomalies and rebalances existing ones (such as the recent Class update), we re-evaluate placements based on the live game. An anomaly that was S-tier might drop to A-tier if its tell signs become more obvious, or a B-tier might rise if a new update makes it harder to detect.
Which anomalies should I memorize first?
Focus on S-tier and A-tier anomalies first — these are the shift-enders. Memorize their tell signs, appearance, and which detection layer catches them. Once you can instantly recognize the top-tier threats, work through B-tier. You can afford to learn C-tier anomalies through gameplay since they are usually obvious and less punishing.
Why are Skinwalker anomalies always high-tier?
Skinwalker-type anomalies are inherently dangerous because they bypass the most commonly used detection layers (visual and photo). A player relying only on "does it look normal?" will miss every Skinwalker-type anomaly. They require CCTV or document inspection to expose, making them consistently among the hardest threats to catch.
Is this tier list for solo or multiplayer?
The rankings reflect solo play difficulty, where one player must handle all detection layers alone. In multiplayer, some S-tier anomalies become easier because a dedicated CCTV player can catch Skinwalkers while the admissions player processes other patients. The relative ranking stays mostly the same regardless of player count.