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.

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 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 Sunday, February 19 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

Amy West

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.