Hit Points, Temporary Hit Points, Bleeding, Death Saving Throw in Dungeons & Dragons

Dungeons & Dragons makes use of hit points to represent the health of a creature. Player characters gain additional hit points as they increase their character levels. The number of hit points varies depending on the character class.

Note that monsters can also be given more or less hit points depending on the situation. As a Dungeon Master you can also "auto-kill" a monster when it gets hit. I have done that once in a while. You just don't want to kill all your player characters. It's just not fun (although once in a while it can happen...)

Hit Points

The Hit Points are determined by rolling your Hit Dice. Since Advanced Dungeons & Dragons 2e (and in 1e, there was an article in Dragon Magazin about that idea), you start with the maximum number of hit points at level 1. This gives you a chance to actually really survive your first adventures until you reach level 2 or 3... and become much healthier.

Monsters generally have been given a number of d8 hit points. These are rolled by the Dungeon Master. To be faster in your game, you could roll those ahead of time. In most cases, scenarios will include a set of hit points for important NPC, but not for all encounters.

As mentioned earlier, these numbers represent the health of a creature. Whenever you get hit and take damage, you hit points decrease. Once you reach 0 hit points, you are unconscious and start bleeding (see below.)

Depending on the edition of the game, you die in various ways while bleeding. Note although that you may die instantly too. For example, if you get desingrated then you're just gone outside of a few specks of dust...

In most cases, players are given the task of tracking their health. Each time they take damage they calculte their current amount of hit points. In some games, the Dungeon Master tracks all thehit points, including the player characters hit points and Turn Watcher™ makes that task particularly easy!

Constitution Effects on Hit Points

The Constitution of a creature gives it additional hit points per level. Note that a low constitution will generate a loss of hit points per level. This can be difficult to manage in a combat unless you track the Dice Rolls for each level, I'm explaining this below.

Whenever a player rolls his six scores, one of those numbers gets assigned to his constitution. A warrior will often put a pretty high number in his constitution because that will allow  the warrior to stand longer in a combat.

Note that a low score in your constitution will instead decrease your number of hit point and not just once, but a number of times equal to your current level (so with a low score that gives you a -2, you will have a -20 penalty on your hit points by level 10! That's a large lost.)

There is a table with the score adjustments on a per edition of Dungeons & Dragons basis. Note that it has not changed since 3e. Ability scores are limited to 18 in 1e until the Monster Manual II came out and shown a table with Scores up to 25. In 3e and 4e, they are not limited. In 5e the limit is 30.

Bonus Hit Points from Constitution
Bonus 0e 1el 2er 3e 4ec 5e
-5       1 1 1
-4       2-3 2-3 2-3
-3     1 4-5 4-5 4-5
-2   3 2-3 6-7 6-7 6-7
-1 3-6 4-6 4-7 8-9 8-9 8-9
+0 7-14 7-14 7-14 10-11 10-11 10-11
+1 15-18 15 15 12-13 12-13 12-13
+2   16-18 16-25 14-15 14-15 14-15
+3   17f 17f 16-17 16-17 16-17
+4   18f 18f 18-19 18-19 18-19
+5   19-20m 19-20f 20-21 20-21 20-21
+6   21-23m 21-23f 22-23 22-23 22-23
+7   24-25m 24-25f 24-25s 24-25s 24-25s


* Chainmail did not include a Constitution (or any Score if that matter!) so there would be not such thing as a bonus depending on your score.

l The Monster Manual II defined very low intelligence Scores starting at 0, but not Constitution (or any other Score.)

f Only fighters and warrior classes gain this bonus. Note that if you multi-class, then you should add this bonus only to your hit dice you gained as a warrior.

m Found in the Monster Manual II.

c The Constitution in 4e gives you a bonus only on your first level Hit Die. Contrary to all other editions where you get that constitution bonus at each level. Although as a side effect, when you increase your constitution while leveling up, you gain a +1 to your hit point. Whenever you increase to or past an even Constitution, you also gain +1 to your healing surges.

s Scores are not limited in 3e, 3.5e, and 4e. Scores are limited to 30 in 5e. For each additional 2 points in your score, add +1 to your bonus. You can calculate that bonus by subtracting 10 if you score is even and 11 if your score is odd, then divide by two. For example, with a score of 7 you do 7 - 11 = -4, then divide -4 by two, it gives you -2. With a score of 40 you do 40 - 10 = 30, then divide 30 by 2, it gives you +15. (My personal idea on this one is that a player should not really be able to go much more than 20 or 21 anyway... but 3e is known for crazy glitches like this one and 4e did not fix the unlimited Scores!)

