Your character hits zero hit points, falls unconscious, and suddenly every roll is a coin toss with your life. That's how death saving throws work: a special saving throw rolled on a plain d20 at the start of each of your turns until you stabilize, wake up or die. It's for players whose character just went down and DMs ruling edge cases. This guide covers the 2014 Player's Handbook and SRD 5.1 rules, exact odds, and the edge cases that start arguments at our table.
What happens at 0 hit points
When damage drops you to zero hit points, one of two things happens. Either you die instantly or you start falling unconscious and making death saving throws.
Instant death from massive damage
If the damage takes you to zero hit points and there is damage left over, compare what's left to your hit point maximum. If the remainder equals or exceeds your hit point maximum, you die on the spot. No rolls.
Say a wizard with a hit point maximum of 12 has 6 current hit points and takes 18 damage. The first 6 damage take her to zero hit points, and the leftover damage carries past zero: 12 points. That equals her maximum, so it's instant death. One point less and she'd be dying instead of dead. This massive damage rule mostly bites at low levels, when a creature's hit point maximum is small.
Falling unconscious
If you survive the hit, the creature drops to 0 hit points and falls unconscious.
Hit points represent physical and mental durability. You remain unconscious until you're healed or stabilize and wake later. While unconscious you can't move or act, you drop what you're holding, attacks against you have advantage, and any attack that hits you from within 5 feet is a critical hit.
No negative hit points
Fifth edition has no negative hit points. You can't go below 0. Older editions tracked a count down to -10, and some groups still house rule it, but by the book your current hit points stop at zero, and negative damage past that point only matters for the instant death check. Other rules in older books worked differently, so check which edition a forum answer is quoting.
How death saving throws work
At the start of each turn while you're dying, roll a d20. The creature stops rolling only when it stabilizes, wakes or dies. This is making death saving throws in its simplest form. No ability score, no ability modifier and no proficiency bonus are added. Death saving throws aren't tied to any ability score, unlike other saving throws.
- 10 or higher: one success.
- 9 or lower: a failure.
- Natural 1: two failures.
- Natural 20: you regain 1 hit point and wake up.
Collect three successes and you become stable. On the third failure, the character dies.
The marks don't need to be in a row. A third success after a couple of misses still stabilizes you.
Resetting the count
Your successes and failures reset to zero the moment you regain hit points or become stable. So if you go down again in the same fight, the death saving tally starts clean. That reset is why getting healed by even 1 hit point matters so much.
Taking damage at 0 hit points
Damage taken at 0 hit points is an automatic failed death save, even with no death saving throws rolled. Failed death saving throws from damage stack with the ones you roll.
If that damage comes from a critical hit, it counts as two failures. The attacker still rolls the attack's damage dice twice, but on a dying character the damage rolls barely matter. Only the hit counts. And if the damage equals or exceeds your hit point maximum, you die outright.
Any melee attack that hits an unconscious creature from within 5 feet is a critical hit, as long as the attack roll lands. One sword swing at a dying creature counts as double. One failure already on the sheet plus that hit means the character dies.
Death saves: survival odds
We computed these by enumerating every sequence of d20 rolls. On a single death saving throw:
| Result | Faces | Chance |
|---|---|---|
| Regain 1 hit point (natural 20) | 20 | 5% |
| Success | 10 to 19 | 50% |
| Failure | 2 to 9 | 40% |
| Two failures (natural 1) | 1 | 5% |
So each roll succeeds 55% of the time counting the natural 20. From a fresh start with no help, here is how it plays out:
| Starting tally | Stabilize | Wake on a 20 | Character dies |
|---|---|---|---|
| 0 successes, 0 failures | 41.4% | 18.1% | 40.5% |
| 1 success, 0 failures | 59.5% | 14.0% | 26.5% |
| 0 successes, 1 failure | 27.5% | 14.3% | 58.3% |
| 1 success, 1 failure | 45.0% | 11.5% | 43.5% |
| 0 successes, 2 failures | 12.5% | 8.8% | 78.8% |
| 2 successes, 2 failures | 50.0% | 5.0% | 45.0% |
Left completely alone, a character at 0 hit points survives about 59.5% of the time.
