- The Depressed Spleen is unbelievably pessimistic and cynical. Here he is, spleen the size of a spleen...
- Speaking of the Spleen, when the Commentors tell Fern to talk to him again she is shown with the Excalibur face.
- Zoe has a photo of Baikinman on her desk. Not bad for a show known only in Asia.
- Phage doesn't want to be disturbed for nothing less than a CK-class reconstructing scenario.
- One of the creatures "outside" the Hospital is Uboa.
- The Ramblin' Evil Colorectal Polyp is practically a walking Shout-Out to the MOTHER series and the initial battle with him is one to the Pokémon series.
- One of the multitude of worms seen on the journey is the Earthworm.
- Phage's full title is "Dr. H. M. Phage, T. E." These honorifics, which stand for Highly Magnified and Thoroughly Educated, are a reference to H. M. Woggle-Bug, T. E., a character from the Oz books.
- The morgue is set up like the maze from Pac-Man, and is run by a gravestone-like being that looks like one of the ghosts. It's haunted by a being called the "Revourer", which is yellow.
- The Extragovernmental Bureau of Socio-Hazardous Aberrations is a page-long SCP Foundation Shout-Out.
- This somewhat familiar offer of assistance, and the reaction:Cyst Dweller: It can be hazardous to venture unassisted. Perhaps I can offer you an implement to mitigate the substantial risk factor?Chest Worm: CHARLIE I SWEAR TO NURGLE...
- In fact, all rotifers worship Nurgle.
- Celia's description of the "community" living to the east of the Horrible Ghastly Death Woods:
- The April Fools' Day update has Doctor Phage singing the doom song.
- The Ghastly Physician Worm starts its fight by proclaiming, "goOod NEWWWwws eVeRyONnnne!!!"
- The fight against Balphin is one huge reference to Final Fantasy. The music that plays during the battle is even The Final Battle from Final Fantasy IV. Word of God even states that Balphin's One-Winged Angel design is based off of angelic final bosses like Sephiroth.
- When Fern finally wakes up in the Morgue, the narration is one to UndertaleAfter all you've been through, you feel like the Hospital should be a piece of cake from here on out, and knowing there are creatures you can actually come to trust in these backwards little universes, or whatever they are, fills you with determination.
- A monster in the distance resembling the Fault Victim.
- A poster depicting Bill Cipher, which has reappeared at least twice now.
- Crash describes his boredom in a manner very similar to how another insane AI describes his hatred:
- One page in Jay's journal mentions encountering a garbage bag with feet, and that it's a sign that the Hospital is "running out of ideas." Bogleech's favorite Pokémon also happens to be a garbage bag with feet that people commonly cite as evidence its creators are running out of ideas.
- Another page in Jay's journal mentions carnivorous pianos.
- Some of the descriptions of Crashslob's attacks are references to Windows 98 screensavers.
- The page titles in the archives are full of these. A few examples:
- On the intermission page explaining the mechanics of Slob formation, Bog declares "You can even make slobs out of other fictional characters!" and then, as seen in the page image, gives us... SpongeSlob◊ SquarePants!
- When Lacey's Macrobobby asks Fern to bring a monster that he can frame for Lacey's cat allergy, one of the possibilities he suggests is a Pattern Screamer.
- The Jagged Stain bears more than a passing resemblance to a Floyag.
Shout Out / Awful Hospital