Extreme is one of the five difficulty options in Granny. It was added to Granny in Version 1.3, and is currently the hardest mode in the game, as it changes various gameplay aspects of Granny.

Sprightly Barbara Prymakowska from Tarnw, outshone other pensioners in the over 60's category of the race after running up the peak 1,986 metres above sea level in a staggering 1hr, 45 minutes.