D&D 5E (2014) Popular death/dying house rules in 2026?

[zakael19]

I agree with this. I built my system 15 years ago with this in mind. It is freeing. But I still think Daggerheart still got it wrong. (We are currently in a Daggerheart campaign.)

There still needs to be a consequence. Consequences build suspense. If I, as a player, just get to choose my consequence, and one of my options are I go unconscious and nothing really happens, then it's a moot mechanic.

The GM is supposed to work with the player to show how things get worse as a PC drops. That can be all sorts of things: the adversaries are emboldened by the sight of a fallen hero; a NPC is endangered or killed because the PC isn’t there to help them; the villain has a chance to achieve their objective or take advantage of the opening to flee; etc.

 

[Sorcerers Apprentice]

No death saves, characters die when they hit 0 HP.

Maybe not a popular house rule per se, but it's how we've been running the latest campaign

 

[greymist]

I have three death-related house rules:

1. All death saves are known only to player and DM - reduces meta-gaming by the other players.
2. When a PC starts their turn unconscious, they gain a level of exhaustion.
3. Each level of exhaustion causes -2 to attacks, saves, and spell DCs; and -5 ft movement.

 

[Scott Christian]

The GM is supposed to work with the player to show how things get worse as a PC drops. That can be all sorts of things: the adversaries are emboldened by the sight of a fallen hero; a NPC is endangered or killed because the PC isn’t there to help them; the villain has a chance to achieve their objective or take advantage of the opening to flee; etc.

Yes, I know they are supposed to work together. But the player can still choose to not have any lasting mechanical consequences. Narratively, it works very well. I like it from a narrative perspective. But some of the suspense is removed without the mechanical consequence.
(Sorry if my original post wasn't clear regarding that.)

 

[TerraDave]

No death saves, characters die when they hit 0 HP.

Maybe not a popular house rule per se, but it's how we've been running the latest campaign

And how is it going?

 

[touc]

We're trying these out (currently up to level 6).

Death saves secret. Other players should not know whether you succeed or fail.

Zero Hit Points, slowed condition. If at 0 HP and healed above 0 HP, until the end of your next turn, you are affected as if by the Slow spell (nonmagical, cannot be removed, cannot be negated by Haste, can stack with Slow magic): 1/2 speed, -2 AC, -2 Dex saves, can’t take reactions, on turn can only take an Action or Bonus action, only attacks once with Attack action, spells with somatic (S) component 25% to fail.

Lingering Injuries (BAM Lingering Injuries, DM Guild). You receive a lingering injury based on the damage type received when you (1) take massive damage, (2) fail a death save by 5 or more, or (3) drop to 0 hit points for the third time in an encounter. The injury is randomly applied with a 1d6 roll after the combat encounter ends based on the damage type that triggered the lingering injury. Cantrips or minor effects (DM discretion) are a 1d3 roll instead. You only get the first triggered injury, not multiple ones, per combat.

 

[dave2008]

I don't remember if there's been any change in 5.5e on death saves, but I think the question applies to both 5e and 5.5e DMs.

Are you using any house rules on PC deaths (mainly on dying by loss of HP) and what is your reason for them?

If you have also tried other house rules previously, feel free to tell why you didn't stick with them.

We have used death at 0 BHP (bloodied hit points) since about 2016 and still use it today.

I do think @mearls changes to death and dying in his 5e derivative Moldavy are interesting. IIRC, basics are you can still act while making death saves. That makes it much more dangerous and likely to get to 3 failed saves and true death if you are not careful. I am sure there are other nuances I am not remembering.

 

[Retreater]

Yes, I know they are supposed to work together. But the player can still choose to not have any lasting mechanical consequences. Narratively, it works very well. I like it from a narrative perspective. But some of the suspense is removed without the mechanical consequence.
(Sorry if my original post wasn't clear regarding that.)

I can see what you mean. I haven't applied this idea to D&D 5E yet. My thought experiment with it would be a chance at a permanent disadvantage in one of your ability scores. What that chance is, I don't know. Maybe 50%?

 

[mearls]

We have used death at 0 BHP (bloodied hit points) since about 2016 and still use it today.

I do think @mearls changes to death and dying in his 5e derivative Moldavy are interesting. IIRC, basics are you can still act while making death saves. That makes it much more dangerous and likely to get to 3 failed saves and true death if you are not careful. I am sure there are other nuances I am not remembering.

Thanks! I started using it in my games last summer, and it stuck on well enough that I've been using it since.

I've included the full rules below under a spoiler tag. The TL;DR - you remain conscious at 0 HP and while making death saves. You make a death save each time you take damage. Three failed saves, and you die. You remove failed death saves with long rests, 1 per rest in the wild and 2 per rest in civilization.

Spoiler: Moldvay Death and Dying Rules

Dropping to 0 Hit Points​

When a creature drops to 0 hit points, it is vulnerable to dying or might die outright. An attack that reduces you to 0 hit points, and any damage you suffer while at 0 hit points, reflects an actual injury that could lead to death.

Instant Death​

Here are the main ways a creature can die instantly.

Monster or NPC Death. A monster or NPC dies the instant it drops to 0 hit points. Optionally, the DM can instead give the creature the dying condition.

Hit Point Maximum of 0. A creature dies if its hit point maximum reaches 0. Certain effects drain life energy, reducing a creature’s hit point maximum.

Death Saves. You die immediately if you gain a third failed death save.

Dying​

If you are reduced to 0 hit points and are not killed, you are dying and must make a death save (described below). While you are dying, you can still act. However, additional damage can kill you and you need to make death saves. You are no longer dying if your hit points increase above 0. Alternatively, you can choose to fall unconscious.

Falling Unconscious. When you are reduced to 0 hit points, you can choose to fall unconscious due to the shock and pain. You are unconscious and dying until you complete a short rest. During that time you do not make death saves on your turn but still make death saves when you take damage. Only an effect that removes unconsciousness can bring you back to action. Healing works as normal but does not wake you up. Otherwise, you regain consciousness when you finish a short or long rest.

Death Saves. You make a death save in three situations:

When you take damage that reduces you to 0 hit points.

When you begin your turn with 0 hit points and are dying.

Each time you take damage while you have 0 hit points and are dying.

Roll a d20 to make a death save, a special type of saving throw that does not use an ability modifier.

If you roll a 20 on the d20, you regain hit points equal to half your maximum hit points.

If the roll is 10 or higher, you gain a successful death save.

If the roll is less than 10, you gain a failed death save.

If you roll a 1 on the d20, you gain a failed death save and are dazed on your next turn.

While you have any failed death saves, you are obviously injured. You move gingerly and wince when others jostle you.

Three Successful Death Saves. When you gain your third successful death save, you immediately regain hit points equal to your level.

Three Failed Death Saves. When you gain your third failed death save, you die. If you gain it during your turn, you die at the end of your turn but cannot regain hit points that turn.

Losing Successful Death Saves. You lose all successful death saves when you are no longer dying.

Losing Failed Death Saves. You lose some, but potentially not all, failed death saves when you finish a long rest.

Other Ways to Gain Death Saves. Some special effects, such as traps, might inflict failed death saves. These effects typically bypass your hit points by striking when you are helpless or otherwise unable to defend yourself.

 

[mearls]

FWIW, I've found in play that this rule makes hitting 0 hit points really tense. In my last in-person game, an evil illusionist hit the party with a prismatic blast that dropped everyone to 0 HP. It made the last round of combat incredibly tense, as the PCs started piling up failed death saves. It also keeps everyone involved. Being at 0 feels a lot more perilous than having only a few HP left.