Illness is a condition that can befall nearly any piñata. It can be cured by Doc Patchingo. If a piñata remains ill for too long, Dastardos will appear to claim its life.

When a piñata becomes ill, it lies down and turns green and yellow if it is a resident. Icons of Dastardos' face are released from its body, indicating that Dastardos is alerted to its condition. When hovering over a sick piñata with the cursor, the player can use the A button (console games) or the Doc Patch icon (PP) to call the doctor to cure the piñata for a fee.