Never ignore a real malware warning; only whitelist if you are the source is reputable.
Some users report that the game tries to load an old PhysX DLL from C:\Windows\SysWOW64\ that no longer exists. mafia 2 skidrow not launching
The most common cause for launch failure is the game's reliance on older versions. Never ignore a real malware warning; only whitelist
Use DXVK (Vulkan-based) or dgVoodoo2 (wraps DX9 to DX11/12). Never ignore a real malware warning
If Mafia 2 Skidrow is still not launching after trying random fixes, follow this :