r Advanced Dungeons & Dragons 2e further offers a minimum to each of your rolls and regeneration for people with an excellent constitution. This minimum is another reason to keep track of each roll as you level up (something not clearly shown in character sheets... sadly.) With a constitution of 20 or more, low rolls are adjusted up as follow:

Min. Hit Points & Regeneration
Score Minimum Regeneration
1-19 1 Nil
20 2 +1 every 6 turns
21 3 +1 every 5 turns
22 3 +1 every 4 turns
23 4 +1 every 3 turns
24 4 +1 every 2 turns
25 4 +1 every turn

For example, if you have a consitution of 22, any Hit Dice rolls you made and any future Hit Dice roll you make for your hit point that is under 3 will be taken as a 3.

Note that if you are a Wizard with a constitution of 23 or more, you actually end up with your maximum per level.

Note that since AD&D 1e you always get at least 1 hit point per level, even if you roll a 1 and you have a constitution eating up your hit points (i.e. -3). So with a constition of 1 and 5 levels, you would still end up with 5 hit points when in full health. This is clearly spelled out since 1e. It was not in original.

Other Constitution Effects

Outside of additional hit points, there has been all sorts of effects attached to your Constitution Score: System Shock Survival, Resurrection Survival, Poison Save, Regeneration, Healing, Spell Effects.

System Shock Survival

In the Original Dungeons & Dragons (OD&D) the players could not be raised back from the dead with a constitution under 7. A constitution between 7 and 12 gave them a good chance of being raised back. With a Score of 13 or more, they would be raised every time. So it was a very important to have a 13+ in that Score if you were planning to die a few times during your adventures.

Note that several types of magic or ability created a Shock. Mainly, anything that affected a person with a transmutation. These included the Raise Dead, Reshape, Age, Petrification,

OD&D Survival
Score Shock Survival
7 40%
8 50%
9 60%
10 70%
11 80%
12 90%
13-18 Always survives

Advanced Dungeons & Dragons changed the table and always gave the character a chance. It also increases chances quite a bit as 40% was already available to someone with a Score of 4. They also added another column with the chance of Resurrection Survival (which applied to the Raise Dead Spell). Note that the Resurrection Spell did not exist in the original edition.

AD&D Survival
Score System Shock
1** 25% 30%
2** 30% 35%
3 35% 40%
4 40% 45%
5 45% 50%
6 50% 55%
7 55% 60%
8 60% 65%
9 65% 70%
10 70% 75%
11 75% 80%
12 80% 85%
13 85% 90%
14 88% 92%
15 91% 94%
16 95% 96%
17 97% 98%
18 100%*** 100%


** From AD&D 2e.

*** In AD&D 2e, the System Shock Survival stays at 99% up to Score 24. At Score 25 you get a 100% chance.

So with 18 in Constitution you could die any number of times since you could be resurrected over and over again.

That being said, Divide Interventions could be used to revive any characters even if they failed their resurrection roll. That being said, you'd have to get a chance to find a god that would help you. Not an easy task.

Also in Advanced Dungeons & Dragons (AD&D 1e), each revivification (Raise Dead, Ressurection, etc.) would decrease your Constitution Score by 1. So in effect you would be limited to a maximum of 18 lifes if you started with 18. (i.e. if you start with 10, then you can only be revived 10 times, even if you find magic to increase your score to incredible levels even 25.) In other words, in AD&D, they plugged that hole! However, they still offered you to be revived using a Wish Spell after the limit defined by your Constitution Score.

The System Shock Survival disappeared since 3e.

The Resurection Spell in D&D 3e would make you lose one level. If you were at level 1, it would instead reduce your constitution by 2 points. If you had a constitution of 2 or 1, you could not be resurrected. The Raise Dead Spell was weaker and as such could not bring a character back to life unless his body was available. The hit to the level or constitution is the same. Note that without any remains, a Resurrection Spell would not work either. In other words, a character eaten by a Tarrasque would need a little more than a Resurrection Spell to come back to life: the True Resurrection Spel.

In all editions, old age is quite terminal... Only magic that makes you younger and that you use before you die can help you on that one.

