The Puker's mutations are extensive and grotesque. The host's original legs have entwined, and a clump of intestines, nerves and muscles have grown down to form an additional leg. Its fingers have merged into three long claws on each hand. Its eyes are missing, and its jaw has fused with its neck, freezing its face in a hollow, blank stare. On its torso, the lungs are clearly visible and are yellow in color, storing a limited quantity of bile to be ejected from the mouth. What remains of the flesh on the Puker's body hangs loosely around its frame. The creature's constant, messy expulsion of caustic fluids has melted away its facial features and the skin and muscle tissue of its torso, revealing its organs.
The Puker has four forms of attacks: the first, it shoots a ball of corrosive bile over a long distance which burns victims and prevents those who are hit by it from running. The Puker's second attack is a projected stream of bile toward its prey at a medium to close range. The third is a melee attack using its claws, and the fourth is a grapple attack in which the Puker grabs the player by the helmet and arm before vomiting on their neck and mouth in order to remove their helmet. The Puker also sports a unique defence mechanism whereby their severed appendages spurt corrosive fluid upon dismemberment.
The Puker in Dead Space 3 differs significantly from those in the previous game. The basic body shape and form is the same, but it is now a strange green color and is apparently much faster, reacts quicker and is more aggressive, even on lower difficulties. It uses the same form of attacks and groans in the same fashion as before.
It is always recommended to engage the Puker from a distance or at least put some space between you and it, considering that it is one of the slowest Necromorphs you will encounter. If you choose to attack the Puker up close, it is advised that you Stasis it in order to stunt its reflexes; otherwise, you run the risk of falling victim to the Puker's grab attack and caustic arterial spray.
- Decapitation of the Puker successfully renders it unable to grab Isaac at close quarters, as well as hinders the Puker from projecting vomit for a short time. However, it does not permanently prevent it from spraying, spewing, and/or otherwise projecting vomit. Always make an effort to dispatch the limbs first. Keep in mind also that if you manage to cut both its legs out, it may attempt to crawl toward you.
- The Puker can withstand serious punishment, even surviving without its legs, arms, and head all at one time, and still manage to puke. This makes explosive weaponry such as an electrified javelin a preferred choice of weapon, as they can do massive damage in a short period of time while giving the Puker a smaller window to retaliate.
- Pukers won't always die when their arms are cut off. Keep this in mind when fighting a large group of Necromorphs: make sure it's down before moving on. However, dismembering both arms does prevent the Puker from using its melee attack, which can be devastatingly powerful on harder difficulties.
- Pukers do have an Enhanced form which appears dark and slimy, doing more damage and moving much faster than normal variants. Players should always make a conscious effort to neutralize Enhanced Pukers first, as the last thing one needs is a bunch of Slashers or Exploders coming at you when you can not run.
- Pukers will spit bile globs from a distance that will not only hurt any Necromorph in its path, but can also be grabbed with Kinesis and hurled at other Necromorphs to do damage. If you grab the bile glob that the Puker spits and use Kinesis to launch it right back, it's usually an instant kill even with the Enhanced forms, and even on Zealot difficulty.
- If Isaac is hit with a bile glob, he will recoil for a moment and slow down greatly, giving other Necromorphs in close proximity an opportunity to strike. Therefore, it would be wise for players to keep their Stasis energy at its maximum capacity.
- Good counter for above is using Contact Beam's secondary fire, if timed right, it knocks out Puker and any nearby Necromorph. Fully upgraded secondary fire further increasing the effectiveness of it, slowing/killing Necromorphs and makes it easier to grab blades of the dead ones. Be wary of ranged attacks, however.
- Despite its emphasis on ranged attacks, the Puker has a fatally surprising output of melee damage in single player and multiplayer alike. No matter how much damage you have inflicted on it, avoid the temptation to try and finish it off with melee as it can kill Isaac with two swats even with a fully upgraded RIG on Zealot mode.
- Although the bile glob does no damage whatsoever to Isaac, even on higher difficulties, it is a death sentence for almost any Necromorph. It is not uncommon in later levels for errant Puker-attacks to instantly destroy Enhanced Slashers.
- When dismembered, Puker vomit will jet out of the severed limb for a second or two. This has the same effect as the vomit attack (removes 2-3 health sections on your RIG on Zealot) and is extremely dangerous on higher difficulties if you have the misfortune to be close to the Puker.
- You can pick up bodies with Kinesis to protect yourself from the Puker's vomit.
- The Puker's grapple attack is very damaging and can severely damage Isaac, even on the easier difficulties. This makes it highly advised to keep your distance from a Puker.
