Ghoul Ghouls or necrotic post - human s are decrepit , rotting , zombie - like mutants . Intense and prolonged radiation has ravaged their skin , much of their flesh and in some cases many of their ligaments . Paradoxically , they also have greatly extended overall lifespans and are , allegedly , immune to ( and even healed of damage by ) background radiation and / or nuclear fallout . Description . < section begin = Background / > Consistent exposure to concentrated levels of background radiation for an extended period of time will randomly result in humans undergoing a mutation / transformation into the ghoul species . Camp Searchlight would also show that quick , perhaps even instantaneous transformations are not unheard of or out of the question . Nevertheless , for typical humans , any serious exposure to background radiation levels results in sickness , shortly followed by death . Most known ghouls in New California were created from vault - dwellers living in Vault 12 under , California ( known as Necropolis after the Great War ) . As part of the vast Vault Experiment Program , the Vault 12 door was designed to be dysfunctional , to be unsealed . Radiation from nuclear detonations and the subsequent fallout contaminated the vault , resulting in the death or mutation of every occupant . The survivors can be found scattered throughout this region , mostly in Gecko , a town established near an old , half - functional Poseidon Energy nuclear power plant . Many could also be found in Broken Hills , an old town located near a uranium mine , typically inhabited by humans , super mutants and ghouls . However , the uranium was eventually depleted and the town was abandoned sometime after 2242 . Ghouls from other regions most likely originated from opportune or home - made shelters . Such shelters were not adequate to fully protect against all the effects of nuclear fallout . Radiation levels in some areas were such that they were low enough not to kill people , but high enough not to leave them unscathed . There are ghouls in the Midwest , most notably a nuclear weapon - worshiping cult in Kansas City . Both Quincy and Springfield also have at least some ghoul occupants . In Texas , many of the former residents of ( known as Los after the Great War ) became ghouls , probably when blocked at the entrance of the Secret Vault . Later , in the same city , the Church of the Lost was created by former vault - dwellers that had become ghouls . In the Capital Wasteland , many ghouls currently alive were born long after the Great War of 2077 , and succumbed to radiation poisoning much later , due to the high levels of radiation in Washington , D . C . and its surroundings for decades following the fall of the bombs . In some cases ( e . g . Charon ) , however , there is evidence of pre - War ghouls . The majority of intelligent ghouls in the Capital Wasteland have chosen to settle in Underworld , a settlement established in the Museum of History in the ruins of The Mall . The settlement got its name from an exhibit on representations of afterlife mythology in which the ghouls established their town . In the Mojave Wasteland , they can be found in small amounts throughout the region , but no town is completely dedicated to them . There are usually a few ghouls living among humans in various communities performing jobs in order to survive , such as the guard Beatrix Russell and the comedian , both of which are in Freeside . The only known community of ghouls in the region is the Bright Brotherhood , a religious faction located in the REPCONN test site , founded and led by an intelligent glowing one named Jason Bright , who wants to leave Earth and go into space to find a " new world , " a promised land foretold by Bright himself . There are also several ghoul rangers occupying Ranger station Echo , implying some level of acceptance of ghouls serving in the NCR . < section end = Background / > Discrimination . Since the War , more people have had run - ins with ghouls , both civil and feral . Because of the animalistic behavior and savage threat feral ghoul s pose , many people view all ghouls negatively . For example , the residents of Tenpenny Tower refuse to let ghouls into their luxurious hotel , despite polite offers of caps . Chief Gustavo is particularly bigoted and feels that " they ' ll all go feral one day . " Negative stereotypes about ghouls stem from wastelanders who couldn ' t care less that not all ghouls are feral . Terms like " zombie , " " shuffler , " or " brain - eater " are common insults . Because of this general negativity , some ghouls , such as Roy Phillips and Mister Crowley , have developed a bitter hatred of humans . Controversy over origins . There is some disagreement , even among the makers of " Fallout " games , about the origins of ghouls . While Tim Cain said explicitly that ghouls are only a result of radiation , consistent with an understanding of the science of radiation as it stood during the 1950s , Chris Taylor said that a mix of both radiation and FEV was involved . While Chris Avellone initially supported the latter view in his " Fallout Bible " , he was later convinced to support the radiation - only version . Biology . Ghouls were " created " in the Great War of 2077 , with the exception of at least one Pre - War ghoul , Edward Winter . Ghouls are still alive during " Fallout " ( 2161 ) , " Fallout 2 " ( 2241 ) , " Fallout 3 " ( 2277 ) , " " ( 2281 ) and " Fallout 4 " ( 2287 ) . All ghouls live considerably longer than normal humans , though they are sterile . The reason for this longevity has to do with differences on the cellular level , and the ability of ghoul DNA to regenerate at a rate unmatched by normal human nucleic acids . Occasionally , additional genetic material is added as a result of the mutation . The unnaturally long lifespan of a ghoul is also due to a mutation within the autonomic nervous system of certain individuals following exposure to specific combinations of ionizing radiation with wavelengths below ten picometers . Radiation that