Last Updated on January 22, 2023
Welcome to our guide to death saving throws in Dungeons & Dragons 5e.
In this guide, we’ll go over the rules of this mechanic, as well as how some different abilities and spells that interact with death saves.
Because there’s every chance you’re reading this article while your favorite character is (figuratively) bleeding before your eyes, you can use the contents sections to jump right into the rules below.
Otherwise, let’s get started.
“The kobold swings its knife at you and…” The DM winces. “It crits. Ok…” She rolls 2d4 and adds 2. She winces again. “You take, uh, 10 points of piercing damage.”
The Wizard falls to the ground, blood spreading from a grievous wound in his chest. His eyes close. This was supposed to be an easy job. A walk in the park. One poorly planned rescue attempt and a few unlucky rolls later, and now the Wizard and the Rogue are unconscious.
The Fighter (who has no healing abilities and a -1 to Medicine checks) is surrounded. The Rogue asks, “So, are we dead?”
Well, maybe.
In Dungeons & Dragons 5e, dropping to or below 0 hit points isn’t necessarily the end of the line.
While it’s unlikely that a higher level character will get downed outside of a climactic boss fight, lower level D&D can feel much more like a survival horror game than heroic fantasy, as characters with fewer than 10 hit maximum points grapple with all manner of nasty dungeon dwellers, fiendish traps, and knife-wielding bandits.
What happens when a player character drops to 0 hit points or below? It’s time for one of two things to happen.
First of all, if the damage you take is enough to bring you far enough below 0 hit points to exceed your maximum HP, you die outright. For example, if a character with a max HP of 10 is at 2 HP and takes 13 points of damage, their hit points are reduced to -11 HP, killing them instantly.
There are also a few spells, like Power Word Kill, which can cause instant, inescapable death.
Otherwise, it’s time to start rolling death saves.
How to Make a Death Saving Throw
When your character drops to 0 hit points but doesn’t die, they fall unconscious. This unconsciousness ends if you regain any hit points.
Whenever you begin a turn in combat with 0 hit points or fewer, the DM will call on you to make a death saving throw. This special type of save determines whether your character inches closer to permanent death or hangs onto life.
Unlike other checks and saving throws, you don’t apply your modifiers to a death save.
Roll a d20. On a 10 or higher, you succeed, taking one more step towards the light. On a 1-9, you fail, and the darkness tightens its grip on you.
If you begin your next turn with 0 hit points, you make another saving throw.
If you accumulate three successful death saving throws before you accumulate three failures, your character is no longer in danger of dying and becomes stable.
A stable character remains unconscious at 0 hit points, unless it takes any more damage or is healed, and will regain consciousness and 1 hitpoint after 1d4 hours.
When you become stable or return to consciousness, all your failed and successful death saves reset.
If you accumulate three failed death saves, your character shuffles off their mortal coil and is truly dead. Turn in your character sheet.
You don’t need to make successful or failed death saves consecutively; you just need to reach three of one result over, at the most, six rolls.
However, in the frantic melee of a D&D combat, things are rarely that simple.
Crits, Fumbles, and other Concerns
There are a few special rules that can affect the outcome of death saving throws.
Crits. If you roll a natural 20 on a death saving throw, your character surges back to consciousness. You immediately regain 1 hit point and can act again as normal – although the first thing you may want to do is to crawl away while trying to look as inconspicuous as possible.
Fumbles. If you roll a 1 on a death saving throw, you mark two failures instead of one.
Taking Damage at 0 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 critical hit, you suffer two failures instead.
It’s also worth noting that, in 5e, any melee attack that hits an unconscious or incapacitated target is made at advantage and, if it hits, is an automatic critical. If the damage you suffer equals or exceeds your hit point maximum, you die instantly.
Medicine Checks. If no one has access to healing spells, any player can attempt to stabilize a dying character by making a Medicine check with a DC of 10.
Death Saves Outside of Combat. There are no specific rules for making death saves outside of the initiative order, although you can try the following…
If a player drops to 0 hit points outside of combat, you can roll initiative and have the players act in turn, making death saves, medicine checks, and casting healing spells until the player regains consciousness or dies.
This can be a slow process and, if there’s a healer in the party, it’s impossible (even if the dying player rolls a natural 1) that they would fail enough saves before being healed.
The alternative is that, if the party has no healing abilities, the player with the highest Medicine proficiency can make a check (at advantage if another player with proficiency helps them).
If that check fails, the dying player makes death saving throws in quick succession until one result is reached.
Spells and Abilities
From healing charms to instant-kill curses, there are a number of abilities, feats, and spells that can affect the outcome of a player dropping to 0 hit points. We’ve broken down how some of these features interact with death saves below.
Spare the Dying
Level: Cantrip
Range: Touch
Cast Time: 1 Action
Duration: Instantaneous
School: Necromancy
Classes: Cleric, Artificer
You touch a living creature that has 0 hit points. The creature becomes stable. This spell has no effect on undead or constructs.
This cantrip can be – quite literally – a life saver. The value of being able to have your party’s healer negate the need for death saving throws altogether (assuming they can get close enough to touch the dying party member) is immense.