- The Puker can engage you at nearly any range with its hindering bile globs, as long as there is a clear way between you and it. Going behind sufficient cover will negate its attack, and will prompt it to try to get closer or to find an opening.
- During the Ubermorph confrontation, Pukers should be a higher priority than even the Ubermorph itself, since they can easily slow you down and make you waste Stasis and ammo simply trying to keep the Ubermorph from gutting you.
- Along with the Slashers, Lurkers and some other Necromorph forms, the Puker in Dead Space 3 also has a major design overhaul, looking more rotten with green mold in various body cavities and on parts of its body. Perhaps the most drastic change is the long, deep gash that runs from what's left of the creature's forehead down to its waist.
- In some of the earlier concept art of the Puker, it had Slasher-like blade arms. In the finished game, the Puker has three-clawed hands that it uses to grab and manipulate its prey, notable through the death scene and first in-game encounter with the Puker.
- In addition to horrible retching and splashing sounds, the developers have used a number of colors that make humans naturally uncomfortable such as olive green, pale red, and off-white to color the Puker's vomit, intensifying its impact on players.
- Because the Puker's spitting bile slows down the player, making them vulnerable to other Necromorph attacks, one could consider it the Necromorph's version of Stasis.
- The Puker in Dead Space 2 is much less agile than the rest of its Necromorph brethren, as whenever it emerges from a vent, it will fall or stumble onto the ground, slamming its head face first into the ground before slowly rising to its feet several seconds later. This can be used to Isaac's advantage as Isaac can score a direct hit with the Javelin Gun or Contact Beam without risking injury. With the Enhanced variant, however, Isaac may not have a high chance to do this.
- The Puker is also the only Necromorph to have such a large variety of attacks ranging from a simple spitball to a relentless vomit-fall.
- Oddly enough, in Multiplayer, the Puker has only two legs which are both skinless and twisted with nubby little feet. Contrary to what would normally be a crippling defect, the Puker's mobility is not affected.
- The Enhanced Puker can survive double arm amputation, especially on higher difficulties, making it the only Necromorph able to do that outside of the Hunter, the Ubermorph, Twitchers, and on rare occasions, Pregnants.
- Both the normal and Enhanced Puker variants explode in a dazzling explosion of its own bile if hit by a Hand Cannon.
- The Puker's melee attack in Multiplayer differs from the campaign. Instead of slow swipes with its claws like in the campaign, in Multiplayer, it swings its arms around in a fast, windmill-like fashion.
- One of the Pukers death scenes is similar to that of the Novistadors from Resident Evil 4, resulting in the player's face being melted.
- The Puker's legs in Dead Space 3 are its real ones, not made from intestines. However, Enhanced Pukers will have the intestine leg, though this does not hinder their new speed and aggression.
- It is safer to approach a freshly dismembered Puker in Dead Space 3 as the bile is not as stong, due to it being not as evolved or it was affected the 200 year time period.
- Whereas there was rarely more than one Puker per encounter in Dead Space 2, there are times a pack of Pukers can spawn in Dead Space 3, forcing the player to keep a constantly lookout for projectiles.
- A Puker among other noises can be heard in the background of the transmission when Isaac and Carver try to contact Earth in Awakened, showing the Moons Necromorph invasion has begun.
- The face of a Puker in Dead Space 3 strongly resembles that of a Lurker in Silent Hill: Homecoming, most notably the vertical slit on the face.
- The death scene of the Puker is one of the few scripted Necromorph death scenes that do not involve even a slight touch of dismemberment in killing the main protagonists of the series. Other instances of this include Swarmers/The Swarm, the poison secreted out by the Wheezer, and the 3 Drag Tentacles that attempt to drag Isaac to his death.
- The Puker overpowers Isaac as it vomits its highly acidic bile on his helmet and neck, dissolving the airtight bond to his suit and allowing the Puker to tear off Isaac's helmet. With Isaac's head vulnerable, the Puker then vomits into his mouth and down his esophagus, thoroughly devastating Isaac's face and internal organs. Isaac then struggles in vain to regurgitate the vomit before eventually collapsing on the floor, dead. This death scene is also present in Dead Space 3.
- If Isaac manages to fend the Puker off, he will grab its head and bust it off over his forearm, throwing the Puker back and giving Isaac an opportunity to finish it.
- If the Puker successfully executes a Sprawl Security Member in multiplayer, the Puker will deliver one final splash of puke to his face and tear off his head. Otherwise, the Security Personel will repel the Puker in the same way that Isaac does in the campaign via busting its head over his arm, except it will die when its head comes off.