That sounds fine until you notice that a pair of failures on the sheet pushes the death chance near 79%. You can check single-roll odds on our dice probability calculator and roll your saves on the d20 roller.
Becoming a stable creature
A stable creature doesn't keep making death saving throws. It stays at zero hit points and stays unconscious. If it takes damage, it stops being stable and starts making death saves again from a clean tally.
Ways to stabilize
- Three death saving throw successes.
- A Medicine check, DC 10, made as an action by someone next to you. This is first aid in game terms.
- The spare the dying cantrip.
- A healer's kit, which stabilizes without a check.
Waking up after stabilizing
If nobody heals a stable creature, it regains 1 hit point after 1d4 hours. Until then, it remains unconscious. It isn't dead.
Healing a dying creature
Any healing that restores hit points ends the dying state at once. A creature that regains hit points wakes up with those hit points regained, and its death saving tally resets.
Cure wounds, healing word and a potion all count for any creature. Hit dice don't help here, because you spend them on a short rest, never mid-fight. No short or long rest happens mid-fight, and a long rest is hours away. Hit points regained always start from zero, never from a negative count.
Temporary hit points don't save you
Receiving temporary hit points while dying does not restore consciousness or stabilize you. Temporary hit points are a buffer, not actual hit points.
They don't add to your current hit points, so you stay down and keep dying. The only true healing is healing that restores real hit points.
Receiving temporary hit points still helps a little: the temporary hit buffer absorbs damage first, so a hit that would cause a death saving throw failure might be soaked. If a spell grants temporary hit points to the whole party, a dying character can absorb a stray arrow. Only one instance of temporary hit points applies at a time; they don't stack.
Healing beyond the maximum
Healing can't push you above your hit point maximum. A character with a maximum of 30 who gets healed for 50 wakes up with 30, not more hit points than that.
Edge cases at the table
Area damage on a dying creature
When an area spell's damage hits someone who is down, it counts as one instance of damage, so one failure. Creatures caught in a fireball at zero hit points mark one failure from the spell's fire damage, not one per die, and the other damage dice don't add anything.
Mixed damage doesn't change that. Flame strike deals fire and radiant damage, but the damage type count is irrelevant: one spell, one mark. Multiple instances of damage, such as three separate attacks, each cause their own failure.
Damage over time
An effect that deals damage at the start of a turn, like a magical aura of necrotic damage, causes a failure each time. That is how a downed hero can creep closer to death. The spell tells you when the damage happens; check it.
Damage equals or beats the maximum while dying
If a creature at zero hit points takes damage equal to or greater than its hit point maximum, it dies instantly.
Bonuses to the roll
Death saves have no relevant ability modifier, but relevant modifiers that apply to every saving throw do apply. Bless adds a d4. A paladin's Aura of Protection adds the paladin's Charisma modifier to other saving throws in range, death saves included. Class features that add to every save, such as a monk's Diamond Soul proficiency, add the same modifier here too.
If the attack involves advantage, that's for attacks against you, not your death saves.
Monsters and death saves
By default, monsters die at 0 hit points. A DM can let important NPCs roll, but when a creature takes damage that drops it to zero, it usually just dies.
Why the rule exists
Dying in 5e is slow and tense on purpose. The party gets a few turns to react, so one bad roll can't erase a character. It's not real life, but life feels on the line.
How to run death saves
A good table habit: the dying player rolls in the open and the whole party watches. Track failures with tokens or our death saves tracker, so nobody forgets.
A single failure and the cleric starts running. If you have more questions on rolling at 0 hit points, our FAQ covers the basics, and our guide to saving throws explains every other save in the game.
2024 rules changes
The 2024 Player's Handbook keeps the core death saving loop: d20, 10 or higher, three of either, with the same natural 1 and natural 20 rules. The odds above still apply.
Quick reference
- Drop to 0 hit points: fall unconscious, or die if the overflow reaches your hit point maximum.
- Roll a d20 each turn: 10 or higher succeeds.
- Natural 1: two failures. Natural 20: regain 1 hit point.
- Three successes: stable. Three failures: dead.
- Damage while down: a failure. Critical hit: double.
- Any healing ends it.