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Damage and Recovery

Those who seek adventure do so knowing that they face the risk of injury and death. A fall onto sharpened stakes of a cunning pit trap, the scimitar swung recklessly by the dastardly pirate, a druid’s summoned lightning striking from a clear sky, or the deadly bite of a giant serpent—all can damage or kill even the mightiest of creatures.

Hit Points

Hit points represent a creature's stamina, willpower, and the luck needed to survive deadly challenges. Creatures with a lot of hit points are harder to kill, while those with few hit points are more fragile.

A creature’s current hit points can be any number from their hit point maximum down to 0. A creature loses hit points when taking damage, subtracting the damage value from current hit points down to a minimum of 0, and regains hit points when it receives healing, adding hit points, up to its hit point maximum.

When a character loses hit points they aren’t necessarily taking physical harm, rather they are avoiding otherwise fatal blows, and their ability to keep doing so is whittled away as they take further damage and their hit points decrease.

Loss of hit points has no effect on a creature’s capabilities until it drops to 0 hit points. 

Damage Rolls

Weapons, spells, and monster attacks specify the damage they deal. You roll the damage die or dice, add any modifiers, and apply the damage to your target. Magic, special abilities, and other factors can grant a bonus, or occasionally a penalty, to damage. With a penalty it is possible to deal 0 damage, but never negative damage.

When attacking with a weapon, you add your ability modifier (the same modifier used for the attack roll) to the damage. A spell tells you which dice to roll for damage and whether to add any modifiers.

Any time an effect deals damage to more than one target at the same time, roll the damage once for all targets. For example when a wizard casts fireball, the spell’s damage is rolled once for all creatures caught in its area of effect.

Critical Hits

When you score a critical hit, you double the attack’s damage against the target (including static modifiers). A critical hit can be turned into a regular hit by sacrificing an equipped shield (see Chapter 4: Equipment) or choosing to suffer fatigue (see Fatigue below).

Damage Types

Attacks, weapons, harmful spells, and other damaging effects deal different types of damage. Although damage types have no rules of their own, other rules (such as damage resistance) rely on damage types.

The damage types follow, with examples to aid a Narrator assigning a type of damage to a new effect.

  • Acid. The caustic spray of a black dragon’s breath and the corrosive touch of an ooze deal acid damage. 
  • Bludgeoning. Blunt hits—punches, hammerblows, and being crushed in a giant’s grip—deal bludgeoning damage.
  • Cold. The numbing chill from a ray of frost and the frigid blast of a white dragon’s breath deal cold damage.
  • Fire. A hot stove, a burning building, a conjured flame, and the inferno of a red dragon’s breath all deal fire damage.
  • Force. Pure magical energy focused to strike at the enemy, force damage is supernatural and dealt mostly by spells (including magic missile and spiritual weapon ).
  • Lightning. The spark from a faulty gnomish gadget, a bolt of electricity striking from a storm, and a blue dragon’s breath deal lightning damage.
  • Necrotic. The touch of a ghost withers flesh and wounds the soul. Necrotic damage is dealt by necromantic magic and the void of undeath.
  • Piercing. Attacks that puncture and impale—arrows, daggers, spears, and monstrous bites with sharp teeth—deal piercing damage.
  • Poison. Envenomed stings, bites and coated blades, toxic toadstools, and the noxious exhalations of a green dragon deal poison damage.
  • Psychic. Monsters with psionic powers and attacks on the mind itself by illusion or enchantment magic deal psychic damage.
  • Radiant. An angel’s smiting weapon or a divine guiding bolt deal radiant damage, burning flesh and searing the spirit with raw power.
  • Slashing. Cuts and swipes—whether from swords, axes, or monstrous talons—deal slashing damage.
  • Thunder. The resonant power of the storm and a concussive burst of sound, such as from the thunderwave spell, each deals thunder damage.

Ongoing Damage

Some attacks, spells, and effects deal ongoing damage. This hit point loss happens at the end of each of your turns. Unless the effect states a damage type, the hit point loss is unaffected by damage resistance or vulnerability (see below).

Ongoing damage could be caused by burning oil, a psychic echo, corrosive ooze, a bleeding wound, or another pernicious element.

The ongoing damage continues until the duration ends, or a creature uses an action to end the effect, as described by the effect that caused it.