Forth Edition included another aspect to the Resurrection and Raise Dead Spells. You had to offer a very expensive component to make sure Death would allow the return of that character's soul. Any god could actually prevent the return of a soul. If you annoyed a god a bit too much...

In Forth and Fifth Editions, the characters brought back to life with a Raise Dead Spell has a penalty to pretty much all of its rolls for a while.

Resurrection and True Resurrection may also affect the caster who then must rest for a few days. These spells are quite powerful so they are taxing on the caster.

Poison, Disease, Petrification, and Paralysis Saves

Your Constitution defines how strong you are in terms of health. Therefore, it makes sense that it will protect you if you are poisoned or catch a disease. When a creature or spell tries to transform you to stone. When you get injected with a fluid paralyzing you.

A low score will obviously lower your chances. A high score may actually save you nearly every time. (Remember that on a Saving Throw, a 1 does not mean automatic failure.)

Concentration Check

Since edition 3e, we have a Concentration Check. In 1e and 2e, being hit was enough to kill your concentration, no matter what (although concentration was rarely a problem... that is, not too many people would take it in account if a spell took just one round to cast.)

Rolling a successful Check (a 1d20 plus your Score Modifier over the required DC) means that you do not lose concentration.

Note that one reason for adding the concept of Concentration in 3e and newer version was because some spell need to be kept alive using said concentration. This means you are very likely to attack a spell caster if you have an effect that lasts more than one round in an attempt to break the spell effects. An interesting side effect in D&D.

Note that a Concentration Check is required even when losing only Temporary Hit Points.

Endurance Skill

Various versions took the Constitution Score as a way to determine the endurance of a player.

A higher Constitution Score allows you to better survive all sorts of ordeal. A low score and you may fall unconscious quite early.

What it protects from varies depending on the version. Exhaustion is the one skill that is found in most versions, mainly because of forced walk day and night. Others include holding your breath, resistance to heat and cold, forced labor, carrying a heavy load, wearing a heavy armor, starvation and thirst, quaff an entire stein of ale in one go, riding a horse or some other mount for long periods of time at high speed, etc.

Temporary Hit Points

Third Edition introduced a new concept: Temporary Hit Points. Just like standard hit points, you could take damage that would reduce those Temporary Hit Points. The interesting concept is that these Temporary Hit Points come in addition to your standard hit points and get reduced first so that your standard hit points do not get affected.

For example, a giant centipede is approaching to attack Grufus the Wizard. Grufus casts False Life on himself. He rolls a 1d4 and gets a 3. He adds 3 + 4 = 7 Temporary Hit Points to his character sheet. These hit points will last up to 1 hour unless he gets hit.

Unfortunately, the centipede gets a higher Initiative Score and attacks first. It hits Grufus for 5 hit points. Now Grufus has 7 - 5 = 2 Temporary Hit Points left. Grufus makes an attack roll with his dagger and misses. The centipede attacks him again and generates another 3 hit points of damage. This time Grufus standard hit points are hit. He first loses the last 2 Temporary Hit Points, then loses 1 of his standard hit points. Finally Grufus rolls a hits and this time he succeeds killing the centipede.

Lucky for Grufus he took the time to cast his False Life spell because 8 damage would otherwise have killed him since he has only 7 standard hit points (1d6 + 1 from his constitution of 13). Wizards at level one are quite weak!

In Fifth Edition, Druids can use their Wild Shape ability and while in that Wild Shape, the Wild Shape hit points are Temporary Hit Points. The only problem is that these are relatively small compared to what the Druid normally has, but it is still a good buffer at the start of combat. The Druid can get killed while in Wild Shape and automatically revert back to normal once it lost all of its Temporary Hit Points. Note that in 3e and 4e, the regular Druid hit points applied.

Note that Temporary Hit Points are not real health. It is a form of buffer of protection. In other words, receiving Temporary Hit Points while dying will not heal or stabilize you like a healing potion or spell would. The Temporary Hit Points can still be useful in case a monster is to hit you again while you're unconscious.

Bleeding (1e, 2e, 3e)

Introduce in Advanced Dungeons & Dragons, probably because Gary Gygax noticed how quickly you could otherwise die, the bleeding mechanism would allow you a second chance at surviving a blow that would put your Hit Points at zero.

So, you manage four states with your Hit Points.


