Death Saving Throws 5e rules

The rules text from Damage and Healing in the SRD 5.1 (the 2014 rules), with the rules around it and the numbers worked out.

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.

Falling Unconscious

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.

Death Saving Throws

Whenever you start your turn with 0 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. You are in the hands of fate now, aided only by spells and features that improve your chances of succeeding on a saving throw.

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 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.

Rolling 1 or 20. When you make a death saving throw and roll a 1 on the d20, it counts as two failures. If you roll a 20 on the d20, you regain 1 hit point.

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. If the damage equals or exceeds your hit point maximum, you suffer instant death.

Stabilizing a Creature

The best way to save a creature with 0 hit points is to heal it. If healing is unavailable, the creature can at least be stabilized so that it isn't killed by a failed death saving throw.

You can use your action to administer first aid to an unconscious creature and attempt to stabilize it, which requires a successful DC 10 Wisdom (Medicine) check.

A stable creature doesn't make death saving throws, even though it has 0 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

Most GMs 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 GM might have them fall unconscious and follow the same rules as player characters.

Knocking a Creature Out (from Damage and Healing)

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.

The odds

Worked out from the rules above, for a creature at 0 hit points that nobody helps and nothing damages:

Outcome	Chance
Rolls a 20 and regains 1 hit point	18.1%
Three successes: stable at 0 hit points	41.4%
Three failures: dies	40.5%

Any healing, even 1 hit point, ends the saves at once. Spare the Dying stabilizes without a check, and so does a healer’s kit.

How death saving throws work

When damage drops you to 0 hit points and doesn’t kill you outright, you fall unconscious. At the start of each of your turns you make a death saving throw: roll a d20, and 10 or higher is a success. Three successes and you’re stable; three failures and you die. They don’t need to be in a row.

A natural 20 means you regain 1 hit point and wake up. A natural 1 counts as two failures. Taking any damage at 0 hit points is one failure, and a critical hit is two, and any attack that hits an unconscious creature from within 5 feet is a critical hit. Any healing at all brings you back up and resets both counts to zero.

Massive damage skips all of this: if the damage left over after you hit 0 equals or exceeds your hit point maximum, you die instantly.

Keeping someone alive

Heal them. Any healing, even 1 hit point, is better than stabilizing. Healing Word is the classic answer because it’s a bonus action from 60 feet.
Stabilize them. With no healing, use your action for a DC 10 Wisdom (Medicine) check, spend a use of a healer’s kit, or cast Spare the Dying. A stable creature stops rolling, stays unconscious, and regains 1 hit point after 1d4 hours unless it takes damage.
Get them out of reach. A melee hit on a downed ally is two failures at once. Moving the enemy away from them, or standing over them, can matter more than your own attack.
If it goes wrong, Revivify brings back a creature that died in the last minute.

What changed in 2024

The death saving throw itself works the same way in the 2024 rules: 10 or higher succeeds, three of either ends it, a 1 is two failures, a 20 brings you back with 1 hit point, and damage at 0 hit points costs a failure (two for a critical hit). Spare the Dying now works at 15 feet instead of by touch, and its range grows as you level.

Common questions

What happens if you roll a 20 on a death save?

You regain 1 hit point, which ends the unconscious state, so you wake up and can act on that same turn.

What happens if you roll a 1 on a death save?

It counts as two failures. Two 1s, or a 1 and one other failure, kills you.

What happens if you take damage at 0 hit points?

You suffer one death saving throw failure, or two if it’s a critical hit. Melee hits from within 5 feet of an unconscious creature are automatically critical hits. If the damage equals or exceeds your hit point maximum, you die outright.

Do bonuses to saving throws help death saves?

Yes. A death save isn’t tied to an ability, but anything that adds to saving throws in general applies, like Bless, a Cloak of Protection or a paladin’s Aura of Protection.

Do death saving throws reset?

Both successes and failures reset to zero when you regain any hit points or become stable. If you drop to 0 again later, you start from scratch.

Do monsters make death saving throws?

Usually not. Most DMs have monsters die at 0 hit points, keeping death saves for important villains and NPCs.

Death saves compared with related rules

Rule	How it compares
Spare the Dying	A cantrip that makes a creature at 0 hit points stable, no check needed. Stops the rolls but doesn’t wake it up.
Healing Word	Any healing ends the death saves and wakes the creature up, and this does it with a bonus action from 60 feet.
Death Ward	The first time damage would drop the target to 0 hit points, it drops to 1 instead. Prevention instead of cure.
Periapt of Wound Closure	You stabilize automatically at the start of your turn whenever you’re dying.
Revivify	For when the third failure comes: brings back a creature that died within the last minute with 1 hit point.