The Last of Us episode 5: The biggest changes between the HBO show and the PlayStation game

The Last of Us



(Image credit: HBO)

The Last of Us episode 5 is undoubtedly the most explosive installment of the HBO adaptation yet – and just like episode 3 did, it takes some creative liberties as it adapts the middle section of the beloved PlayStation game.

In last week’s installment, we saw Ellie (Bella Ramsey) and Joel (Pedro Pascal) hole up in Kansas City, a location not seen in the game – though much of the events that play out match what goes down in Pittsburgh in the source material. At the very end of ‘Please Hold My Hand’, the pair are crept up on in the night by a young man and a kid, and the cliffhanger leads directly into episode 5.

While we do see our pair team up with that pair and descend underground to escape the hunters and bandits who have ravaged the metropolis, just like in the game, there are a few changes made to the story, like Sam’s age and the mysterious Kathleen’s inclusion. We explore all the major differences below.

Unsurprisingly, this article contains spoilers for The Last of Us episode 5, so proceed with caution if you’ve yet to tune in and don’t want to know exactly what happens. All up to date? Well, let’s get into it…

Sam is deaf (and only eight years old)

The Last of Us

(Image credit: HBO)

In The Last of Us TV show, Sam is played by deaf actor Keivonn Woodard and the character, unlike in the game, is actually hard-of-hearing himself, too. He’s also confirmed to be eight years old, whereas the game version of Sam is 13, closer to Ellie’s age.

“One of the changes that we made for the TV show is we made Sam deaf… That kind of constraint led to really interesting storytelling decisions that, in some ways, make that sequence more impactful than it is in the game,” co-creator Neil Druckmann previously told The Washington Post (opens in new tab).

Given that the show can pivot away from Joel and Ellie any time it wants, we spend a lot more time with Sam and his older brother Henry (Lamar Johnson) here, as they seek shelter in an abandoned building and the character they’ve hunkered down with, the doctor from episode 4, ventures out each day to find food. One day, their ally doesn’t come back, which causes Henry to fear the worst and make the weighty decision that the twosome will have to move on from their hideout. Due to their more fleshed out characters, it’s extra emotionally gutting when their fates are revealed.

Henry’s backstory 

The Last of Us

(Image credit: HBO)

Melanie Lynskey’s Kathleen is a completely original character when it comes to the TV show, so any subplot she’s directly involved in is new – and that includes Henry’s backstory. 

After he convinces Joel and Ellie that the safest way out of Kansas City is through its “formerly” infected-infested sewers, Henry admits to Joel that he sold Kathleen’s brother Michael out to FEDRA in exchange for life-saving medicine for Sam and that’s why she’s hunting him.

“I wasn’t exactly telling you the truth before, about me not killing someone,” he says during a brief rest-up. “There was a man, a great man. He was never afraid, never selfish, and he was always forgiving. You ever met someone like that? The kind of man you’d follow anywhere? I wanted to, I would’ve, but Sam got sick. Leukemia. 

“Anyway, there was one drug that worked and well, big shock, there wasn’t much left of it and it belonged to FEDRA. If I wanted some, it was gonna take something big, so I gave them something big: that one great man, the leader of the resistance movement in Kansas City.”

Kathleen’s reign of terror (and her gruesome demise)

The Last of Us episode 5

(Image credit: HBO)

Like we’ve said, everything involving Kathleen is new, and while those who have played the game are all too aware that the cities were often crawling with crooks, her reign of terror over Kansas City is a big departure from the source material.

In response to the riots in the streets, the ruthless resistance leader rounds up several survivors and berates them for “betraying their neighbors to FEDRA”. After taunting them for a while, she orders them to give up Henry. When no one complies, she tells her right-hand man Perry and his troops to “kill them”. 

“He’s with Adelstein,” one man whimpers in response. “Adelstein was a collaborator? Well, he was a lot more discreet than you fucking idiots,” Kathleen smirks back before turning to Perry and suggesting they “burn the bodies” as it’s “faster”. 

The meanie gets her somewhat abrupt comeuppance, though, later on in the episode, when she’s attacked by a nasty clicker and seemingly ripped apart. Bye, Kathleen.

The action sequence plays out a little differently

A Bloater in The Last of Us episode 5

(Image credit: HBO)

When Joel, Ellie, Henry, and Sam make it out of the sewers, they’re forced to travel through the suburbs in both the game and the show. For the most part, these sections are pretty similar but in true TV fashion, the small screen adaptation is a bit more dramatic.

Before everything kicks off, though, Show Joel sneaks into a building and quickly disarms a sniper; something that proves much of a challenge in the game, as he has to fight off other hunters to get to him. Once he comes face-to-face with the shooter, Game Joel and the sniper fight, which doesn’t happen in the series. Instead, Joel offers the man a chance to put down his gun and walk away. When the man jerks his pistol, Joel kills him. A manned turret is also present in the games. In the show, it’s a convoy of Kathleen’s men.

Later, when the infected break free from their underground “prison” and start attacking Joel, Ellie, Henry, Sam, and the last remaining hunters, the foursome flee to a nearby radio tower in the game. In the show, they managed to make it to a rundown motel. It’s also worth pointing out that Joel and Ellie meet a bloater for the first time much earlier on their journey in Bill’s town.