All good and kicking! You have 1 or more hit points, you can do whatever you want, including running away (unless you are on a branch hiding from the wolf below...)

Although some Dungeons Masters probably used your level of Hit Points as a way to tell you whether you were too tired to take certain actions, I have not see any rules that would imply such. So whether you have a single Hit Point left or you are at your maximum, you can continue to do things the normal way. However, if you are at a high level of exhaustion, you could lose that one last Hit Point and go unconscious!

Stabalized (a.k.a. Unconscious but not Dying)

You got hit and your hit points fell to exactly 0. This is a rare event, but a good one. Your attacker is likely to live your body alone. He sees you as dead now. But Unconscious means that you are in a stable state. In other words, you are not die just yet, although someone will need to help you to get you out of your unconscious state.

Bleeding (a.k.a. Dying)

Your hit points fell under 0. You have between -1 and -9 Hit Points. Each round you lose another Hit Point until you reach -10.

This gives you a few rounds (it really very much depends where you started...) for another character to come to your rescue and at least stabalize you if they cannot give you a Healing Potion, cast a Healing Spell, or lay their hands on you.


In OD&D, AD&D 1e or AD&D 2e, at 0 you are dead. Although in 1e and 2e, a Dragon article gave you a system similar to what we have in 3e, giving you a little breathing room before you die.

In 3e, your Hit Points reached -10 or less. Note that in 3e, when you get hit by a blow that gets you at -10 Hit Points or less at once, then you were killed instantly.

In 4e or 5e, you're dead after you fail 3 Death Saving Throws. Although you could be instantly killed too if you took too much damages at once.

Outright Death

There are several ways that a character (or monster) dies an outright death. Each editions have been trying to ameliorate the system as time passed. I think that they succeeded at making progress, not without going back and forth with various attempts.

The following discusses what happened in various versions. Note that I omit Chainmail since it was a completely different game system.

OD&D, AD&D 1e

In the old versions, any time you were hit for an amount of hit points equal to what you had left or more, you would die, outright.

Dragon magazin published an article about AD&D 1e and how to use a new method which gave you a small buffer of an additional 10 points. You would die at -10 or less. Between -1 and -9 you were dying and losing one hit point per round. At 0 you were stabalized. These rules were officially introduced in D&D 3e.

AD&D 2e

This version introduced an amount of hit points that kills you outright.

This amount is 50 hp. If a creature attacks you and is somehow able to inflict 50 or more Hit Points at once, then you die outright, whenever you have 50 or more Hit Points left.

This edition still had you die at 0 hp.

D&D 3e and 3.5e

This edition officially adds the rule with the -10 points as mentioned above. So you die at -10. At 0 you are stable but unconscious. Between -1 and -9 you are dying and will be losing 1 hit point per round until you reach -10 or you get healed. Note that a healing spell ignores the negative hit points. So if you get healed by 1d8 and receive 5 Hit Points, the your character has 5 Hit Points. This is certainly one reason why Fifth Edition removed the concept of negative Hit Points.

Also Dungeons & Dragons Third Edition was extended to give you the ability to become stable while bleeding. You have to roll a 1d100. If you get 10% or less, then you are now stable and start losing 1 hit point per hour instead of every round, but you are still unconscious and your hit points don't go back to 0. Now, every hour you again roll the 1d100 and if you get 10% or less, you become conscious. If you fail that d% roll, then you lose another hit point.

In other words, 3e introduced a Pre-Death Saving Throw concept as we have in 4e and 5e.

That being said, hopefully you get someone to help you get out of it. But it can be an interesting concept where all get killed, although some are still bleed, and the enemy just leave. Then you still have a chance to snap out of it and live. Previous versions did not offer such a last chance of survival. Truly, though, this is rather complicated.

Note that in this edition, 0 Hit Point is not making you unconscious. You are, however, disabled. While disable, you can still perform an action. Only by doing so you will lose 1 hit point and fall unconscious and bleed to death... so hopefully your action is drinking that one last healing potion!

Thrid Edition kept the 50 or more Hit Points strike as a: You Die Outright if you sustain such heavy damage at once, even if you still have more than 50 Hit Points.


This Edition is a mix between 3e and 4e.

The hit points still go negative, as in 3e, but the limit is now equal to the character Constitution Score. So with a constitution of 20, you can survive up to –20 Hit Points.

