I guess theme hospital isn't so niche, but it probably among my age group

Roller Coaster Tycoon 2 is worth any negative social impact it has on my life.

Steam has a 4X sale going on now and the latest Theme Hospital spiritual successor made two spinoffs.

They made a sequel to Evil Genius in 2021.

Whatever interests from the late 20th century you think only you had are almost certainly disappointingly mainstream now.

But hey, keep at it. I'm still holding out hope for EA pulling off a Dungeon Keeper sequel at some point even if it's a PR stunt.

My wife just picked Black & White (2001) back up. That game has held up better than I’d ever have expected.
- The B&W games feel weirdly... mobile these days. They put a lot of work into that 3D hand interface and it turns out they just ended up stumbling upon a semi-competent touchscreen UX.
You'll want to check out "Dungeons". I recently played Dungeons 3 and it is basically an improved dungeon keeper except you can go into the overworld too.
- I played them all. They're not the same.
  I'd say that Evil Genius sequel is the closest we've had, honestly.

Oh I love it, but my ultimate favorite is the 1988 DOS gama Life & Death where you had to cirurgically remove the appendix (and there was also brain operation). The graphics were shit of course but the amount of steps on each operation was awesome. You have to cut each layer of skin, remove the apendix, suture each layer back not leting the patient bleed of die. Amazing

Edit: You can play online https://www.myabandonware.com/game/life-death-h6

PLEASE if you are a game designer remaster it!

Holy crap, I had this game and never once successfully completed a surgery. Everyone died.
I was still in elementary school, so it was still fun to goof around.
- Yes it was super dificult! We did it once, years later, following a tutorial lol
I played "The Surgeon". I think it was on Amiga. I had a perfect record. Not one of my patients survived.
I believe you had to put in an aortic graft. I got to that part a few times before they died.
Trauma Centre on the DS is pretty much that.
Also Surgeon Simulator (and the VR port) but that's more a comedy take of it.
- 🤣🤣🤣🤣Sugeon similator is nothing like this

Dungeon Keeper.
Pharaoh.
Emperor: rise of the middle kingdom.
Theme Hospital.
Zeus.

Gimme

I sank so many hours into Dungeon Keeper 2. Such a good game.
Theme hospital was great

I liked it too but was never good at it as a kid though I imagine I'd kill it as an adult.
Have you played the new Project Hospital (on steam)? Not "new" but current lol
It's pretty good!

OpenTTD.

Sid Meier's Alpha Centauri Colonization Master of Orion II Age of Empires II

A handsome young cyborg named Ace
Woo'd women at every base
But when ladies glanced at
His special enhancement
They vanished with nary a trace

Mary had a little lamb,
Little lamb little lamb,
Mary had a little lamb,
whose fleece was white as snow.

Civ III is a masterpiece

So hot

For me it's PSOBB on emu servers

Hey fellow hunter!
It's been a while for me but I should hop back on to Ephinea to scratch the old itch

Traffic giant is the best game ever!

I mean the beauty is there's probably a community or discord for that. A lot of fringe interests tend to have one brave group organizer to keep the conversation going.