For example, a fire elemental’s touch will cause its target to catch on fire. The burning creature takes 1d10 ongoing fire damage at the end of each of its turns until a creature uses an action to smother the flames.

Damage Resistance, Vulnerability and Immunity

Some creatures and objects are exceedingly difficult or unusually easy to hurt with certain types of damage.

A creature or an object with resistance to a damage type takes only half the damage whenever it takes damage from that type.

A creature or an object with vulnerability to a damage type takes twice the damage whenever it takes damage from that type.

Resistance and then vulnerability are applied after all other modifiers to damage. For example, an imp is resistant to cold damage and is hit by a powerful ray of frost for 25 cold damage. The imp is also sitting in a magical cage which reduces all damage by 5. The 25 damage is first reduced by 5 and then halved, so the imp takes 10 cold damage.

Multiple instances of resistance or vulnerability affecting the same damage type count as only one instance. For example, if that imp with resistance to cold damage was additionally protected by a magical spell that granted resistance to all damage, the cold damage it takes is still only reduced by half (not reduced by three-quarters).

Some creatures and objects are immune to certain types of damage, or damage inflicted by mundane weapons. Damage immunity does not modify damage dealt; instead the immune creature is unaffected by damage of that type. Furthermore, some creatures are immune to certain conditions.

Fatigue, Death, and Doom

When you take damage you risk injury, unconsciousness, and death.

Massive Damage and Instant Death

Massive damage can injure or kill you instantly. If you are reduced to 0 hit points after taking an amount of damage equal to or greater than 20 + three times your character level (or Hit Dice for creatures), you make a DC 15 Constitution saving throw . On a failure, you die instantly, while on a successful result you live, but suffer one level of fatigue and one level of strife.

For example, an 3rd-level cleric with 24 hit points is subjected to a black dragon’s acid breath, taking 54 acid damage and being reduced to 0 hit points. Because they took massive damage (29 or more), the cleric must succeed on a DC 15 Constitution saving throw to avoid instant death.

If the sorcerer had succeeded on their saving throw against the breath weapon to take half as much damage, or if they had had resistance to acid damage, they would have only taken 27 acid damage, and although still reduced to 0 hit points wouldn’t have taken massive damage (and so isn’t at risk of instant death).

Dropping to 0 Hit Points

If damage reduces you to 0 hit points and fails to kill you, you are unconscious . This unconsciousness ends if you regain any hit points.

Falling unconscious during an encounter is traumatic and inflicts a level of fatigue (see below).

Dying and Death Saving Throws

Whenever you start your turn with 0 hit points and you’re not stable (see below), you are dying and you must make a special saving throw called a death saving throw to determine whether you slip closer to death or cling to life. Unlike other saving throws, a death saving throw isn’t tied to an ability score, but can be affected by spells and features that modify your chances of succeeding on a saving throw.

Roll a d20. If the result is 10 or higher, you succeed. Otherwise, you fail. However, a single success or failure won’t spare or kill you. On your third success, you become stable. On your third failure, you die. These successes and failures don’t need to be consecutive—keep track of both until you collect three of a kind. The number of both is reset to zero when you regain any hit points or become stable.

Rolling a 1 or 20. When you make a death saving throw and roll a 1 on the d20, you suffer one level of fatigue and one level of strife. If you roll a natural 20, you regain 1 hit point, immediately regain consciousness, and are able to take the rest of your turn.

Being Attacked at 0 Hit Points. If you take damage from an attack while you’re on 0 hit points, the attacker can choose to make you suffer a death saving throw failure, one level of fatigue, or one level of strife. 

Other Damage at 0 Hit Points. If you take any other damage while you have 0 hit points, you suffer a death saving throw failure. At the Narrator's discretion, depending on the nature of the damage, such as blasting steam or errant magic, this may instead inflict a level of fatigue or strife.

When you take massive damage (20 + character level or more damage) while on 0 hit points you risk instant death.

Stabilizing a Creature

Healing a creature on 0 hit points is the best way to save it. Where healing is unavailable, the creature can be stabilized so that it doesn’t die due to failed death saving throws.

As an action, you can administer first aid to an unconscious creature to attempt to stabilize them, with a successful DC 10 Wisdom (Medicine) check.

A stable creature doesn’t make death saving throws, even though it has 0 hit points, but it does remain unconscious. The creature stops being stable and must start making death saving throws again if it takes any damage. A stable creature that isn’t healed regains 1 hit point after 1d4 hours.


