Last Updated: September 26, 2021
It’s a simple fact of adventuring that you character will take damage at some point, and they may even die. Even the toughest and most skilled adventurers run the risk of untimely death.
Injuried in Dungeons and Dragons are approximated by damage and hit points. This is a vague approximation of real-world injury, but it saves us the tedium of tracking things like individual injuries, broken bones, and blood loss. Crippling long-term injuried like losing a limb are exceptionally rare, and generally only occur as a plot point or because some strange creature has the specific ability to cause them.
Hit points aren’t necessarily a representation of a creature’s ability to be stabbed repeatedly. Hit points measure a combination of stamina, mental durability, will to live, and a bit of luck. Taking damage might be represented as minor injuries, near misses, or gradual exhaustion as the creature continues to fight. You’re free to narratively represent hit points however you like in your game.
Hit points in Dungeons and Dragons work the same way that you might expect from any number of video games: Creatures each have a “Hit Point Maximum” which represents that creature’s ability to suffer damage without dying. A creature’s current hit points (typically just called “hit points”) can be any number up to the creature’s hit point maximum and down to 0. This number changes frequently as creatures suffer damage and heal, sometimes multiple times in a single round.
Whenever a creature takes damage, subtract the damage from the creature’s current hit points. Losing hit points has no effect on the creature until it drops to 0 hit points. A creature’s hit points can never fall below 0.
Sometimes, applying damage to a creature is slightly more complicated. If the creature has effects which subtract a flat number from the damage taken, such as the Heavy Armor Master feat. Next, if the creature has immunity to the type of damage take, the damage is negated. If it has resistance to the damage type, the damage is halved. If it has vulnerability to the damage type, it is doubled. Finally, if if the creature has any temporary hit points (see below) subtract the damage from those hit points first. Any remaining damage is then applied to the creature’s current hit points.
Temporary Hit Points
Some spells and special abilities confer temporary hit points to a creature. Temporary hit points aren’t actual hit points: they are a buffer against damage, a pool of hit points that protect you from injury.
When you have temporary hit points and take damage, the temporary hit points are lost first, and any leftover damage carries over to your normal hit points. For example, if you have 5 temporary hit points and take 7 damage, you lose the temporary hit points and then take 2 damage.
Because temporary hit points are separate from your actual hit points, they can exceed your hit point maximum. A character can, therefore, be at full hit points and receive temporary hit points.
Healing can’t restore temporary hit points, and they can’t be added together. If you have temporary hit points and receive more of them, you decide whether to keep the ones you have or to gain the new ones. For example, if a spell grants you 12 temporary hit points when you already have 1O, you can have 12 or lO, not 22. Usually you want to take the larger number, but some effects provide temporary hit points alongside other benefits, and the other benefits end when the pool of temporary hit points which they provide expire.
If you have O hit points, receiving temporary hit points doesn’t restore you to consciousness or stabilize you. They can still absorb damage directed at you while you’re in that state, but only true healing can save you.
Unless a feature that grants you temporary hit points has a specifiedduration, the temporary hit points last until they’re depleted or you finish a long rest.
Each weapon, spell, and harmful ability specifies the damage it deals. You roll the damage die and add modifiers as specified by the weapon, spell, or ability, and you apply the damage to your target. The target then adjusts the damage to account for damage vulnerabilities, resistances, and immunities, as well as other effects which might alter the damage which the creature takes, then subtracts the damage from their current hit points.
When you make an attack with a weapon, you roll the weapon’s damage die or dice and you add your ability modifier (the same one which you added to the attack roll). For example: An attack with a greatsword deals 2d6 damage + your Strength modifier, while an attack with a longbow deals 1d8 damage + your Dexterity modifier.
A spell will tell you what damage to roll and whether to add any modifiers. If a spell does not specify that you add your ability modifier to the damage, you don’t add any ability modifiers to the damage. For example: The spell fire bolt deals 1d10 damage when cast by a 1st-level character. No ability modifiers are added to this damage.
If the spell or other effect deals damage to more than one target at the same time, roll the damage once for all of the targets. For example, when a Wizard casts fireball or a Cleric casts flame strike, the spell’s damage is rolled once for all creatures caught in the blast.
When you score a critical hit, you get to roll extra dice for the attack’s damage against the target. Roll all of the attack’s damage dice twice and add them together. Then add any relevant numeric modifiers (like your ability modifer) as normal. To speed up play you can roll all the damage dice at once; you don’t need to roll them once, count them up, then roll them all again.