Ellie tries to save Sam with her blood

The Last of Us

(Image credit: HBO)

In the game, Sam successfully hides the fact that he’s been scratched by a clicker from Henry, Ellie, and Joel until it’s too late, and they awaken the morning after the escape to find him already turned and snarling. In the show, Sam reveals his bite to Ellie the night before and the optimistic teen cuts herself and rubs some of her blood into his wound, assuring him that she’s immune and it will probably help.

The sequence not only highlights the pair’s innocence and makes it all the more devastating when Ellie’s efforts prove fruitless, it showcases Ellie’s hope and faith in herself being a cure. Given how faithful the show has been so far, it seems safe to assume that the first season will end in the same way, and it’s going to be all the more heartbreaking now.


The Last of Us continues on Friday, February 10 on HBO and HBO Max in the US, and Sky Atlantic and NOW the following day in the UK. Make sure you never miss an episode by checking out our The Last of Us release schedule and our breakdown of how many episodes are in The Last of Us.

For more from the series, check out our guide to the major Last of Us episode 4 changes from the games and a terrifying look at the Cordyceps fungus

Get the best gaming deals, reviews, product advice, competitions, unmissable gaming news and more!

I am an Entertainment Writer here at GamesRadar+, covering all things TV and film across our Total Film and SFX sections. Elsewhere, my words have been published by the likes of Digital Spy, SciFiNow, PinkNews, FANDOM, Radio Times, and Total Film magazine.

Read More
Elida Pingree

Latest

One of the Best Movies of 2025 is Finally Coming to Prime Video

There were a lot of great movies in 2025. Movies like Sinners, Marty Supreme, Weapons, and even Superman not only captured moviegoers attention, but delivered solid entertainment and great stories as well. They’re films that fans keep returning to well after their theatrical runs have ended and now, one of the best of the year

Oregon Sues Oklahoma Transfer Over Alleged Unpaid $10K NIL Contract Buyout

The University of Oregon says one of its former football players owes it $10,000, and the school is willing to go to court to get it. The school filed a lawsuit in Lane County Circuit Court last week against Dakoda Fields, a defensive back who spent two years with the Ducks before transferring to Oklahoma

Breaking Down Ole Miss’ Strengths, Weaknesses and One Thing It Needs to Beat LSU

The hottest location in college football this year brings LSU and Ole Miss together for a matchup that should be as close are expected. Both teams are rebuilt through the transfer portal and new coaching staffs, and this Sept. 19 matchup will be the first big test for either squad. So what gives Ole Miss

What are Indiana Football’s Biggest Trap Games of 2026?

Where will Indiana be ranked to start the 2026 college football season? While debate will rage regardless of the number next to Indiana's name to start the year, the Hoosiers will likely be favored in no fewer than 11 of their 12 regular season contests. That doesn't mean there won't be challenges along the way

Newsletter

Don't miss

One of the Best Movies of 2025 is Finally Coming to Prime Video

There were a lot of great movies in 2025. Movies like Sinners, Marty Supreme, Weapons, and even Superman not only captured moviegoers attention, but delivered solid entertainment and great stories as well. They’re films that fans keep returning to well after their theatrical runs have ended and now, one of the best of the year

Oregon Sues Oklahoma Transfer Over Alleged Unpaid $10K NIL Contract Buyout

The University of Oregon says one of its former football players owes it $10,000, and the school is willing to go to court to get it. The school filed a lawsuit in Lane County Circuit Court last week against Dakoda Fields, a defensive back who spent two years with the Ducks before transferring to Oklahoma

Breaking Down Ole Miss’ Strengths, Weaknesses and One Thing It Needs to Beat LSU

The hottest location in college football this year brings LSU and Ole Miss together for a matchup that should be as close are expected. Both teams are rebuilt through the transfer portal and new coaching staffs, and this Sept. 19 matchup will be the first big test for either squad. So what gives Ole Miss

What are Indiana Football’s Biggest Trap Games of 2026?

Where will Indiana be ranked to start the 2026 college football season? While debate will rage regardless of the number next to Indiana's name to start the year, the Hoosiers will likely be favored in no fewer than 11 of their 12 regular season contests. That doesn't mean there won't be challenges along the way

Green steel startup Boston Metal is doubling down on critical metals

The startup Boston Metal has raised a $75 million funding round to produce critical metals, MIT Technology Review can exclusively report.   The company has been known largely for its efforts to clean up steel production, an industry that's responsible for about 8% of global greenhouse emissions today. With the additional money, the new focus could

Tesla’s Business Has Become Much More Diversified in Just the Past Five Years. Does That Make Its Stock a Better Buy Today?

Key Points Tesla's energy generation and storage segment generated 27% revenue growth last year. The company's non-automotive segments were able to help offset a double-digit decline in auto revenue in 2025. These 10 stocks could mint the next wave of millionaires › Tesla (NASDAQ: TSLA) is known for its electric vehicles (EVs), and while they

WD sees sustainability as key business driver in an ‘AI economy’

Hard drive company WD promoted long-term operations and sustainability executive Jackie Jung to become its first chief sustainability officer in February, as it steps up sales to companies building AI data centers. Her vision: Turn sustainability into a “brand” for WD, a strategy that reduces risk for the $6 billion company (formerly known as Western

5 Business Ideas Worth Starting in 2026

If there is one thing Nigerians understand well, it is how to spot opportunity inside hardship. In 2026, that mindset will matter more than ever. The economy is tough, competition is rising, and many people are looking for smarter ways to earn, build, and survive. But even in a difficult environment, some businesses still stand