The Medium

The Medium is Bloober Team's psychological horror game from January 2021, and it holds a distinction almost nothing else in our benchmark library can claim: at its worst moments it renders two complete game worlds at the same time. Across more than 3,700 measured CPU and GPU combinations in our database, the average system manages just 43 FPS at 1080p Ultra, 36 FPS at 1440p Ultra, and 28 FPS at 4K Ultra. The fastest combinations touch 586 FPS at 1080p Low; the slowest crawl along at 9 FPS at 1080p Ultra. That spread, and the low averages, tell you most of what you need to know before spending money: this is one of the heaviest horror games ever benchmarked here, heavier than many open-world titles, and it punishes hardware that would cruise through bigger names.

Unreal Engine 4 and the dual-reality problem

The Medium runs on Unreal Engine 4, but stock UE4 performance knowledge only gets you halfway. The game's signature mechanic is its dual-reality sequences, where Marianne exists in the material world and the spirit world simultaneously, shown in split screen. During those passages the engine renders two full scenes, with two sets of geometry, lighting, and post-processing, and frame rates drop accordingly. Our database minimum of 9 FPS at 1080p Ultra comes from exactly this: weak hardware hitting a dual-world scene with everything maxed. Even strong hardware feels the effect. The game's averages are low partly because a meaningful share of its runtime is spent rendering what is effectively two games at once.

Outside those sequences, load behavior is more conventional, and the balance tilts toward the GPU. This is a fixed-camera, slow-paced horror title with small to medium environments, so CPU simulation load is modest. There are no crowds, no physics chaos, no streaming open world. A decent modern 6-core processor is enough; the game does not scale dramatically past that, and spending on a flagship CPU buys little here. Memory requirements are moderate by 2026 standards: 16 GB of dual-channel DDR5 or DDR4 is the sensible baseline, and the game fits in that without the constant asset churning you see in open-world titles. Where The Medium does stress the memory subsystem is VRAM. Ultra textures plus ray tracing push hard against 8 GB cards, and that is one of the main reasons the same GPU can look fine in reviews of other games yet struggle here.

Ray tracing deserves its own mention because it changes the hardware calculus. The Medium was one of the early showcases for hardware RT on PC, offering ray-traced reflections and ray-traced ambient occlusion, with DLSS available to recover performance. Turn RT on and the averages above, which are already low, fall further. Turn RT off and even mid-range cards start looking reasonable. This is a game where one toggle in the settings menu is worth more than a full GPU tier.

1080p: heavier than it has any right to be

The 43 FPS average at 1080p Ultra needs context, because it is lower than what the same database shows for far larger games. A mid-range build that plays most 2021-era titles at 80 to 100 FPS at 1080p will sit closer to 40 to 60 here, and the dual-reality sequences will drag it below that. The 9 FPS floor at 1080p Ultra comes from older or entry-level hardware attempting maxed settings, presumably with ray tracing in play, and it stands as a warning rather than a curiosity: this game does not degrade gracefully. Settings scale matters enormously.

The other end of the table is instructive too. A 586 FPS ceiling at 1080p Low shows what the engine does when a flagship GPU is freed of visual load: in single-world scenes with settings down, this is a very light game. The gap between 43 and 586 is mostly settings, not scene complexity, which makes The Medium unusually tunable. If your goal is a smooth, locked experience rather than eye candy, the path is short: drop from Ultra to a tuned mix, kill ray tracing, and most mid-range hardware from the last several years holds 60 FPS or better at 1080p. If your goal is maximum atmosphere with RT on, the best graphics card for The Medium at 1080p is not a mid-range part; you want something with strong RT throughput and at least 10 to 12 GB of VRAM, plus DLSS engaged.

For practical targeting: 1080p 60 FPS at a tuned High without RT is achievable on mainstream hardware. 1080p 60 at Ultra with RT demands a genuinely strong card. Chasing 144 FPS at Ultra to feed a 144Hz monitor is a realistic goal only on high-end hardware, and pointless anyway, which brings us to pacing.

1440p and 4K: a GPU wall with a multiplier on top

At 1440p Ultra the average falls to 36 FPS, and at 4K Ultra it reaches 28. Two things stand out in those numbers. First, they are low in absolute terms; plenty of 2021 hardware simply cannot do this game at high resolution with maxed settings. Second, the scaling is surprisingly shallow: 43 to 36 to 28 is a much gentler slope than most titles show, which is consistent with the dual-reality rendering imposing a fixed cost that does not scale with resolution. The game is expensive before pixels are even counted, and adding pixels hurts less than expected.