Extra dice include any damage applied by the attack, including Sneak Attack, Divine Smite, and similar abilities. If the extra damage allows a saving throw to resist it (like poison damage from a giant spider’s bite), the damage isn’t multiplied.
For example, if you score a critical hit with a dagger, roll 2d4 for the damage, rather than 1d4, and then add your relevant ability modifier. If the attack involves other damage dice, such as from the rogue’s Sneak Attack feature, you roll those dice twice as well.
Damage comes in different “damage types”. For most humans, this won’t matter: damage is damage. However, some creatures respond to damage differently due to immunities, resistances, and vulnerabilities.
- Acid. The corrosive spray of a black dragon’s breath and the dissolving enzymes secreted by a black pudding deal acid damage.
- Bludgeoning. Blunt force (hammers, falling, constriction, etc.) deals bludgeoning damage.
- Cold. The infernal chill radiating from an ice devil’s spear and the frigid blast of a white dragon’s breath deal cold damage.
- Fire. Red dragons breathe fire, and many spells conjure flames to deal fire damage,
- Force. Force is pure magical energy focused into a damaging form. Most effects that deal force damage are spells, including magic missile and spiritual weapon.
- Lightning. A lightning bolt spell and a blue dragon’s breath deal lightning damage.
- Necrotic. Necrotic damage, dealt by certain undead and spells such as chill touch, withers matter and even the soul.
- Piercing. Puncturing and impaling attacks, including spears and monsters’ bites, deal piercing damage.
- Poison. Venomous stings and the toxic gas of a green dragon’s breath deal poison damage.
- Psychic. Mental abilities such as a mind flayer’s psionic blast deal psychic damage.
- Radiant. Radiant damage, dealt by a cleric’s flame strike spell or an angel’s smiting weapon, sears the flesh like fire and overloads the spirit with power.
- Slashing. Swords, axes, and monsters’ claws deal slashing damage.
- Thunder. A concussive burst of sound, such as the effect of the thunderwave spell, deals thunder damage
While some damage types seem like opposites, like cold and fire or necrotic and radiant, this has no in-game effect. Damage of different types does not negate damage of any other type.
Damage Immunity, Resistance, and Vulnerability
Some creatures respond differently to specific types of damage, like a skeleton breaking more easily when dealt bludgeoning damage or a red dragon being immune to even the hottest flames.
Immunity to a damage type completely negates any damage of that type dealt to the creature. Immunity is considered before resistance and vulnerability. If a creature somehow has immunity and vulnerability to a damage type at the same time, it still negates the damage.
If a creature or an object has resistance to a damage type, damage of that type is halved against it. If a creature or an object has vulnerability to a damage type, damage of that type is doubled against it. While rare, it’s possible for a creature have both resistance and vulnerability to the same damage type. For example: A white dragon might be under the effect of protection from energy.
Multiple instances of immunity, resistance, or vulnerability that affect the same damage type do not stack. For example, a tiefling wearing a ring of fire resistance still only has resistance to fire damage.
Unless damage kills you, it isn’t permanent. And in a game with numerous magical options for raising the dead, even death isn’t permanent. Creatures can regain hit points by resting (see Resting, earlier in this guide), by using special abilities like the Fighter’s Second Wind feature, by magical methos like the spell cure wounds, and by drinking potions of healing.
When a creature receives healing of any kind, hit points regained are added to its current hit points. A creature’s hit points can’t exceed its hit point maximum, so any hit points regained in excess of this number are lost. For example, a druid grants a ranger 8 hit points of healing by casting the spell cure wounds. If the ranger has 14 current hit points and has a hit point maximum of 20, the ranger regains 6 hit points from the druid, not the full 8, and the remaining 2 hit points are lost.
A creature that has died can’t regain hit points until magic such as the revivify spell has restored it to life. Dead creatures remain at 0 hit points until they return to life.
Dropping to 0 Hit Points
Dropping to 0 hit points means a brush with death. You might recover almost instantly and rise triumphantly to fight again, you might die slowly over the next several rounds, or you might simply die outright if you take enough damage at the same time.
