North, South, East, and West will no longer be visible on the compass, so be sure to check the time of day and where the sun is located (rises in the East, sets in the West).

Waypoints are shown only when you get close to them.

Fast travel isn't possible in Hardcore Mode.

There is no autosaving. The game can only be saved by drinking Saviour Schnapps, sleeping in your own bed, paying for a bathhouse full service, or exiting the game (deletes once the game is started up again).

You can't rely on eating from the cooking pots. The best way to regenerate health is to sleep. Food and healing potions take quite a while to kick in.

You're only alerted to your current health and stamina levels by means of in-game visual effects.

Combat is more realistic in Hardcore Mode. Strikes have a more realistic impact, and engaging in combat with an experienced warrior without wearing quality armor is very deadly.

Traders pay less for goods and rewards are lower overall. Repairing items are even costlier.

Nightmares: Every time you wake up you are shaken from your nightmare and suffer a short-term debuff. Sleeping becomes more of a "tactical" choice.

Claustrophobic: When you close your helmet visor, your attack lowers. You have to choose between better protection or higher attack.

Hemophilia: You bleed more which makes taking hits in combat riskier.

Numbskull: Lowers your XP gain. A perfect perk for players who thought the vanilla skill progression was too fast and felt overpowered in the late game. It's more work to out level your opponents with this perk.

Shakes: For true sadists. Makes aiming a bow and picking pockets and locks harder.

Consumption: Your stamina regenerates slower. Combat is more challenging and requires thinking ahead of each strike.

Tapeworm: You get hungry faster, and since eating from pots around the world is no longer such a viable option, this makes the survival element even more prominent.

Sonambulant: Fun perk. There is a slight chance you will wake up somewhere else than where you fell asleep. Provides quite a challenge when you wake up in an unknown place and can't see your position on the map. Very rarely you can also sleepwalk your place to some secret areas.

Brittle Bones: You must be careful while running down cliffs and riding a horse. Falls are more dangerous.