The game accommodates two to four players, each playing one of seven possible roles: dispatcher, medic, scientist, researcher, operations expert, contingency planner, or quarantine specialist.

The players are also helped by the Event cards, which allow for similar one-time actions, such as direct removal of a few disease cubes or immediate construction of a research station.

The challenges include a fifth disease, Mutation, which must be cured or not present at the game board when the players score for victory.

Another challenge is the Virulent Strain, which makes one disease particularly deadly, replacing standard Epidemic cards with new ones.

A second expansion was released in the summer of 2013,[12] with a new game board that allows players to research disease cures in a laboratory.

[23] A second edition of Pandemic was released in 2013, with new artwork and two new characters: the Contingency Planner and the Quarantine Specialist.

All components contained in a metal box made to represent a first aid kit from the early 20th century.

This edition is a remake of the original game, but includes additional room within the box to hold expansions.

[29] An expansion to the game, Pandemic: The Cure - Experimental Meds, was released in November 2016, adding a fifth disease and a new hot zone mechanism.

[30] Pandemic: Reign of Cthulhu, designed by Matt Leacock and Chuck Yager, was released at GenCon 2016.

This led to some brand confusion, and the idea was eventually abandoned in favour of the “Pandemic System” label.

[45] Players roll dice and allocate the results to various actions, including producing resources, piloting the plane towards affected cities, recycling the waste created by producing resources, and dropping off finished supplies in the cities that need them.

[45] Players win by delivering relief to all cities and lose by running out of time or creating too much waste.

[45] The Hot Zone games are streamlined quicker variants of Pandemic featuring smaller maps of one section of the world, miniature cards, and just three diseases.

The New Scientist listed Pandemic as one of "9 of the best board games to play for fans of science and tech".

[52] Pandemic has been described as a "modern classic" with a "simple and compelling" design by Ars Technica.

[53] The Guardian also praised the theme, stating that "Sam Illingworth has used [Pandemic: Iberia] to help teach schoolchildren about the different causes of disease and the importance of water purification", and suggests that it has “a brilliant central message that it’s not just one scientist in a lab, fighting disease, it’s lots of people working together”.

[63] Ars Technica also praised the game's legacy format as 'immeasurably satisfying and stating that the "clever innovations boost almost every aspect of play".

[68] In 2013, an iOS version entitled Pandemic: The Board Game was released by Asmodee Digital.

He also designed the Thunderbirds board game in 2015, celebrating the 50th anniversary of the 1960s television series and published by Modiphius Entertainment.

He is currently working with Matteo Menapace on Daybreak, a tabletop game about the global response to climate change, to be published by CMYK.