Mods / Very Tough

• Nnotthumpergame - Hit The Beats Perfectly Or Dieby 76561199217565268hit the beat or lose471 downloadsupdated 5 y ago
• FFlavor Foley - 炜WARD ROMANCEby 76561199182714028The difficulty of burning your hands463 downloadsupdated 20 mo ago
• Aacid-Notation - The Yandere's Puppet Showby 76561198899452545<color=#808080>------- CREDITS -------</color> Gameplay, VFX & Stage Pixel Art: <color=#8100ff>purplpasta</color> Drawn Assets: <color=#e64782>mochiiniko</color> <color=#808080>-------------------------</color>441 downloadsupdated 2 y ago
• Ffemtanyl - KATAMARIby WillowJUMP JUMP JUMP413 downloadsupdated 2 y ago
• Ffizzd - Oriental Techno but it's unfairly harderby 76561198858985971What used to be the easiest first level of RD, is now painstakingly hard...406 downloadsupdated 5 y ago
• あああああ & Frums - スター・オブ・ザ・COME ON!!by 76561199023457814Logan EVOLUTION!!!!!! (Warning: This level has fast Hemiolas!)379 downloadsupdated 5 y ago
• KKobaryo - RTX 20000by 76561198982303569[20000 BPM WARNING]371 downloadsupdated 4 y ago
• FFrums - My Capacitanceby 키위Frums - My Capacitance345 downloadsupdated 5 y ago
• Aacid-Notation - The Yandere's Puppet Showby 76561199121655986Two patients getting weird. they have to get a emergency aid. Something big you didn't experienced is coming... Escaping from them, treat the broken love, and find the main cause. (up to 16 beat is coming...) <#2 CherryBlossom Bunny chart>344 downloadsupdated 5 y ago
• Kkikuo - COPYCATby 76561199825348897观赏性关卡，目前还未做完手打适配，故此版本都是npc的线 有很多意味不明的小互动和滤镜，自行脑补剧情吧（悲） （有另一个玩家版本但是未做适配） 随便玩了一下编辑器里面的精灵页面（你）332 downloadsupdated 10 mo ago
• AARForest - I'll Be Thereby RebeLin325 downloadsupdated 10 mo ago
• CCreo - Engimaby 76561199561931445After all the tutorials the farmer went to the hospital, and reporting feeling multiple heartbeats at the same time and you are gonna have to solve all of them325 downloadsupdated 14 mo ago
• FFrums - Pictured as perfectby 76561199200161397AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA...323 downloadsupdated 5 y ago
• YYonKaGor - I Still Createby 76561199405087053This level in one word: 5-XN (Is that even a word?) Welcome to 7/8 hell, featuring burn beats, subdivisions, and holdshots. All to an irregular time signature! Good luck! Now supporting 2 Players! Grab a friend and let's suffer together!312 downloadsupdated 2 mo ago
• Ccola - 东方电舞曲（EX超级加强版）by 76561198830288744This is my first work.It must have much bugs,but I am still wish you play it happily.300 downloadsupdated 4 y ago
• かかめりあ (Camellia) - KillerBeastby 76561198863457524A wild KillerBeast has appeared!288 downloadsupdated 4 y ago
• LLeaF - Armageddonby 76561198899452545<INITIALIZING...> <PREPARING PAYLOAD>284 downloadsupdated 10 mo ago
• かかめりあ (Camellia) - Blackmagik Blazingby 76561199029078484260 downloadsupdated 4 y ago
• かかめりあ (Camellia) - We Could Get More Machinegun Psystyle! -And More Genre Switches-by 76561198364647482259 downloadsupdated 4 y ago
• GGrantare - Applecoreby 0utofnameideasThis level is probably beyond Very Tough, it's definitely unfair (especially at the last part) but i'll improve with practice. This was made just to get back into rhythm doctor so it might not be perfect.255 downloadsupdated 5 y ago
• 重重音テトUTAU & ぴーなた - Q&A(求＆影)by 76561198760485713注意事项（依旧）： 只有二拍子！采音练习只是...非常难，做好心理准备的！254 downloadsupdated 5 mo ago
• DDanimal Cannon - Chronosby 76561199129275931My second level, any tips to further improve will be highly appreciated.246 downloadsupdated 5 y ago
• かかめりあ (Camellia) - Hello (BPM) = 2024by 76561199220510138A simple chart of Hello (BPM) = 2024. No decoration, no effects, jus the chart. Requires 2 keys to play :0222 downloadsupdated 3 y ago
• AAsh Astral - endless.realityby 76561199381427774This is the rhythm doctor version of the featured levels in adofai In order to beat this level perfectly you need superhuman reaction time and some part of this level rely on guessing the next beat as well because i dont have that much skill to make every beat guessable?? so the judgement will be...216 downloadsupdated 17 mo ago