Remember, however, that Spare the Dying won’t bring a downed party member back into the fight, just prevent them from succumbing to their injuries. Having this cantrip in your back pocket, however, makes for a fantastic last resort.
Lay on Hands
Class: Paladin
HP Pool: 5 x Paladin Level
Range: Touch
Duration: Instantaneous
As an action, you can touch a creature and draw power from the pool to restore a number of hit points to that creature, up to the maximum amount remaining in your pool.
A lot of inexperienced players are wont to throw out their entire Lay on Hands HP pool in a single big heal.
However, the true value of this class feature is that you can dispense as little as 1 HP at a time, meaning that a 1st level Paladin can potentially bring a dying player back into the fight five times. A 2nd level Paladin can do this ten times! Just make sure you can actually get to your downed ally in time.
Bardic Inspiration
Class: Bard
Die Size: d6 at 1st level. The die becomes a d8 at 5th level, a d10 at 10th level, and a d12 at 15th level.
Cast Time: Bonus Action
Duration: 10 Minutes
As a bonus action, choose one creature other than yourself within 60 feet of you who can hear you. That creature gains one Bardic Inspiration die, a d6.
Once within the next 10 minutes, the creature can roll the die and add the number rolled to one ability check, attack roll, or saving throw it makes.
There aren’t many ways to affect the results of a death saving throw, but Bardic Inspiration (due to the fact the rules state it can be used on any saving throw) is one of them.
It’s worth noting, however, that because granting Bardic Inspiration needs the recipient to be able to hear the Bard granting it, a downed character must have already had an unused Bardic Inspiration die before they were reduced to 0 hit points.
Some DMs rule that being dropped to 0 hit points doesn’t render you unconscious, merely unable to move, in which case that character could still receive bardic inspiration.
Bane
Level: 1st
Range: 30 ft
Cast Time: 1 Action
Duration: 1 Minute
School: Enchantment
Classes: Bard, Cleric (Grave Domain), Paladin (Oath of Vengeance).
Up to three creatures of your choice that you can see within range must make Charisma saving throws. Whenever a target that fails this saving throw makes an attack roll or a saving throw before the spell ends, the target must roll a d4 and subtract the number rolled from the attack roll or saving throw.
Like the cruel mirror to Bardic Inspiration, Bane causes you to subtract 1d4 from all saving throws (including death saves) for a minute. Watch out for this nasty spell – a favorite of necromancers and evil mages everywhere.
Power Word Kill
Level: 9th
Range: 60 ft
Cast Time: 1 Action
Duration: Instantaneous
School: Enchantment
Classes: Bard, Sorcerer, Warlock, Wizard
You utter a word of power that can compel one creature you can see within range to die instantly. If the creature you choose has 100 hit points or fewer, it dies. Otherwise, the spell has no effect.
This is one of the most devastating spells in a BBEG’s arsenal, and can make for a truly gut-wrenching moment if a DM decides to pull it out. Unless your party’s spellcaster has a sufficiently beefy Counterspell up their sleeve, someone with fewer than 100 hit points is going to die and there is nothing you can do about it.
You have been warned.
It’s also worth noting that the Disintegrate spell also kills you outright if it reduces you to 0 HP.
Lucky (Feat)
You have inexplicable luck that seems to kick in at just the right moment.
- You have 3 luck points. Whenever you make an attack roll, an ability check, or a saving throw, you can spend one luck point to roll an additional d20. You can choose to spend one of your luck points after you roll the die, but before the outcome is determined. You choose which of the d20s is used for the attack roll, ability check, or saving throw.
- You can also spend one luck point when an attack roll is made against you. Roll a d20, and then choose whether the attack uses the attacker’s roll or yours. If more than one creature spends a luck point to influence the outcome of a roll, the points cancel each other out; no additional dice are rolled.
- You regain your expended luck points when you finish a long rest.
Like with Bardic Inspiration, anything that lets you affect the outcome of a saving throw also applies to death saves. The other cool thing with this feat is that it lets you reroll an attacker’s d20 roll as well. Keeping in mind that, if you’re unconscious, attacks made against you have advantage and automatically crit, being able to make it a little harder for a goblin to gut you where you lie is no bad thing.
Common Questions About Death Saving Throws
I played my first tabletop RPG (Pathfinder 1e, specifically) in college. I rocked up late to the first session with an unread rulebook and a human bard called Nick Jugger. It was a rocky start but I had a blast and now, the better part of a decade later, I play, write, and write about tabletop RPGs (mostly 5e, but also PBtA, Forged in the Dark and OSR) games for a living, which is wild.
Forgot that Paladin’s Aura of Protection affects death saves as well
1. Why no mention of the humble Healer’s Kit? It allows stabilizing a creature that has 0 hit points without needing to make a Wisdom (Medicine) check.
2. Resistance, the Cantrip. It gives +1d4 on all saving throws – which includes death saving throws. Works for sure if the cantrip is cast before the victim goes down, but since the only condition is that the target is ‘a willing creature’ and even the souls of dead creatures must be willing to be brought back to life—according to the Dungeon Masters Guide—I would argue that unconscious creatures can still be willing and thus be a valid target for the cantrip.