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Dr. Chang felt that, despite all the bad she had done by making GLOW, Pestilence was her ultimate creation. Initially, Pestilence fought very slowly by spilling acidic GLOW in the nearby area, throwing one of its many limbs and firing out explosive GLOW bubbles at Kyle. Kyle defeated Pestilence a first time but Pestilence changed, blowing off its shell and degrading into a slimmer, more humanlike form. In this form, Pestilence used fighting combos, energy blasts and acquiring church pews as weapons to defeat Kyle. Kyle finally defeats the monster and it melts into nothing. Dr. Chang was very fond of Pestilence, to the point of calling it "sweetie" and babying the monstrosity. It, in turn, protected her and attacked Kyle at her command. Unlike the other Horsemen, Pestilence doesn't seem to be anyone the player has met previously.