this post was submitted on 12 Apr 2026
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off the top of my head, gamma world, mutant crawl classics, Mutant (and its more modern version mutant year zero).
Mutants and masterminds depending on your definition of mutation, since its more like "superhero marvel mutants" than like "radioactive mutants"
Monte cooke games also has a 5e supplement called "arcana of the ancients" that includes mutation rules that are pretty good IMO.
I dont know if it will include it, but i am like 90% sure the upcoming mystic punks from exalted funeral is going to have something to do with mutants.
Other Dust and its more recent incarnation, Ashes Without Number, are OSR games from Kevin Crawford with many systems to help you create your own post-apo setting and run adventures within it.
Other Dust was especially written as an homage to Gamma World and so has an entire section on creating mutant PCs (5 pages or so of mutations). The setting's gimmick is that any living being affected by radiation gets "healed" by the global nanite system. But because the system was corrupted during the apocalypse, it will turn those beings into monstrous freaks.
Ashes Without Number goes a bit more generic with more options as to what kind of apocalypse happened, but still has that section on mutations.
Other Dust was a bit involved, with mutation powers, then separate flaws and benefits on top of it, so a mutation could be beneficial or not, regardless of its nature. Then separate to that are stigmatas which are visible aesthetic traits that mark you as a mutant in the eyes of strangers. Ashes Without Number simplified things a bit with positive and negative mutations. And stigmatas which are still there as an aesthetic layer. In both cases Kevin takes care to offer options to pick mutations, randomly or not.