The d% was also replaced by a Constitution Check which is adjusted by the current amount of Hit Points. So if you are at -5, you must roll a 15... because 15 - 5 is 10 and that Constitution Check is a DC 10 — so roll 1d20 add your Constitution Modifier, and if you got 15 or more, you succeeded.

Succeeding that check gets you out of unconscuiousness. This was an attempt at ameliorating the Pre-Death Saving Throw introduced in 3e. I think that the concept of adding the Hit Points is interesting, but if I am at -20... not much chances that I'll get back to consciousness on my own!

The 50 Hit Points damage killing a creature outright became an optional rule in Pathfinder. I could imagine that many would not use it. After all, if you have 100 Hit Points, you should be able to sustain 100 Hit Points of damages before you die.

D&D 4e

Starting with 4e, the -10 Hit Points rules gets replaced with the Death Saving Throw.

The 50 or more Hit Points strike rule gets removed.

However, you can still get killed outright if you sustain more damage than you can handle. This amount is defined as your bloodied amount. The bloodied amount is  50% of your level rounded down. So at level 1, you die outright when you reach 0 hit points. Very much the same as OD&D, AD&D 1e, and AD&D 2e.

Although it will save you at higher level, it is clearly an interesting choice that they made in the Forth Edition. Note that is somewhat counter balanced by the fact that you get more hit points from the start.

D&D 5e

The authors of Fifth Edition kept the same ideas of Death Saving Throw and Bloodied as in Forth Edition.

There are two main difference, though. The Bloodied amount is your total amount of Hit Points. So at level one, a Barbarian will have at least 12 hit points, possibly 19 with a good Constitution Score. Using the negative system as before, he will be killed outright only if he receives damages that go as far down as -12 (or -19 with the best Constitution.)

Note that 5e uses a different way to calculate whether the Character dies to avoid having negative Hit Points. There are two reasons. Most people do not like to deal with negative numbers and also it can be confusing that you are at -7 and get a Healing Spell giving you +5 and instead of going to -2 you actually go to 5 Hit Points all of a sudden. I think this makes sense. So the math goes like this instead:

Whenever a person receives damages:

  • If the amount of damages is small than the number of Hit Points the Character still has, then you calculate: Hit Points - Damage, this is the new number of Hit Points the Character has.
  • If the amount of damage is larger or equal to the number of Hit Points the Character still has, then you calculate two numbers:
    • Remaining Damage = Damage - Hit Points
    • Hit Points = 0
    • If the Remaining Damages is equal or higher than the Character's Maximum Hit Points, then the Character dies outright
    • Either way, the characters falls Unconscious.
    • If the Remaining Damages are not zero and the Character did not Die Outright, then the Character is Dying, meaning he has to start rolling a Death Saving Throw on each round until he dies or recovers.

Note that this is a very subtle difference with 4e, when you reach 0 hit point in 4e, you are dying instead of being stable.

I think that generally speaking, this is a better system than what we had in all the older versions.

The bloodied in 4e was kind of like going back to AD&D. The bleeding for about 10 rounds introduced by Dragon magazin and made official in 3e was somewhat long and often gave you a chance of survival that was not really as realistic as one could expect a combat to be.

Death Saving Throw (4e, 5e)

In Forth Edition, the bleeding was transform from losing one hit point per round (3e officially introduced that mechanism, it was available in 1e and 2e through a Dragon article) until you reach -10 to a Death Save Throw.

The rules for 4e and 5e are different.

Forth Edition

In 4e, you have to roll a 1d20 until:

  • you get stabilized by another;
  • fail 3 times, in which case you die; or
  • roll 20 or more, in which case you can use a healing surge to heal yourself (if you still have such at your disposal... otherwise you are still dying, but did not increase your fail score)

The Death Saving throw is a DC 10. Note that you can add bonuses to your die roll. These will depend on various feats that you can take, such as Human Perseverance (+1). There is no Score Modifier mentioned, such as Constitution, so you have to assume that none apply.

Fifth Edition

In 5e, you have to roll a 1d20 until:

  • you get stabilized by another;
  • fail 3 times, in which case you die; or
  • succeed 3 times, in which case you are auto-stabilized.

When another stabilizes you, it is considered that you succeeded three times.

Rolling a natural 1 is considered to be equivalent to 2 Death Saving Throw failures.