The practical reading: if a system is borderline at 1080p, it will be only somewhat worse at 1440p, so moving up a monitor tier is cheaper here than in most games. Conversely, 4K Ultra at 28 FPS average means that without upscaling, 4K in this game is a slideshow by action-game standards on most hardware, and even flagship cards of the game's own era barely held 60. DLSS transforms this. With DLSS Quality, 4K becomes genuinely playable on high-end cards, and 1440p becomes comfortable on upper-mid-range ones. The game never received FSR support, so AMD and older NVIDIA owners rely on the resolution scale slider or accept lower settings. In a slow, fixed-camera horror game, an upscaled image holds up better than it does in fast competitive titles, so use it without guilt.

Recommended settings: where the performance actually is

The Medium's settings menu has clear winners and losers, measured across our combination data. Ray tracing is the first decision: it is the single most expensive feature in the game, and turning it off recovers more frame rate than every other adjustment combined. It looks good, especially the reflections, but the cost is disproportionate on anything below a strong RT-capable card. If you keep it, DLSS stops being optional and becomes mandatory.

After that, the usual UE4 suspects apply. Shadows are expensive relative to their visibility in a game this dark; High to Medium costs little image quality. Effects quality, which covers the volumetric fog the game leans on heavily, is the second-biggest GPU cost after RT and looks nearly as good one notch down. Textures are VRAM-limited rather than frame-rate-limited: on cards with 8 GB or less, dropping textures one step stops hitching in dual-world scenes without visible loss at 1080p. View distance and post-processing are cheap; leave them up. Anti-aliasing should stay on, since the fixed camera and slow motion make shimmering unusually visible. A sensible tuned profile, RT off, shadows and effects one notch down, textures matched to your VRAM, DLSS Quality at 1440p and above, typically doubles or better the Ultra frame rate on the same hardware in our data, which is a larger tuning dividend than almost any other title we track.

One more note: this is a fixed-camera, slow-walking horror game with no combat and no competitive stakes. Frame rate targets that matter in shooters are irrelevant here. A locked 60 is the entire requirement for a premium experience, and a steady 40 with good frame pacing is perfectly playable. Spend settings budget on image quality and stability, not on chasing triple digits.

What hardware do you need?

Entry level (older quad-core, 8 GB VRAM-less cards, 16 GB RAM): 1080p Low to Medium in the 30 to 45 FPS range with RT off, dipping in dual-reality scenes. The 9 FPS floor in our data lives in this tier when people insist on Ultra. Respect the settings menu and it is a completable, atmospheric experience; ignore it and the game is miserable.

Mid-range (modern 6-core, 16 GB dual-channel RAM, mid-tier GPU with 8 to 12 GB VRAM): 1080p tuned at 60 to 80 FPS without RT, 1440p tuned with DLSS in the 50 to 70 range. This is the value sweet spot for The Medium, and a sensible gaming PC build for this title prioritizes the GPU and VRAM over the processor. RT at this tier is possible at 1080p with DLSS but expect the frame rate to sag during split-screen sequences.

High-end (fast modern CPU, strong RT-capable GPU, 12 to 16 GB VRAM): 1080p Ultra with RT locked near 60, 1440p tuned with DLSS in the 70 to 100 range, 4K with DLSS around 60. This is where the game shows what it was designed to look like, and the dual-reality sequences stop being a frame-rate event.

Flagship: 4K with RT and DLSS Quality at 60 to 90 FPS, and the 586 FPS ceiling at 1080p Low that shows how light the game can be when unshackled. Overkill for a 2021 horror title, but this is one of the few games where flagship hardware of the game's era genuinely could not max it, so the headroom is not wasted if you insist on every toggle.

Laptop playability

Laptops handle The Medium better than its desktop numbers suggest, for a simple reason: the game is GPU-bound with modest CPU and RAM demands, and modern gaming laptops are exactly that profile. A current mid-range mobile GPU plays it at 1080p tuned comfortably, and mobile RT parts with DLSS can even manage ray tracing at 1080p, which is more than can be said for many heavier open-world titles on the same machines. The cautions are thermal and textural: laptops sustain loads poorly in long sessions, and this is a long-session game, so expect some clock decay through a multi-hour evening. Mobile GPUs with 6 GB of VRAM or less should keep textures at Medium to avoid dual-scene stutter. Thin-and-lights and integrated graphics are out; the dual-reality rendering is fatal to them even at Low.

