A Proto-Ghoul resembles a half-ghoul in that a human subject undergoes a surgical operation that transforms them into a ghoul-like creature that possesses a Kakuhou and Kagune, as well as a single incomplete kakugan. Proto-Ghouls seem to have more strength, speed, stamina, higher reaction times and durability than humans, in addition to having the typical ghoul regeneration, albeit a weakened form. As incomplete half-ghouls, Proto-Ghouls are weaker than both normal ghouls and One-Eyed Ghouls, but still come somewhat close to them in terms of physical feats. Additionally, Proto-Ghouls have trouble utilising their Kagune. Due to the origin of proto-ghouls from a purely human base, their RC supply is nearly non-existent, requiring the consumption of a considerable amount of human or ghoul meat to bolster their RC counts to even the level of a low-ranking ghoul. They also experience greater difficulty than regular ghouls with retaining the RC cells consumed in their kakuhou, necessitating more frequent meals. This accounts for their general weakness compared to one-eyed or regular ghouls. Given enough time and food, a proto-ghoul would hypothetically gain regenerative powers and kagune control equivalent to a normal ghoul, but this is yet to be proven. The first and only so far successful Proto-Ghoul surgery was conducted by Aogiri's genius scientist Juha Weirwight and turned Rank 2 Investigator Kichirou Kurosawa into a Proto-Ghoul after the former had spent a considerable amount of time researching ghoulification.

The ghoulification procedures is as follows. A kidney is extracted from the surgery subject and contained in a cast of bio-gel bathed in a nutrient medium. The gel helps the kidney retain its shape for the remainder of the experimental manipulation. Exposed to a number of factors, the kidney is essentially reverted to its stem cell origins, giving it the ability to transform into another organ. After exhaustive research, Juha was able to identify the developmental factors that trigger the growth of a kakuhou in a developing ghoul fetus. By applying these to the kidney-based stem cells, a kakuhou-like structure made of the subject's own tissues was created, circumventing the possibility of transplant rejection. From there, the proto-kakuhou is simply reinserted in approximately the same spot as the original kidney. Proto-ghouls Kagune are typically malformed and unstable, at least until the ghoul gains enough RC cells and control over their abilities to proficiently form it.

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