Medium undead, neutral evil

Armor Class 12 (natural armor)
Hit Points 78 (12d8 + 24)
Speed 0 ft., fly 30 ft. (hover)

17 (+3) 10 (+0) 15 (+2) 8 (-1) 13 (+1) 12 (+1)

Saving Throws Con +4, Wis +3
Damage Immunities poison
Condition Immunities blinded, charmed, deafened, exhaustion, frightened, poisoned, prone
Senses blindsight 60 ft. (blind beyond this radius), passive Perception 11
Languages understands the languages of its creator but can’t speak
Challenge 4 (1,100 XP)


  • Blood Bearer. A creature that subsists on blood, such as a vampire, can use its action while within 5 feet of the ortifex to drain blood from it. The creature can drain up to the ortifex’s current temporary hp, regaining hp equal to that amount. The ortifex then loses temporary hp equal to that amount.
  • Blood Sense. The ortifex can pinpoint the location of creatures that aren’t constructs or undead within 60 feet of it and can sense the general direction of such creatures within 1 mile of it.
  • Hypnotic Heartbeat. A creature that can hear the ortifex’s heartbeat and starts its turn within 60 feet of the ortifex must succeed on a DC 13 Wisdom saving throw or be charmed until the start of its next turn. While charmed, it is incapacitated and must move toward the ortifex by the most direct route on its turn, trying to get within 5 feet of the ortifex. It doesn’t avoid opportunity attacks, but before moving into damaging terrain, such as lava or a pit, it can repeat the saving throw, ending the effect on a success. Unless surprised, a creature can plug its ears to avoid the saving throw at the start of its turn. If the creature does so, it is deafened until it unplugs its ears. If the creature unplugs its ears while still within range of the ortifex’s heartbeat, it must immediately make the saving throw.


  • Slam. Melee Weapon Attack: +5 to hit, reach 5 ft., one target. Hit: 7 (1d8 + 3) bludgeoning damage plus 7 (2d6) necrotic damage.
  • Blood Siphon (Recharge 6). The ortifex drains blood from nearby creatures. Each creature within 20 feet of the ortifex must make a DC 13 Constitution saving throw, taking 14 (4d6) necrotic damage on a failed save, or half as much damage on a successful one. The ortifex gains temporary hp equal to the single highest amount of necrotic damage dealt. If it gains temporary hp from this action while it still has temporary hp from a previous use of this action, the temporary hp add together. The ortifex’s temporary hp can’t exceed half its hp maximum. A creature that doesn’t have blood is immune to Blood Siphon.


A large, rotting heart floats forward, its hypnotic heartbeat echoing all around it.

Vampiric Hunters. An ortifex’s singular purpose is to absorb blood from living creatures. When seeking blood, it disorients victims with an ominous, hypnotic heartbeat, then magically siphons their blood, leaving behind a shriveled carcass.

Harvested from Giants and Dragons. Only large hearts can be made into ortifexes, which are typically created from the hearts of giants, dragons, and particularly large beasts. Necromancers who create ortifexes for vampiric clients pay well for a sizeable heart, especially if it is minimally decomposed.

Agents of Oppression. When a blood cult, necromancer, or intelligent undead wants to demoralize a village or demand a sacrifice, it often sends an ortifex to collect payment in blood.

Undead Nature. An ortifex doesn’t require air, food, drink, or sleep.

Section 15: Copyright Notice

Tome of Beasts 2. © 2020 Open Design LLC; Authors Wolfgang Baur, Celeste Conowitch, Darrin Drader, James Introcaso, Philip Larwood, Jeff Lee, Kelly Pawlik, Brian Suskind, Mike Welham.

This is not the complete section 15 entry - see the full license for this page