has such a short wavelength , is known as gamma radiation ; normally lethal to healthy humans in even moderate doses . The mutation in response to gamma radiation that produces ghouls disrupts the normal process of decay in the neurotransmitters along the spinal cord . Ghouls were not an immediate phenomenon ; the process took months or years for some . After a few weeks , their skin slowly started to flake off and crack , as well as partial or complete hair loss . In " Fallout 3 " , Carol explains that even after the War it took a while for the ghouls to start looking like they do now . However , there have been occasions when ghouls are made instantly by large doses of radiation . For example , Camp Searchlight , where an entire base of NCR soldiers were transformed into ( excepting Private Edwards ) by a radioactive device used by Caesar ' s Legion , and the ghoulification of Moira Brown after the warhead in Megaton was detonated by the Lone Wanderer ( if the player chose to do so ) . Although often lacking strength due to decayed tissue , ghouls have heightened senses , making them more perceptive and lucky than other wasteland humanoids . As a result , chems like Jet barely affect them . Doctor Barrows , when healing the player , bemoans the fact that " You humans are so fragile . " Specifically , the neurotransmitters affected in a ghoul ' s mutation are those responsible for cardiac and respiratory function in a healthy human being . These transmitters are continually regenerated at a greatly accelerated rate after the mutation sets in , carrying sufficient oxygen to sustain the life of the subject while being insufficient to retain dermal elasticity and avoid the resulting necrosis , the result of which is the decaying , corpse - like appearance of post - mutation humans . Old ghouls may also still suffer from some of the debilitating effects of old age , however , as some of the two century - old ghouls like Raul Tejada and Dean Domino complain of knee problems when made to crouch ( and both of them were far from elderly when they became ghouls ) . Raul also mentions how he ' s no longer as swift and agile as he used to be in his youth , though this might be psychosomatic and / or fed by Raul ' s continuous doubts about his age and place in the world . Still , these may indicate that their regenerative abilities ' problems with skin could extend to other soft tissues of their joints . Considering that ghouls are missing their noses , the pinna of the ear , and some complain about knee pain , it may be that the process of ghoulification also damages cartilage in the human body . In physical appearance , a ghoul ' s flesh is constantly rotting off , appearing very raw and discolored from necrosis ( although , in the case of non - feral ghouls seen in " Fallout 4 " , the physical appearance of their flesh is more consistent with severe burn scars than necrosis ) . Lips and eyelids are sometimes absent , and noses are in almost every case completely rotted off . Feral ghouls are typically heavily emaciated and hunched over ( possibly due to malnutrition and lack of sunlight ) , while non - ferals typically have a healthier , more human - like build and posture . Another major difference between ferals and non - ferals is dress : while non - ferals usually dress like normal humans , feral ghouls wear little clothing other than tattered pants or sections of old armor , having long ago lost the mental capacity to mend or replace their clothes . Ghouls , at least the non - feral ones , are generally as intelligent as normal humans . However , their intelligence has in some cases decreased at varying rates as a result of the radiation rotting their brains ; this continues until their ability to reason has gone completely , and they become feral . Their physical repulsiveness makes the life of a ghoul difficult at best - only the most tolerant human communities accept them as anything more than monsters . Some ghouls eventually go mad , and it remains unclear exactly what precipitates this change in neurobiology and psychology , but anecdotal evidence seems to indicate that non - social ghouls , or those in isolation , are more prone to the condition . It is known that ghouls can turn feral when exposed to excessive levels of radiation . In the only known case of a ghoulified child , Billy Peabody survived for 210 years locked inside of a refrigerator subsisting on nothing but radiation and whatever meager contents that his prison still retained . Ghouls that succumb to insanity are called " feral ghouls " : they are mindlessly aggressive and , having lost their ability to reason , driven entirely by their instincts . These feral ghouls strongly resemble zombies like those depicted in old horror films , and this misconception succeeds in alienating non - feral ghouls even more from humans . The term " zombie " has become an offensive racial slur to ghouls and " smoothskin " is a derogatory term for humans often used by ghouls . Ghouls are immune to most forms of radiation that still remain in the wasteland . Radiation poisoning cannot get worse for the ghouls , though it can hasten the process of decay and lead to their decline into the feral state as described above . However , many ghouls report feeling healthier when exposed to low - level radiation , and thus make their homes near locations with acute background radiation . The ghouls known as " glowing one s " actually enjoy large amounts of radiation , which they describe as being " comfortably warm . " They are even healed by it . One of the most common side effects of ghoulification is sporadic or even complete hair loss : few ghouls retain enough hair on their heads to actually maintain a haircut , and ghouls with facial hair are even rarer . Another is vocal degradation : ghouls with clear voices are very uncommon , most having a raspy rattle to theirs . Desmond Lockheart from " Point Lookout " and Raul Tejada from " Fallout : New Vegas " are two of the few examples of ghouls with facial hair , and Plik from Point Lookout and