If you roll a natural 20 instead, you become conscious with 1 hit point.

Note that since the DC is 10+, you are actually given 55% chance of succeeding and 45% of failing, with 5% of double failure and 5% of instant success.

Being hit by a creature and taking damage is considered a failure (apparently, having temporary hit points does not prevent such.) Being critically hit is considered as two failures.

Roll Result Other Method
1 Double Failure Critical Hit
2-9 Failure Taking Damage
10-19 Success Stabilized (med. kit)
20 Instant Recovery Healing Spell

Chart visually describing the Hit Point processes in Dungeons & Dragons Fifth Edition.The flow chart on the right describes the Dungeons & Dragons Fifth Editor Hit Points Management in combat (click to enlarge). The chart includes the handling of temporary hit points which is different depending on whether you are conscious, unconsicous and stable, or unsconscious and dying. Note that there is controversy about whether you always become immediately unstable when hit and have temporary hit points. It is likely that you do with the rules as written, but I think it makes more sense to allow a little buffer of life when you got stabilized and given additional temporary hit points. My chart shows it that way.

HP – Hit Points
– Temporary Hit Points
D – Damage

In both cases, you have to calculate how much damage you took passed 0 (in 5e, they don't use negative numbers, but it is very much the same.) Say you have 12 hits points left, with a maximum of 35. You get hit for 19 damage. You go from 12 hit points to -7, which is more than -35, you do not die instantly. The limit in 4e is your bloodied value, a negative number which is not automatically equal to your maximum number of hit points. The 5e version describes the negative problem by inversing the numbers. So if the amount of damage is larger than the number of hit points you currently have, you put your hit points to 0 and calculate a number defined as "Damage - Remaining Hit Points", which in our case would be 7 (19 - 12). 7 is less than the maximum of 35, we did not die outright. Obviously, low level characters are much more likely to die outright (for example, they are attacked by a Barbarian with a battle axe which rolls a 12 on 1d12 and adds +5 for his strength, that 17 damage. That would kill most first level spellcasters outright.)

This changed from 3e where the dying outright was exactly 50 hp (rule that appeared in 2e). There was also the case where your Hit Points went under -9. A blow generating 50 Hit Points of damage would apply for any hit, though, not just hits bringing your under 1 Hit Point.

You're Stabilized, now what?

This also changed between versions.

In AD&D 1e and 2e, a character died at 0 Hit Point. Later, a Dragon article offered a system where a character would die at -10. At 0 hp, he would be stabilized. At -1 to -9, he would be dying. Stabilizing the character was possible and it would right away be given 1 hit point, albeit not able to do anything until rested (at least 24h) or magically healed.

Stabilizing in 1e and 2e meant having a medicine kit. Without the kit you couldn't do it. Everyone would always get such a kit! The stabilization would work every time as long as you had a kit.

In 3e, when you are at 0 hit points you are not yet unconscious. Instead you are considered disabled. You can still act, including taking a potion! Also a dying character has a 10% chance per round to become stable, just like that. If that happens, then he goes to 0 Hit Points and can drink his healing potion. While at 0 hit point, it takes 1 hour for the character to get a 10% chance of getting out of being disabled (i.e. back to having 1 hit point.) He can roll each hour. If another character tends to a dying character, he stabilize him and gets at 0 hit point and gets the 10% chance each hour to snap out of being disabled.

Like in 1e and 2e, you need a kit or an ability to make sure it works. Otherwise, you could do an attempt with a DC 15 Heal check (Wisdom).

In 4e, falling at 0 hit points puts you in the Dying state. This is different from 3e and 5e where 0 Hit Points means the character is unconscious or disabled. So even at 0 Hit Points the character starts bleeding and has to roll his Death Saving Throws.

The heal kit does not give characters any hit points, but it will stabilize the dying to 0. Resting can be used to regain hit points.

In 5e, falling to 0 hit points exactly means that you are unconscious (i.e. you had 7 hit points left, that Goblin attacked you with his rusty sword and got a hit. He rolls a 1d10 and gets a 7, you get to exactly 0 and fall unconscious.) You are down and can't do anything, but you are not bleeding. This is really rare, though... If instead you receive a blow that would get you a negative number of hit points, 5e does not consider the character as having negative his points. Instead, if you take too much damage, you can die outright and if you do not die outright, you have to make Death Saving Throws and your Hit Points are at zero... so two different states with the same amount of Hit Points, like in 4e. If you succeed the Death Saving Throws, you stay at zero Hit Points but are considered stabilized.