Streaming and content creation

The Medium is a streamer-friendly game in every respect except one. It is slow, atmospheric, fixed-camera, and story-driven, ideal for horror audiences, and its moderate CPU load leaves real headroom on a modern 8-core for broadcasting. Even so, hardware encoding is the right choice: NVENC on NVIDIA cards or AMF on AMD handles 1080p60 with no measurable cost, while x264 CPU encoding competes for the same cores during dual-reality scenes, exactly when frame times are already stressed. The single exception to its friendliness is that split-screen rendering: the frame-rate dips are sudden, and an uncapped stream will show them. Cap frame rate a little below your worst-case dual-scene performance and the broadcast stays clean. For capture-card dual-PC setups none of this matters, but almost nobody needs one for this game. If you are cutting highlights afterward, the game's heavy RT look means video editing with hardware-accelerated decoding in your workstation pipeline saves real time on timeline scrubbing, the same RT cores that render the game decode it well.

Common problems and fixes

Massive frame drops when the screen splits into two worlds: this is the game working as designed, rendering two scenes. No setting removes it. Lowering effects and shadows blunts it; RT off blunts it more. Frame caps hide it.

Stuttering despite a good average FPS: usually VRAM overflow with Ultra textures on 8 GB cards, worst during world transitions. Drop textures one notch. It costs almost nothing visually in a game this dark.

Poor performance with ray tracing on a mid-range card: expected. The Medium's RT is among the most expensive implementations of its generation. DLSS on, or RT off; there is no middle path that performs well.

Long loads or hitching on world transitions: the game belongs on an NVMe SSD. It is not the worst offender in our library for storage, but dual-world asset streaming punishes hard drives audibly and visibly.

The game feels slow even at high FPS: it is. Fixed camera angles, deliberate walking speed, and slow pans are the design, not a performance fault. Do not chase 144 FPS for a game that never moves faster than a walk.

Upgrade priorities

The Medium's upgrade order is almost the mirror image of CPU-bound titles. First, the graphics card: it is the bottleneck at every resolution and every setting tier that matters, and VRAM capacity specifically is the quality-of-life line, with 8 GB the practical minimum for High textures and 12 GB comfortable for Ultra. Second, upscaling support: if your card lacks DLSS, that alone is a reason to weigh NVIDIA in any GPU purchase aimed at this library, since the game leans on it and never got FSR. Third, RAM: reaching 16 GB in a proper dual-channel configuration matters if you are below it, and it is cheap. Fourth, storage: an NVMe SSD fixes the transition hitching. Last, the processor: a CPU upgrade is the lowest-value spend for this game, because anything from a modern 6-core up already outruns what the engine asks for. If your frame rate disappoints in The Medium, look at the GPU and the RT toggle before anything else.

Frequently asked questions

Q: Why is The Medium so demanding for a 2021 horror game?

A: Its dual-reality sequences render two complete game worlds simultaneously, and its ray tracing implementation is among the heaviest of its generation. The 43 FPS average at 1080p Ultra across our database is the result: lower than most open-world games of the same era.

Q: Is The Medium CPU or GPU intensive?

A: Strongly GPU intensive. The fixed camera and small environments keep CPU load modest, so a modern 6-core is plenty. VRAM capacity matters more than the processor, especially with Ultra textures or ray tracing.

Q: Can a mid-range PC run The Medium at 60 FPS?

A: Yes, at 1080p with tuned settings and ray tracing off. Ultra with RT is a different story and genuinely needs a high-end card. The settings menu is worth more here than in almost any other game we track.

Q: Does The Medium support DLSS or FSR?

A: DLSS yes, FSR never arrived. At 1440p and 4K, DLSS is effectively part of the recommended configuration on NVIDIA hardware. Other cards fall back to the resolution scale slider.

Q: How much does ray tracing cost in this game?

A: More than any other setting, typically enough to drop a tier of hardware. On anything below a strong RT-capable GPU, leaving it off is the single highest-value adjustment you can make.

Q: Is 60 FPS enough for The Medium, or should I target high refresh?

A: 60 is the whole requirement. It is a slow, fixed-camera, narrative horror game with no combat and no reaction-time demands. A locked 60 with good frame pacing is a premium experience; 144 FPS adds nothing you can see.

The bottom line

Five years on, The Medium occupies a strange spot in the benchmark library: a modest-selling horror game with the performance profile of a much bigger production. Its averages, 43 at 1080p Ultra, 36 at 1440p, 28 at 4K, still look like a warning label, and the 9 FPS floor shows what happens when entry-level hardware meets dual-reality rendering with everything maxed. But the same data carries the good news: with a 586 FPS ceiling at low settings and a settings menu that gives back performance generously, this is one of the most tunable heavy games we track. Treat ray tracing as a luxury, match textures to your VRAM, lean on DLSS at higher resolutions, and a mid-range machine delivers the full experience. Run it naive at Ultra and it will punish hardware that handles far larger games without complaint. Bloober Team has moved on to bigger projects since, but for readers checking whether their PC can handle this one, the answer is almost certainly yes, provided you respect what that split screen is actually asking of your GPU.