Ghoul, Gravid

This horrid creature walks upon the hands and legs of a female humanoid body bent over backward, its spine painfully creased at an acute angle. Protruding from its flaccid, torn abdomen sits an infant-sized creature with a two-foot-long, bright-red tongue that constantly bathes its gaunt, pallid flesh in sanguine fluids scooped from the cavity in which it sits.

Chaotic evil Medium undead

Armor Class 11
Hit Points 60 (11d8 + 11)
Speed 30 ft., climb 20 ft.

16 (+3)12 (+1)12 (+1)7 (-2)12 (+1)16 (+3)

Saving Throws Dex +3, Wis +3
Condition Immunities exhaustion, fright, poison, unconsciousness
Languages Common
Skills Perception +3, Survival +3
Senses darkvision 60 ft.
Challenge 3 (700 XP)


  • Multiattack. The gravid ghoul bites twice and attacks once with its tongue.
  • Bite. Melee Weapon Attack: +5 to hit (reach 5 ft.; one creature). Hit: 1d6 + 3 piercing damage, and the creature must make a successful DC 11 Con saving throw or contract ghoul fever (see below).
  • Tongue. Melee Weapon Attack: +5 to hit (reach 10 ft.; one creature). Hit: 1d4 + 3 piercing damage plus 2d6 psychic damage, and the creature must make a successful DC 11 Con saving throw or contract ghoul fever (see below).

Special Traits

  • Blood Frenzy. A gravid ghoul that drops a foe to 0 hit points gains 10 temporary hit points and continues attacking the dying creature until that foe is dead. Until its foe is dead, the gravid ghoul’s AC is reduced by 2.
  • Diseased Exudate. The flesh of a gravid ghoul constantly seeps disease-ridden fluid. Any creature that strikes the gravid ghoul from a range of 5 feet or less, or comes into physical contact with the gravid ghoul, must make a successful DC 11 Con saving throw or contract ghoul fever (see below).
  • Ghoul Fever. A creature that contracts ghoul fever must make a DC 11 Con saving throw every time it completes a long rest. If the saving throw fails, the creature gains 1 level of exhaustion; if it succeeds, there is no effect. A creature can’t recover from exhaustion by resting while it has ghoul fever; the disease must be cured with lesser restoration or comparable magic first. A humanoid that dies from ghoul fever transforms into a ghoul moments after its death.
  • Smell Blood. The gravid ghoul has advantage on Perception checks to detect injured creatures and on Survival checks to track injured creatures.
  • Stress Mind. The very sight of a gravid ghoul instills a sense of anxiety in living creatures. Upon seeing a gravid ghoul within 60 feet, a creature with Intelligence 3 or higher must make a successful DC 13 Wis saving throw or be frightened for 1d6 rounds. If the saving throw succeeds or after the fright ends, the creature is immune to this effect for 24 hours.


Environment Any land
Organization solitary or gang (2–4)

The gravid ghoul is an undead creature of the foulest nature. In the darkest alleys of inner cities, there are humanoids who will pay for the touch and bed of an undead creature. Whether out of fascination, fetish, or illness of the mind, these couplings on occasion have been known to develop into a gravid ghoul. The ghoul harlot typically is unaware of its pregnancy until it is far too late. The fetal ghoul that grows inside the undead mother awakens with blood lust and the hunger of a newborn. The only warning the ghoul mother receives is an increase in its own feeding instinct and a slight swelling of the midsection before the small ghoul-thing bursts from the mother’s abdomen. The newborn creature sits within the gaping cavity of the mother’s broken body, which is folded in half in a backbend to serve as a perch and means of mobility for the offspring. Despite its appearance as vehicle and driver of a sort, the offspring and mother are a single creature and cannot be separated without destroying both.

The new gravid ghoul awakens not only with a terrible hunger, but with a terrible intelligence as well. Through the umbilical attachment, it can access its mother’s husk and what’s left of her mind, devouring her memories and controlling her body’s movements. It perches atop the ruined remains of the body and makes use of her arms and legs in spider-like movements to walk and climb. The rigors of its indelicate control often fracture the bones of the mother’s limbs, creating joint articulations that were never meant to be, but the controlling offspring cares little and finds its movements unimpeded by these injuries. The controlling offspring and the lolling, idiot head of the mother sport the same terrible grin of razor-sharp teeth. The gravid ghoul’s fetal skin tissue is dry and cracked. It uses its tremendously long, bright-red tongue to bathe itself in its mother’s bloody, rotting fluids.

The flesh of the fetal portion of a gravid ghoul is fragile and requires constant bathing in the moisture of its womb-perch to avoid drying out. However, in a dry environment, this is insufficient to maintain the tissue’s requirements, causing it to desiccate and crack. If a gravid ghoul does not have access to a moist environment for more than 1 hour (a place that is foggy or has open puddles of water is sufficient to meet its needs), it begins drying out painfully. More than an hour of drying out shuts down the ghoul’s Diseased Exudate ability until it reaches another source of moisture.

A gravid ghoul stalks the night looking for prey. They tend to venture into sewer networks, better to keep out of sight and in the shadows. The wet nature of sewer systems helps the gravid ghoul to keep its fetal-self moist.

Section 15: Copyright Notice

The Tome of Blighted Horrors, © 2016, Frog God Games, LLC; Authors John Ling, Authors Richard Pett, Pete Pollard, Alistair Rigg, Jeffrey Swank, and Greg A. Vaughan.

Additional Credit Author Jeffrey Swank.