Jason Bright from " Fallout : New Vegas " are two examples of ghouls with an exceptionally clear voice . While the exact cause of the typical " voice damage " is unknown , it is more than likely partial decay of the vocal cords . In the case of Billy Peabody , the only known child ghoul , his normal speaking voice was retained while his parents ' voices were severely distorted . According to M . A . R . Go . T . , the " unidentified persons " ( feral ghouls ) in the Presidential metro area " possess no internal body heat and emit lethal levels of radiation . " Variants . Feral ghoul . Feral ghouls are among the more unfortunate mutants whose minds have deteriorated from prolonged radiation poisoning , becoming instinct - driven savages , attacking anyone and anything relentlessly , save for other ghouls . Wearing the ghoul mask in " Fallout 3 " makes all feral ghouls ignore the player unless directly assaulted . Despite what Roy Phillips says , no matter how close one gets to a feral ghoul when wearing the ghoul mask , they will not " Sniff you out , " and become hostile . Feral ghoul roamer . Roamers are less common feral ghouls dressed in worn - out sections of old combat armor , giving them greater damage resistance . The armor does not , however , slow them down ; in fact , they are slightly faster than regular ferals . They typically can be found alongside two or three ferals , and attack in groups . Alone they are still weak and easily brought down with most weaponry , but they can easily flank the player during a group attack . Feral ghoul reaver . This rare flavor of ghoul , dressed in rusty remnants of metal armor , appears throughout the post - apocalyptic Mojave Wasteland , the Commonwealth , and the Capital Wasteland ( in the last case via the " Fallout 3 " add - on " Broken Steel " ) . They also appear frequently in the swamps of " Point Lookout " . A greenish smoke issues from their scars , and their flesh appears to be melted and even bubbling in some areas , as if being " cooked " by the radiation they have absorbed . In " Fallout 3 " they are among the toughest enemies in the game , able to take a direct hit from a Fat Man and survive . Besides being incredibly fast and having a deadly swipe , they can pull chunks of radioactive gore from their guts and hurl it with deadly accuracy . In " Fallout : New Vegas " , reavers are much weaker and lack the ability to throw gore , making them much easier to handle . Glowing one . These ghouls have absorbed so much radiation they glow a ghastly green color in the dark . They are known as " glowing ones , " and are often considered outsiders even by other ghouls . The glowing ones can sustain a lot more damage than other ghouls , second only to reavers ( see above ) . They also emit radiation from their whole body , and can even release a devastating blast of energy from their bodies at will , healing nearby ghouls and harming unlucky attackers caught in the blast radius . People have seen on more than one occasion a feral glowing one fighting or being chased by " normal " feral ghouls . Although very rare , it is possible for a glowing one to retain their intelligence and cognitive functions , such as Jason Bright and Oswald . Intelligent ghoul . Intelligent ghouls have suffered far less mental degradation from their condition and retain their full faculties from before their transformation . These ghouls possess the ability to talk , and they normally wear clothing , as well as carrying and using weapons . Some may have hair on their head , but not a lot . Some male ghouls , such as Raul Tejada , may even be lucky enough to retain some semblance of facial hair , similar to Desmond in the " Fallout 3 " add - on " Point Lookout " , with hair on both his head and face . They normally have a low , gravely and rather raspy voice , most likely due to damage to their vocal chords from a combination of radiation and necrosis . Jason Bright , an intelligent glowing one , from " Fallout : New Vegas " has a normal voice , although it has an odd echoing quality to it . If Megaton is destroyed in " Fallout 3 " , Moira Brown has a similar , but notably different voice effect . Regular ghouls walk normally , unlike ferals , which hunch over . The majority of them are not hostile and will not attack without provocation . Ghouls often refer to humans as " smoothskins . " These ghouls also find terms such as " shuffler " and " zombie " to be offensive . Hostile intelligent ghouls , violent even without provocation , do exist , however ; most noteworthy are the Chinese remnant , Chinese spies , soldiers , and special forces units trapped in the United States following the Great War . Remnant forces are wholly unaware ( or perhaps in denial ) of the worldwide nuclear destruction that has occurred and believe that they are still in a state of war , continuing to follow old objectives sent to them pre - war by the People ' s Liberation Army . Remnant forces have retained much of their intelligence and training , and attack all those they encounter without hesitation . Remnants only appear in " Fallout 3 " . Marked men . Skinned alive by the winds of the Divide ( via a failed Big MT experiment ) , and turned into ghouls by the radiation of the exploded underground missiles , marked men suffer from a unique form of ghoulification only seen in the Divide . The injuries they suffer from would mean the death of an ordinary ghoul , and the radiation of the Divide is believed to be the only thing keeping them alive . Despite still being cognitive enough to carry weapons and utilize advanced tactics such as constructing outposts and utilizing guard towers , they are still immediately hostile to any and all outsiders that ventures into the Divide . Born ghoul . Through cruel experimentation on humans by Dr . Sebastian at the Reservation , born ghoul s were created . They are ghouls who were not mutated humans , but who were actually born into ghoul - dom . There are only three known born ghouls . Appearances . Ghouls appear in every " Fallout " game to date .