• Llinear ring - Can you hear me?by 76561198863457524I haven't heard it. But.. I heard hallucinations202 downloadsupdated 4 y ago
• CCansol - 1,2,3,4! Overclocked Editionby 765611990950573391! 2! 3! 4! -Credits- Used BoxOfShapes by Kin188 downloadsupdated 4 y ago
• Tt+pazolite - CHEATREALby Happybearfirst level, more me messing with the settings than a playable level187 downloadsupdated 4 y ago
• CCeiling - Insomniac Drillby 76561198400893301Insomniac drill + samurai182 downloadsupdated 4 y ago
• TTimed spam (cornandbeans-castle crashers menu loop)by 76561199184077246this is a timed spam level177 downloadsupdated 5 y ago
• FFemtanyl - KATAMARIby 76561199875557554157 downloadsupdated 11 mo ago
• YYonKaGor - Trash Talkin'by 76561199241545134This new paitient seems to have a lot of conditions -Ian P.S hope you have a LOT of field expirience154 downloadsupdated 22 mo ago
• Ffizzd (Hafiz Azman) - classy but with 16 patientsby 76561199519122413choas served in classy form151 downloadsupdated 10 mo ago
• Ffizzd - Steinwayby 76561199225404794Are these birds cursed? This seems like 8-X to me...145 downloadsupdated 5 y ago
• DDiesel - Ornate Onslaughtby 76561199210195958Second chart!!! Same artist cuz their songs are awesome!! Tower Heroes Rhythm Doctor babbyyyyy Special thanks to TehSepnia for the "moral support"140 downloadsupdated 8 mo ago
• LLeaF - ℵ0by 76561199123849547visual effects have not yet been added / will be added later139 downloadsupdated 2 y ago
• SSeabass671 - A Test of Polyrhythmby Ruckus671It is recommended to play this level with one player since it's more challenging. (Inspired by RHYTHMMASTER's Polyrhythm Test in Geometry Dash)130 downloadsupdated 4 y ago
• RRhythm Doctor OST - Invisible - Stellar Shiftby 76561199225404794Worse than Midnight? Stellar? Oh No... The Final Installment in the Invisible Trio XD129 downloadsupdated 5 y ago
• SSTOMACH BOOK - Animalsby 76561198855850911How could they seek to kill something so unique? - Music by STOMACH BOOK123 downloadsupdated 2 y ago
• BBlksmiith - operation nemesisby 76561199212389318121 downloadsupdated 21 mo ago
• Ffizzd (Hafiz Azman) - Super Battleworn Insomniacby 76561199443311039If the "Super Battleworn Insomniac" had already existed in the demo version... (I should have added the health bar, but I simply didn't have the time or energy; and I really don't know how to do it either :(121 downloadsupdated 13 mo ago
• Ffizzd - Love Letters (night shift)by 76561199390263509118 downloadsupdated 4 y ago
• FFizzd - Rhythm Doctor's Plot in Under 2 Minutesby 76561199108833378originally from a youtube video i exported it to steam workshop cause people asked for it have fun you monsters117 downloadsupdated 9 mo ago
• Mminimusicman - Crazy La Paint (Night shift)by 76561199381427774Yes. you heard me right. This is the Markiplier outro song! but harder! nobody's at the hospital. just you and your patiants115 downloadsupdated 8 mo ago
• JJ. Paradox - Serenityby 76561199052550487my first chart just had to be insanely tough serenity is from fnf: comaverse coma wanted me to make this...113 downloadsupdated 4 y ago
• RRhythm Doctor OST - Invisible but Ian's missing - Midnightby 76561199225404794Oh No.... Why.... HELP!!!!!107 downloadsupdated 5 y ago
• Hhuhby 76561199446585736idk what this is okay i was just goofing around with the editor106 downloadsupdated 10 mo ago
• RRhythm Doctor OST - ...like rhythm to heavenby SpiderkingYea this is hell record is C-106 downloadsupdated 15 mo ago
• PPopskyy - Samuraiby Aratonati105 downloadsupdated 4 y ago

141 very tough mods, most downloaded first. Each one has its own page here with what it needs to run and where its author publishes it; the files themselves stay with the author and are never re-hosted on this site.