At some point in your D&D game, your character is bound to find themselves dropping to zero hit points.
Whether it’s because of a dastardly trap, fierce enemy, or the dice just deciding that they don’t want to be nice to you today, it’s wise to know what happens next!
Dropping to Zero Hit Points Doesn’t Mean Death… Usually
In Dungeons & Dragons 5e, dropping to zero hit points doesn’t always mean that your character is dead. While there are a few circumstances that do result in instant death, we’ll cover those a bit later.
In most cases, though, dropping to zero hit points means that your character is unconscious and bleeding out. In this state, you are on the ground and cannot move (hence the whole unconscious thing…)
Receiving healing allows you to stabilize and regain consciousness.
You Don’t Go Below Zero Hit Points
Let’s say you have 5 hit points. You’re standing your ground and attempting to continue fighting off the gnolls that are attacking your group.
One of the creatures readies its spear and lunges at you. As the spear pierces through you, you take 8 damage and fall unconscious on the ground.
In previous editions like 3.5, you would be at -3 hit points.
However, dropping to zero hit points in D&D 5e stops at 0.
Because of this, even a single point of healing is enough to get you back on your feet.
Death Saving Throws
When your character is at zero hit points, they are at death’s door. Unless they get some healing, they are entirely in the hands of fate.
Death saving throws are made at the beginning of the character’s turn. Unlike other saving throws, there is no bonus from ability modifiers to this roll.
Roll a d20. If the result is a 10 or higher, it counts as one success. If the result is less than 10, it counts as a failure. You want to get three successes to cling on to life and become stable. If you get three failures, your character dies. It doesn’t matter what order these successes or failures come in.
It is possible to have a critical success or a critical failure on your death saves.
On a roll of 1, you take two failures instead of the normal one.
If you roll a 20, you instantly recover with 1 hit point.
The odds of fate are slightly in your favor with death saving throws, but the stakes are still high!
Stabilizing a Character at Zero Hit Points
A character that is at zero hit points but is stable does not have to make death saving throws.
Sometimes you may find yourself in a situation where there is no healing available. Maybe the party has used all of their healing potions and none of the conscious members have healing magic.
There are still some ways to stop the character from dying!
Spare the Dying is a great “just in case” cantrip that comes in handy in moments like this. While it doesn’t provide healing, it takes no spell resources to cast and instantly stabilizes the target.
If nobody has Spare the Dying, a character can attempt to make a DC10 Wisdom (Medicine) check to use first aid and stop the bleeding.
While the stabilized character is still at zero hit points and unconscious, at least they have staved off death until another day.
Taking Damage When You’re Unconscious
A character can still take damage when they’re unconscious.
Some particularly brutal enemies may see an unconscious character and use this as an opportunity to dogpile them even if other characters are still standing.
In this case, the enemy would roll their melee attack against the downed character with advantage. If the enemy is within 5 feet of the downed character, any attack that connects counts as a critical hit.
If the unconscious character takes damage, it counts as a failed death save. (This would most likely be due to an area-of-effect spell.)
If the enemy gets a critical hit, it counts as two failed death saves.
If the attack causes the unconscious character to take damage that is equal to or greater than their maximum hit points, they die.
When Zero Hit Points Means Instant Death
There are a few occasions in which dropping to zero hit points in D&D 5e means instant death.
Because of the relative ease in picking a character up from zero hit points with a spell like Healing Word, these situations cause the pendulum of fate to swing the other direction.
A character may take overwhelming massive damage that instantly kills them.
For example, your party is making their way through a dungeon when they hear that familiar and ominous “click” of a trap being activated. Everyone looks back in horror to see that the bard has accidently stepped on a pressure plate trap.
The bard is currently at 6 hit points out of his maximum 12. The trap rolls damage for a total of 18. The bard is engulfed in flames from the trap as he takes 6 damage to fall to zero hit points. However, the 12 remaining points of damage are equal to his maximum hit points. In this case, the bard has died.
If the trap had instead rolled for 17 damage, the bard could still be saved as the remaining 11 points of damage does not equal or exceed his maximum hit points. He is at zero hit points and making death saving throws until he is healed or stabilized.
Similarly, any damage you take that is equal to or greater than double your character’s maximum hit points will instantly kill them.
Some spells can cause a character to instantly die upon dropping to zero hit points.
Disintegrate is a particularly nasty and infamous example of this.
A character who fails their Dexterity saving throw against a Disintegrate spell takes a punishing amount of damage that reduces them and their non-magical items to ash if it causes them to drop to zero hit points.
Beholders are notorious for killing characters with Disintegrate. No death saves. No resurrection without a 9th level spell like Wish or True Resurrection. No non-magical loot for your friends to scavenge off of your still-warm body.
It’s hard to put it any other way: instant-death spells are brutal.
There are several creatures with the ability to instantly kill a character.
Some, such as Wights or Wraiths, have life drain abilities that reduce their victims’ maximum hit points. When the character’s maximum hit points are reduced the zero, they are instantly killed. (Though in these cases, that’s just the tip of the iceberg…)
Will-O’-Wisps similarly have the ability to instantly kill a character who has dropped to zero hit points. Their Consume Life ability lets them instantly kill their target while regaining their own hit points.
But some creatures prefer to do the deed quickly.
Mind Flayers have a tentacle attack that grapples and stuns their victims. With the character unable to fight back, the Mind Flayer extracts their brain for a colossal 10d10 damage. If this is enough to reduce the character to zero hit points, they are killed outright as the Mind Flayer devours their brain.
It’s a lot harder to die in Dungeons & Dragons 5e than it was in previous editions. But that doesn’t mean you should let your guard down!
You never know when you’re going to find yourself without a healing spell or getting overrun by hungry beasts.
Good luck and may your death saves be ever in your favor!