Injury and the risk of death are constant companions of those who explore fantasy gaming worlds. The thrust of a sword, a well-placed arrow, or a blast of flame from a fireball spell all have the potential to damage, or even kill, the hardiest of creatures.
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.
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 seemingly possible to deal 0 damage, but an attack will always deal at least 1 damage, and 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.
For a full breakdown of the various types of damage that exist in Dungeons & Dragons, see Damage Types.
Creatures can also be affected by damage in different ways, taking more or less damage from particular sources, or no damage at all! These special circumstances are discussed here, under Damage Resistance, Vulnerability, and Immunity.
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 modifiers as normal. To speed up play, you can roll all the damage dice at once.
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.
When you drop to 0 hit points, you either die outright or fall unconscious, as explained in the following sections.
¶ Instant Death
Massive damage can kill you instantly. When damage reduces you to 0 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 0 hit points, but 12 damage remains. Because the remaining damage equals her hit point maximum, the cleric dies.
If damage reduces you to 0 hit points and fails to kill you, you fall unconscious. This unconsciousness ends if you regain any hit points.
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 considered stable. Normally, you cannot choose to knock a creature out using ranged attacks unless a rule specifies otherwise, or the DM chooses to allow it.
Creatures rendered unconscious due to being at 0 hit points immediately begin dying unless stabilized and starts making Death Saving Throws on each of their turns. below.
¶ Monsters and Death
Most DMs have a monster die the instant it drops to 0 hit points, rather than having it fall unconscious and make Death Saving Throws.
Mighty villains and special nonplayer characters are common exceptions; the DM might have them fall unconscious and follow the same rules as player characters.
Unless it results in death, damage isn't permanent. Even death is reversible through powerful magic. Rest can restore a creature's hit points, and magical methods such as a cure wounds spell or a potion of healing can remove damage in an instant.
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. 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 8.
A creature that has died can't regain hit points until magic such as the revivify spell has restored it to life.
Additionally, there are some spells, features, and items that can grant a creature Temporary Hit Points. Temporary hit points aren't actual hit points; they are a buffer against damage, a pool of hit points that protect you from injury and are always removed first when a creature with Temporary Hit Points takes damage.
Character death often becomes no more than a minor inconvenience in some campaigns. Once an adventuring party reaches a certain level, the spells available to return fallen comrades from the afterlife—including revivify, raise dead, and resurrection— make death no more than a temporary setback, potentially undermining one of the most significant elements of danger and threat in the campaign story.
For players and DMs who wish to elevate the gravity of character death, the optional rules in this section offer three different approaches.