There are many different ways that you can die.

As mentioned above, taking more damage than you have Hit Points will eventually kill you.

A huge blow can kill you outright.

A certain number of spells, such as the Petrification, Power Word Kill, and Disintegrate kill you if you fail your Saving Throw(s).

In Fifth Edition, the Petrification gives you two chances! If you miss your first Saving Throw, you get paralyzed on the first round you are hit, and if you succeed your second Saving Throw, you go back to normal.

In some cases, you die because you can't breath (teleported in a rock, your underwater and you lose your ring of underwater breathing...)

You can also die of exhaustion, although in most cases, you can avoid that one (and well... maybe someone else dies instead since you get there late.)

When an undead that can transform you in its own kind, such as a Vampire or a Shadow, gets you unconscious or kills you outright, then you are transformed. Some don't see that as death... but remember that while you are a Vampire or some other undead, you can't be resurrected.

Traps can kill too. Once I had a whole team enter a chamber. Only one small door to go in. They decided to stay in for a little while not noticing that it was very cold. They froze and were all trapped in that room, dead. I've read a similar story where a whole group of characters all jumped through a portal to realize that once on the other side they were being disintegrated.

There are a few other types of death when you start playing in the Planes. There you can be transformed in various types of aimlessly wandering souls. In many cases you will be 100% under the control of another creature living on that Plane. These are just dangerous, even more than a dungeon with a gelatinous cube eating you alive with its acidic juices.

Necrotic Damage Drain

Introduced in Dungeons & Dragon Fifth Edition, the Necrotic Damage Drain reduces the maximum number of hit points of the victim.

This is somewhat similar to losing a level, without actually losing a level. (See Energy Level Drain below, old editions used to make you lose levels!) More or less, it makes you weak while you are in that battle and until you get a long rest or receive a magical cure, a Greater Restoration Spell. This is a 5th level spell so your Cleric needs to be level 9 to be able to cast the spell while on an adventure.

Although this is much better, you still have other really bad things when hit by undead. Shadows transform you to shadows, mummy curse you and give you rotting diseases, vampires transform you into vampires. Pretty much the usual undead most unpleasant side effects.

Note that only powerful undead such as Vampires and Wraight will lower your Maximum Number of Hit Points. If you get hit by a Zombie, you can get healed normally with a first level Healing Word Spell.

Energy Level Drain (The Horrible —)

In Original Dungeons & Dragons and Advanced Dungeons & Dragons 1e and 2e, many undead were able to suck your energy out of you with one hit (an instant bite!)

Depending on the version, they could suck one (Wraight) or two (Vampires) levels out of you.

This drain of energy level meant that you would lose all that you gained at your last level... This included:

  • Hit Die—so in effect you lost Hit Points; this is one other reason you wanted to keep track of your per level hit points
  • Spell Abilities—if you earned spell slots and learned new spells, those are all but gone now
  • Combat Abilities—you could do two attacks? Well... you're back to one now and you still have to kill that damn Vampire which, by the way, regenerates on each round
  • Experience Points (XP)—losing a level meant reseting your experience point to the start of the previous level (so if the new level where you are now requires 5,001 XP, you get back to 5,001)
  • Etc.

This was really horrible. Needless to say, we would avoid such creatures like a real plague! It was really hard to kill a Vampire and if it were to drain your energy, it was TWO levels gone. The problem was not so much the loss of the levels in itself, but the fact that all of a sudden you were not powerful enough to beat the Vampire in the first place! Not to mention that the Vampire would transform to mist to escape once it reached 0 hp anyway. In other words, you would not have killed it. And you'd have to go adventuring some more to regain those two levels before coming back and finishing him off, eventually. Argh!

Third Edition eased the loss by introducing a saving throw. At the same time, they also introduced an ability that drain 2d4 energy levels! This ability drains you of your levels only 24 hours later, so if you're lucky you will get healed before the drain itself happens, but 2d4 levels??? Even if you succeed with half of your saving throws... What kind of madness was that?

Forth Edition did completely away with such.

As we've seen earlier, Fifth Edition uses permanent Necrotic Damage that reduces the maximum number of hit points until healed with a powerful spell or after a long rest.

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