Install BepInEx 5 (x64)
BepInEx is the loader that injects mods into Unity games. Installing it is just three moves: download the matching build, unzip it into your game folder, and launch the game once so it writes out its folder structure. Do this before adding the Overhaul.
Two Point Hospital is a 64-bit Unity Mono game (you can confirm this: its data
folder contains a Managed directory full of .dll files). That means you
want BepInEx 5, Windows, x64 — the asset named like
BepInEx_win_x64_5.4.23.5.zip. Avoid the x86 build and the IL2CPP / Bleeding-Edge
6.x builds; they won't load this game's mods correctly.
01 Download the right build
Always pull BepInEx from the official GitHub releases page so you get a clean, current copy.
BepInEx 5.4 is the final major v5 line; later 5.4.x releases are just fixes, so grabbing the
newest win_x64 5.4 asset is always safe.
Open the official releases page
githubHead to the BepInEx releases page and find the latest stable 5.4.x release
(do not pick a -be Bleeding-Edge build).
Grab the Windows x64 asset
Under that release's Assets, download the Windows 64-bit zip. At the time of writing that's:
BepInEx_win_x64_5.4.23.5.zipIf the patch number differs, that's fine — any BepInEx_win_x64_5.4.x file is correct.
02 Extract into the game folder
This is the step people most often get wrong, so go slowly: the contents of the zip go directly into the game folder — not the zip's own subfolder, and not a new "BepInEx" folder you make yourself.
Open your game's install folder
From Steam: right-click Two Point Hospital → Manage → Browse local files.
You should see TPH.exe in there. That's your target folder.
Unzip the BepInEx contents here
drag & dropOpen the downloaded zip, select everything inside it, and copy those items into the
game folder next to TPH.exe. From the zip you're moving these:
After this, your game folder contains a BepInEx folder plus
winhttp.dll and doorstop_config.ini sitting right beside the
executable.
If you end up with …\Two Point Hospital\BepInEx_win_x64_5.4.x\BepInEx\… — a folder
named after the zip — you've nested it one level too deep and BepInEx won't load. The
winhttp.dll must sit in the same folder as
TPH.exe. Move things up one level if needed.
03 Launch once to build folders
BepInEx finishes its own setup the first time the game runs. This pass generates the
config, plugins, cache folders and a log file — the folders the
Overhaul needs in the next step.
Start the game normally
Launch Two Point Hospital from Steam as usual and let it reach the main menu. The first launch may sit on a black window a little longer than normal while BepInEx initialises — that's expected.
Quit back to desktop
Once you've seen the main menu, fully exit the game. BepInEx has now written out its folders. You don't need to load a save for this — reaching the menu is enough.
04 What you should see
Open the BepInEx folder inside your game directory. After that first launch it should now
contain the full set of subfolders below, including the all-important plugins and
config folders and a LogOutput.log file:
If you see cache, config, core, patchers,
plugins and LogOutput.log, BepInEx is working. The
Verify your install page shows this exact folder in a real screenshot you
can compare against.
Want a quick sanity check on the log itself? Open LogOutput.log in any text editor — near
the top you'll see BepInEx print its version and Chainloader started. If the file exists and
has content, the loader is live.
05 Common mistakes
If the folders above didn't appear, it's almost always one of these:
- Wrong architecture. Using the x86 zip on this 64-bit game. Re-download the
win_x64build. - Nested too deep.
winhttp.dllended up inside an extra folder instead of besideTPH.exe. Move the contents up one level. - Never launched. The
config/pluginsfolders only appear after the first run. Start the game once, reach the menu, quit. - Bleeding-Edge build. A
6.0.0-bebuild instead of stable 5.4.x. Grab a non--be5.4 release.
The Troubleshooting page expands on each of these with fixes.