Is Pixel Hospital censored by Apple?

Why it is unavailable

Five things can put an app out of one App Store. Each is weighed below against what can be seen from outside — open a card for the reasoning.

• A government or a court demanded itLikely

  and Apple complied. Apple publishes a count of these per country each year and never says which apps they were. Apple's 2025 App Store Transparency Report

  • 58% of Games apps are unavailable in mainland China — 14,561 of 25,014 — against 28% of everything we test there.
  • 24 other apps left mainland China the same day, Mar 29, 2021.
  • Apple reports 1,213 government-ordered removals in Russia for 2025, naming none of them.
• Apple applied a rule, unaskedLikely

  either its own review guidelines, or its own reading of a local law, with nobody having demanded anything. This is the largest category in Apple's own removal figures by a wide margin, and it covers distribution permits as well as content — Apple kept a free Bible app out of mainland China in 2021 for want of one. Apple's 2025 App Store Transparency Report

  • 58% of Games apps are unavailable in mainland China — 14,561 of 25,014 — against 28% of everything we test there.
  • 24 other apps left mainland China the same day, Mar 29, 2021.
• The developer withheld itUnlikely

  freely, or under legal advice of their own, or because Apple's guidelines require that kind of app to be limited to certain countries. Switching a country off is easy for a developer to do in Apple's own tools: it needs no new version of the app, and it leaves no public trace other than the app being unavailable.

  • 58% of Games apps are unavailable in mainland China — 14,561 of 25,014 — against 28% of everything we test there.
  • 24 other apps left mainland China the same day, Mar 29, 2021.
• Something brokeUnlikely

  a rejected update, a lapsed certificate, a payment or licensing problem, a mistake nobody has got round to noticing.

  • 58% of Games apps are unavailable in mainland China — 14,561 of 25,014 — against 28% of everything we test there.
  • 24 other apps left mainland China the same day, Mar 29, 2021.
  • Gone for 5 years.
• A local rule about paying for itRuled out

  gambling licences, financial rules, tax — the kind of law that governs a transaction. Apple can obey every one of them by refusing the payment, which is why this is the only restriction we would accept and the only one that cannot touch a free app.

  • It is free, so Apple sells nothing here.

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