When playing this game on a high resolution screen the game will look small and dense, which may be irritating that it does not scale to ones resolution as it can be difficult to read the text or see what is going on.
The game does not surface the needed info one would want to know in order to make sure their routes in the game succeed. This means players will be left guessing as to why some succeed and some fail, which detracts from the gameplay and makes one question the AI.
Unlike many transport management games that focus on one type of transport such as trains or boats, Train Fever features trains, buses and trucks. This makes for varied gameplay as different tactics and skills will need to be used in order to utilize each mode of transport.
Minimalist design and relaxing music makes this a very different experience from the bustle of some others. A minimal zen like game that allows one to relax while playing. While gameplay may get hectic there are modes of play that do not allow for loosing meaning that you can relax and just play...
As your fleet grows, having to select each destination and cargo for each journey of each boat could become tiresome. Compared to the set-it-and-forget it approach of route planning in other games. This may be time consuming for some players who would rather focus on the main aspects of the game.