Sometimes during an encounter, a creature will gain an injury representing a serious wound. This is represented by fatigue.

You gain a level of fatigue when:

  • Each time you take damage that makes you fall unconscious during an encounter.

  • You are hit by a critical hit while at 0 hit points.

  • When you take a critical hit, you can use your reaction to block it, turning the critical hit into a regular hit and suffering a level of fatigue (if you have a shield, you can Sacrifice Shield instead; see Chapter 4: Equipment ). Once you have turned a critical hit into a regular hit in this way, you cannot do so again until you finish a short or long rest.

The effects of fatigue gained during combat are only felt after the encounter in which they were inflicted has ended. During the heat of battle it is easy to fight on without realizing the extent of your injuries.

A creature can survive multiple such injuries and continue adventuring; however injuries are not to be ignored lightly. If you gain 7 levels of fatigue, you are doomed to die (see below), as your combined injuries mean you’re beyond the aid of all but the most powerful healing magics.

A creature can recover from the initial level of fatigue during a long rest anywhere, but recovering from two or more levels of fatigue requires long rests taken at a Haven, reducing its level of fatigue by one each time.


A doomed creature has sustained damage to their body, mind, and spirit that puts it beyond the help of normal recovery and lesser magic. While the symptoms of a doomed creature’s injuries might be removed, only powerful spells such as regeneration or resurrection can spare it from death or restore it to life.

Suffering the effects of 7 or more levels of fatigue is one way to become doomed; however at the Narrator's discretion a creature might become doomed for any number of other reasons.

For more details on the doomed condition see Conditions .

Monsters, NPCs, and Death

Rather than falling unconscious, accruing injuries, or making death saving throws, a monster that drops to 0 hit points usually dies immediately.

Essential villains and important nonplayer characters are common exceptions. The Narrator might have any nonplayer character follow the same rules as player characters, or they might become doomed the moment they hit 0 hit points—allowing them a final dramatic action or speech before they succumb and die.

Knocking a Creature Out

Rather than killing, sometimes an attacker wants to incapacitate their foe, perhaps because they’ve sworn not to kill or simply to interrogate the enemy for information. When an attacker reduces a creature to 0 hit points with a melee attack, the attacker can knock the creature out. This choice is made the instant the damage is dealt. The creature falls unconscious, gains a level of fatigue, and is stable.

Healing and Recovery

Damage which doesn’t kill you isn't permanent, and even death can be reversed with powerful magic. Rest can restore a creature’s hit points, and magical means such as cure wounds and a potion of healing can remove damage in an instant.

Any time a creature receives healing, hit points regained are added to their current hit points. A creature’s hit points can’t exceed their hit point maximum, so hit points regained in excess of this number have no effect. For example, a cleric casts cure wounds to heal a ranger 6 hit points. If the ranger has 10 current hit points and a maximum of 13 hit points, they regain 3 hit points to their maximum (not 6).

A creature that has died can’t regain hit points until magic such as the revivify spell has restored them to life.

Recovering From Fatigue

Recovering from fatigue is more difficult than restoring hit points.

A creature can recover from the initial level of fatigue during a long rest anywhere, but recovering from two or more levels of fatigue requires long rests taken at a Haven, reducing its level of fatigue by one each time.

Temporary Hit Points

Some spells and special abilities confer temporary hit points to a creature, a separately tracked buffer against damage.

When you have temporary hit points and take damage, the temporary hit points are lost first, and any leftover damage is then subtracted from your normal hit points. For example, if you have 5 temporary hit points and take 8 damage, you lose the temporary hit points and then take 3 damage.

Healing can’t restore temporary hit points because they are separate from your actual hit points, however they can exceed your hit point maximum. A creature can be at full hit points and receive temporary hit points.

Temporary hit points can’t be added together—if you have temporary hit points and receive more of them, you decide whether to keep the temporary hit points you have or gain the new temporary hit points. For example, if a spell grants you 10 temporary hit points when you already have 5, you can have either 10 or 5 (not 15).

If you have 0 hit points, receiving temporary hit points doesn’t restore you to consciousness or make you stable. They still absorb damage directed at you while you’re in that state, but only true healing can save you.

Unless a feature that grants temporary hit points has a duration, they last until they’re depleted or you finish a long rest .