Desperation is the second chapter of the first act of Gears of War 2. It takes place in a hospital, after the player has chosen whether to train Carmine or not. Marcus and Dom have to defend the hospital from Locust attacks. They meet up with Tai early on and accompany him onwards. The reason for the Locust attack is debated during the initial parts of the chapter. Dom believes it has to do with courage, while Marcus thinks it's an act of desperation. They fight through the hospital while heavy fighting occurs on the outside. A King Raven is shot down and crashes into the hospital, nearly crushing Delta Squad. Delta eventually helps secure the hospital and push the Locust back. The chapter is the first "real" fighting chapter in the game. The level does, however, support a lot of ammo caches, as well as most of the Locust retreating when you encounter them, making this a relatively easy level to complete.




Note: This walkthrough is made for Insane difficulty, but will also work on lower difficulties.

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Shoot the canisters.

Follow Tai through the doors labeled. Eventually, there will be a courtyard where some explosive canisters have been placed as a part of the ambush. Take cover and wait for the Locust to blast the doors and rush in. Be patient, and do not shoot at them. When Marcus yells "Shoot the tanks!", shoot them. This is the easiest way to dispose of all Locust in this part.

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Grenades are effective on all difficulties.

Follow Tai and Dom as they talk about Rust Lung. Pick up some ammo on the way, with some grenades to the right and behind the ammo box, at the boarded-up door. You will come to an open area with a large statue in the middle. Here you will get a checkpoint. Some Locust will be retreating beneath you. Fire at them as best you can, but do not take any unnecessary chances (on Insane, only a few shots can kill you). When the Locust beneath you have been killed or have run away, move to the left. When you start moving on the path at the left, two Locust will spawn. An easy way to dispose of them is by lobbing in a grenade. Just make sure you do it when they are reloading, or busy focusing on Tai or Dom. When they are dead, pick up their Hammerbursts and the ammo cahche.

Directly in front of the left path there will be an open door with a hallway behind it. Outside mortars can be seen. Take cover and wait for a moment. Some Locust will enter, but will quickly killed by a King Raven.

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Watch out for the drone with a Boltok. On Insane, two shots will kill you.

Pick up dead Locust's ammo and move on. You will enter a room with surgery tables. Run to the nearest one and take cover by flipping it over. Use your Hammerburst to dispatch the Locust in the room (at close range, headshots can easily be made). Before moving on to the next room, make sure you have killed the fast Locust with a Boltok Pistol. Feel free to visit the X-ray-like room at the left of when you entered. There will be grenades there. Police the dead Locust's ammo, and especially the Boltok. When you exit the room, there will be some grenades to your left, it would be smart to pick them up too.

Continue down the stairs and you will come to a lobby. Dom and Tai will be fighting on the other side of the room, meaning that the Locust in the room will be subjected to crossfire.
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The Locust in this room will be under heavy crossfire. Use it to your advantage.

This area should not present any problems, but for those who have little time, putting the most pressure on the Locust is key. To do this, flip the table at the left entry, this will shorten the range between you and the Locust, making it easier to kill them. Gather all the ammo you can find (there are some grenades in the area) and meet up with Dom and Tai.

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You will now enter a large outdoor area, with Locust fighting COG. Take cover behind the wall at you left, and sight out the largest group of Locust. They will probably be behind the large COG statue in the middle. Lob a grenade in there when they are not shooting at you and you will dispose of many. Dom and Tai will be very active, most likely killing those who survived your grenade. When all initial Locust are dead, move quickly (run) to the other side (directly behind the COG statue). A Reaver will drop in, so move fast. Take cover behind the center pillar, and wait for the Reaver to leave. When it has left, collect some ammo (there are a few caches scattered around). When you are ready to move on, open the door leading onwards (where Tai and Dom are waiting).

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In the beginning of the next area, you will find a doorway next to a counter leading to a surgery room. Stop by this room and pick up some grenades. Continue out where Dom and Tai are fighting. Use your Hammerburst or a grenade when the Locust are shooting at Dom or Tai, or when they are reloading. They might retreat to the back of the room. There is a gas container there that will blow up if shot at it.

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A King Raven gunship.

Moving on, you will come to a mess hall. The best course of action is to flank the Locust. This can be done from the left or right. Use any weapon to dispose of them. Moving on, a King Raven gunship will crash though the ceiling, and Locust will immediately swarm your position. Make sure you head left or right as soon as the Raven crashes, or else you will be subjected to heavy fire from above. If you head left, there will be a few operating tables that you can take cover behind. Throw a grenade or use your weapons to dispose of the Locust that are there. When all are dead, retrieve their ammo and the grenades at the right staircase (if you need them).

The next area is a tough one. While JACK fixes the door, take cover in the counter at the middle of the room. Locust will then attack. They will first attack from the right-hand side, from the door furthest to the back. They can easily be killed by lobbing a grenade or two in the doorway as they enter. Finish off eventual stragglers without leaving the reception/counter at the center of the room. When they are all dead, the door at the middle left will immediately open, and Locust come out. Hurry and take cover, then use your remaining grenades (or weapons) to kill the Locust. When all Locust are dead, gather some ammo, and meet up with Carmine.

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This is the final area. Feel free to use all your ammo, since it will not follow you on the next mission.

The next area is also quite difficult. Locust have surrounded the entrance to the hospital, and are raining down hell on the soldiers guarding it. A good tip is to head left, and flank the Locust from there. Using the Hammerburst is recommended due to its rapid fire and zoom function. Eventually, a King Raven gunship will arrive and spray bullets on the Locust who are at the far street. When it leaves, head over to the shop at the left, and get in. This will give you a drop on the Locust. Once in the shop, take cover behind the counter. Using your Hammerburst or Boltok Pistol, you should be capable of killing all the remaining Locust. The final area will be right after the one mentioned above. Take cover behind the cars, and use a Hammerburst, or other weapon to dispose of the Locust.


  • Doctor’s Journal: After the fuel tank ambush, go up the left hallway. There will be an open door, with a patient inside it. The collectible is here.
  • Jacinto Medical Center File: Center of the office area. In the area, just after you kill the Drone with a Boltok Pistol.
  • COG Letterhead: Outside the cafeteria, just before the King Raven crashes. There will be a kitchen on the left side of the cafeteria. Just prior to this kitchen, there will be a room with a door blown off. The collectible is in here.
  • COG Proclamation: When you enter the hospital lobby, where JACK has to open the main door. Stay upstairs and check the ground on the right side of the balcony
  • COG Tags: Just outside the hospital, after JACK has opened the door. Check the pillar to your right.


  • Upon completing this chapter, you will unlock the "It's a Trap!" achievement.
Gears of War 2 Walkthrough
Gears of War 2 Act 1: Tip of the Spear · Act 2: Denizens · Act 3: Gathering Storm · Act 4: Hive · Act 5: Aftermath
Act 1 Welcome to Delta · Desperation · Rolling Thunder · The Big Push · Roadblocks · Digging In
Act 2 Scattered · Indigenous Creatures · Disturbing Revelations · Sinking Feeling · Captivity · Intestinal Fortitude
Act 3 Dirty Little Secret · Origins · Rude Awakening · Ascension · Displacement · Brackish Waters
Act 4 Priorities · Answers · (Dark Corners Bonus Chapter: Road to Ruin) · Hornets' Nest · No Turning Back · The Best-Laid Plans · Royal Inquisition
Act 5 Escape · Desperate Stand · Free Parking · Tenuous Footing · Closure

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