The official rules are conspicuously lacking any consoling words on the matter, so allow me to break up the flood of rules information with a little but of emotion:
Death is rarely fair. It’s usually untimely, and it can happen to anyone at seemingly any time. Dungeons and Dragons is no different, and the added risk of fighting eldritch horrors from beyond the stars does little to extend your character’s life expectency. Even the most beloved characters often meet their ends in ways that can feel random and insignificant after a lifetime of saving the world from all manner of dangers.
It’s important not to take character death personally. The Dungeon master rarely sets out with the intent to kill the players, but sometimes a bad roll of the dice or an honest mistake can lead to a dead character. I’ve lost plenty of characters over the years, many of which I was emotionally attached to. Fear of loss makes something precious. If you’re unfortunate enough to lose a character, just remember not to take it personally. Even the most pointless, frustrating death is still taking place in a game run by someone who is likely your friend, and no matter how awful it may feel, they’re not out to get you.
Plus, once you’re high enough level you can find someone to cast Raise Dead to bring a dead character back to life. All things considered, death in 5th edition Dungeons and Dragons is a fairly minor setback once you’ve reached a high enough level and saved enough gold to buy enough diamonds to cast the spell raise dead.
Massive damage can kill you instantly. When damage reduces you to O hit points and there is damage remaining, you die if the remaining damage equals or exceeds your hit point maximum.
For example, a cleric with a maximum of 12 hit points currently has 6 hit points. If she takes 18 damage from an attack, she is reduced to O hit points, but 12 damage remains. Because the remaining damage equals her hit point maximum, the cleric dies.
If damage reduces you to O hit points and fails to kill you, you fall unconscious (see Conditions, later in this guide). This unconsciousness ends if you regain any hit points (at which point you regain consciousness) or if you die.
Death Saving Throws
Whenever you start your turn with O hit points, you must make a special saving throw, called a death saving throw, to determine whether you creep closer to death or hang onto life. Unlike other saving throws, this one isn’t tied to any ability score, so you don’t add an ability modifier. You are in the hands of fate now, aided only by spells and features that improve your chances of succeeding on a saving throw, such as the spell bless.
Roll a d20 If the roll is 10 or higher, you succeed. Otherwise, you fail. A success or failure has no effect by itself. On your third success, you become stable (see Stabilizing a Creature, below). On your third failure, you die. The 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 (see Stabilizing a Creature, below).
Roll 1 or 20
When you make a death saving throw and roll a natural 1, it counts as two failures. If you roll a natural 20, you regain 1 hit point. As normal, this returns you to consciousness and resets your death saving throw successes and failures to 0.
Damage at O Hit Points
If you take any damage while you have 0 hit points, you suffer a death saving throw failure. If the damage is from a criticai hit, you suffer two failures instead. If the damage equals or exceeds your hit point maximum, you suffer instant death as described above under “Instant Death”.
Stabilizing a Creature
Sometimes an ally will fall to 0 hit points, and like a good friend you probably want to save them rather than leaving them to their fate. Remember: a natural 1 on a death saving throw or a few hits from an enemy can immediately end your friend’s life, so there is rarely time to delay when their life is on the line.
The best way to save a creature with 0 hit points is to heal it, most commonly by using magic like the spells cure wounds and healing word. If healing is unavailable, the creature can at least be stabilized so that it isn’t killed by a failed death saving throw, at which point you can get them out of danger and either wait for them to recover or seek healing.
To stabilize a creature, you can use your action to administer first aid to an unconscious creature. Make a Wisdom (Medicine) check against a DC of 10. If you succeed, the creature is stabilized. If you have a Healer’s Kit, you can use it to stabilize a creature without making an ability check. The cantrip spare the dying will also stabilize a dying creature.
A stable creature doesn’t make death saving throws, even though it has O 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.
Monsters and Death
Usually when anyone except a player character is reduced to 0 hit points, they simply die. Tracking death saving throws for fallen monsters quickly becomes tedious, especially in encounters with numerous enemies, and enemies surviving a fight with the party after being reduce to 0 hit points is a rare exception.
In the case of NPCs or major villains, the DM might make an exception, choosing to have them fall unconscious using the same rules that apply to the player characters.
Knocking a Creature Out
Sometimes an attacker wants to incapacitate a foe, rather than deal a killing blow. When an attacker reduces a creature to 0 hit points with a melee attack, the attacker can knock the creature out. The attacker can make this choice the instant the damage is dealt. The creature falls unconscious and is stable.
You cannot choose to knock a creature out with a ranged attack or with a spell or special ability which does damage in an area.