Elemental, Blood

Family: Elementals

Large elemental, neutral

Armor Class 14 (natural armor)
Hit Points 95 (10d10 + 40)
Speed 30 ft.

16 (+3) 13 (+1) 18 (+4) 5 (-3) 10 (+0) 5 (-3)

Damage Vulnerabilities poison
Damage Resistances acid, fire; bludgeoning, piercing, and slashing from nonmagical attacks
Damage Immunities necrotic, psychic
Condition Immunities exhaustion, grappled, paralyzed, petrified, poisoned, prone, restrained, unconscious
Senses darkvision 60 ft., passive Perception 10
Languages Primordial
Challenge 5 (1 ,800 XP)

Special Traits

  • Coagulate. Each time the elemental takes cold damage, its speed is reduced by 10 feet until the end of its next turn.
  • Destroyed by Water. If the blood elemental becomes entirely submerged in water, it dissipates and dies instantly.
  • Liquid Form. The elemental can enter a hostile creature’s space and stop there. It can move through a space as narrow as 1 inch wide without squeezing.


  • Multiattack. The elemental makes two slam attacks.
  • Slam. Melee Weapon Attack: +6 to hit, reach 5 ft., one target. Hit: 12 (2d8 + 3) bludgeoning damage.
  • Blood Drain (Recharge 4-6). Each creature in the elemental’s space must make a DC 15 Constitution saving throw. On a failure, a creature takes 10 (3d6) necrotic damage and, if it is Large or smaller, it is grappled (escape DC 13). A grappled creature is restrained and unable to breathe. If the saving throw is successful, the creature is pushed out of the elemental’s space. The elemental can grapple one Large creature or up to two Medium or smaller creatures at one time. At the start of the elemental’s turn, each target grappled by it takes 10 (3d6) necrotic damage. A creature within 5 feet of the elemental can use its action to make a DC 15 Strength check, freeing a grappled creature on a success. When Blood Drain deals 30 or more necrotic damage, the elemental grows in size as though affected by an enlarge/reduce spell. This increase in size lasts until the blood elemental finishes a long rest.


A swirling, bubbling, ambulatory glob of blood the size of a hogshead cask lurches forward. Native to a lake of churning blood on an abyssal plane, blood elementals aren’t typical elementals.

Blood mages seem able to retain tiny blood elementals as familiars or guardians of some kind, though the exact nature of their bond is a mystery they guard jealously. Many small sects of blood cultists seem to learn the secret, leading some savants to believe that this knowledge is freely shared by priests of Marena and similar dark gods.

Drawn to Life. A blood elemental is drawn to movement and absorbs whatever living creatures it finds, increasing its size and power in the process. Though feeding is not necessary to sustain themselves, blood elementals, over time, will shrink unless they consume living creatures. However, their need for prey is relatively slight-once a week to maintain their size.

Blood Summoning. Offerings of blood and blood magic spells draw blood elementals from their planar homes, with the proper ritual. They also sometimes follow in the wake of certain demons and devils, devouring entire bodies in a matter of hours.

When a blood elemental feeds, it first removes all liquids, then liquefies and consumes the remaining flesh, and finally sucks out the marrow, leaving behind only dry, reddish bones.

Elemental Nature. The blood elemental doesn’t require air, food, drink, or sleep.

Section 15: Copyright Notice

Creature Codex. © 2018 Open Design LLC; Authors Wolfgang Baur, Dan Dillon, Richard Green, James Haeck, Chris Harris, Jeremy Hochhalter, James Introcaso, Chris Lockey, Shawn Merwin, and Jon Sawatsky.

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