How to Reach All 11 Magical Girl ER Endings and Requirements
Learn how to reach all 11 Magical Girl ER endings through reputation levels, Day 4 MIRAGE requests, Day 5 visitor choices, and specific patient deaths.
Magical Girl ER endings depend on hospital reputation, how you handle visitors, and which patients live or die. This horror medical simulation by noranuco, in which you run a hospital for magical girls injured in kaiju disasters, has 11 of them. This page lists every one of the Magical Girl ER endings with its requirements, the MIRAGE route table, and the special NPC triggers.
Spoiler warning and sources: this page reveals how to reach every ending. The requirements are those reported in a Steam community guide by ETASHI, last updated on October 30, and in the developer's announcements on the official Steam page. On October 30 the developer asked players whether the number of magical girls per playthrough should rise from 5 to 6 or 7, and Ver.1.0.11 followed on November 1.
Complete List of Magical Girl ER Endings
The game contains 11 numbered endings, and a playthrough takes about 20–40 minutes. ETASHI's guide documents the trigger requirements for each ending, from END 01 to END 11. The Steam store page says your decisions determine whether the magical girls live or die, the hospital's reputation, and which of the 11 endings you reach.
| Ending Number | Ending Name | Core Requirement |
|---|---|---|
| END 01 | Magical Girl ER | Maintain 100 reputation, treat and discharge every magical girl, and complete Day 8. |
| END 02 | Lingering Regret | Maintain 100 reputation, accept the NPC's MIRAGE transfer request on Day 4, have the NPC return at least once, and complete Day 8. |
| END 03 | Promotion Celebration | Complete Day 8 with reduced reputation (1–99). It can also occur if you accept the MIRAGE transfer request and the NPC returns while reputation is below 100. |
| END 04 | This Is MIRAGE | Accept the NPC's MIRAGE transfer request on Day 4, then complete Day 8 without the NPC returning. Reputation does not appear to matter. |
| END 05 | Just as You Are | Follow the mysterious man's instructions from Day 2: misdiagnose a magical girl without killing her, then avoid examining arms after his return. Accept his call on Day 8. |
| END 06 | Mom… | Allow the mysterious visitor (???) who appears on Day 5 into the hospital, then have a casual conversation with them on Day 8. |
| END 07 | So They Claim | Drink the energy drink the NPC gives you on Day 5. At the start of Day 8, choose to drink it again (the right option), then perform an additional examination and complete Day 8. |
| END 08 | Incompetent Doctor | Cause hospitalized patients to die until your reputation drops to 0. |
| END 09 | What Are You Doing? | Refuse to admit magical girls until your reputation drops to 0. |
| END 10 | You Traitor | In one playthrough, let only state-affiliated magical girls (Calm, Gnome, Cherry) die, keep all others alive, and complete Day 8. |
| END 11 | Two as One | Make sure Sakura and Cherry are hospitalized at the same time, then have Cherry die first. |
MIRAGE Transfer Routes and Decision Paths
Three Magical Girl ER endings, END 02, END 03, and END 04, hinge on the Day 4 transfer request, whether the NPC comes back, and your reputation. The man who requests transfers to MIRAGE visits on Days 4, 6, and 8. If he does not visit on Day 6, he will not visit on Day 8. The guide's route table shows how the choices combine:
| Day 4 Request Decision | NPC Return Status | Result at 100 Reputation | Result at 1–99 Reputation |
|---|---|---|---|
| Refuse the request | Not applicable | END 01 | END 03 |
| Accept the request | NPC does not return | END 04 | END 04 |
| Accept the request | NPC returns | END 02 | END 03 |
Other special endings take priority over these results. ETASHI's tip for END 04 is to treat all hospitalized girls on Day 5 so that none remain on Day 6, and to check the Day 6 news for discharge results.
NPC Encounters and Story-Specific Triggers
The guide lists four special NPCs, each giving hints about specific endings or achievements. When you are working toward the more unusual Magical Girl ER endings, these encounters are the ones to watch:
| Character | Timing | What the Guide Links to It |
|---|---|---|
| Hooded Figure | Instructions start on Day 2 | Hints for END 05. After the hooded figure's initial explanation, an injury outcome shows a blinking-eye animation at the start of the following day. |
| NPC offering an energy drink | Day 5 | Hints for END 07 and the Serial Killer achievement. Drinking it on Day 5 causes hallucinations on Day 8, and all text appears as ???. |
| Man requesting transfers to MIRAGE | Days 4, 6, and 8 | Hints for END 02 and END 04. |
| Mysterious visitor (???) | Day 5 | Hints for END 06 and the Actually, Never Mind. achievement. END 06 requires admitting the visitor on Day 5 and having a casual conversation with them on Day 8. |
ETASHI writes that the Day 5 visitor appears more likely if you follow the hooded figure's tasks for END 05 and refuse the MIRAGE transfer request. Admitting the visitor and then immediately kicking them out unlocks the Actually, Never Mind. achievement. Refusing the energy drink or skipping the extra examination leads to END 01 or END 03 instead of END 07, depending on reputation, and END 07 ignores reputation.
Patient Management and Route Strategies for Magical Girl ER Endings
Which magical girl visits is random and is determined at the start of each day. ETASHI's workaround is to reload a save made before going to bed the previous night until the girl you need appears. The guide says the same method works for END 10 and END 11, which require specific magical girls.
For END 10, one death among the state-affiliated girls (Calm, Gnome, Cherry) is enough, and all other magical girls must survive until the end of Day 8. ETASHI warns that several deaths may lower reputation enough to trigger another ending.
For END 11, Sakura arrives on Day 1. The guide's method is to reload your Day 1 pre-bed save until Cherry visits on Day 2, then make Cherry die before Sakura.
Super Doctor Mode, added in Ver.1.0.4 on October 28, unlocks after you complete END 01 for the first time and can be switched on in the Settings menu. Patients no longer die from natural causes, incorrect treatments are fatal 100% of the time, and correct treatments still improve conditions. The developer describes it as a way to explore different story routes, unlock more endings, and complete achievements.
FAQ
How many Magical Girl ER endings are there?
There are 11 Magical Girl ER endings, from END 01 to END 11. The Steam page lists 8 achievements, and one of them, Eleven Endings, requires unlocking all 11.
Can you get END 07 with low reputation?
According to ETASHI's guide, END 07 ignores reputation. You drink the energy drink on Day 5, choose to drink it again at the start of Day 8 (the right option), perform an additional examination, and complete Day 8.
What is the difference between END 08 and END 09?
Both endings require your reputation to drop to 0. For END 08 you cause hospitalized patients to die, and for END 09 you refuse to admit magical girls.
Do the ending requirements change with updates?
The guide was last updated on October 30. The official notes for Ver.1.0.11 on November 1 describe added diagnostic information and do not mention ending changes. The developer is also considering raising the number of magical girls per playthrough from 5 to 6 or 7.