Against All Odds

The Hardcore run with all negative perks enabled at once. The one thing to get right: you select perks only when you start a Hardcore game and you cannot add them later, so tick every negative perk on the character-setup screen or the run can't earn this. Play it out and you'll pop Hardcore Henry II at the same finish line, so always do the full-perk version and get both in one go. The perks make travel, food and fatigue more of a chore rather than the combat harder - budget saves and rest, and it's more tedious than difficult.