How Hit Points Work in D&D 5e: HP, Healing, and Dying

26 March 2026

You took a greataxe to the “shoulder” and you’re somehow still standing, and that bothers people until they remember what hit points are in fifth edition: a composite of toughness, luck, and narrative durability, not a literal wound ledger. Learning HP means knowing when you’re fine, when you’re lying there counting failures, and when the game skips the drama and declares you dead.

If you want the combat frame around attacks, start at how combat works; if you’re caster-focused, pair recovery with spell slots.

Starting HP (level 1)

At 1st level, your hit point maximum is:

Hit Die maximum + Constitution modifier

Hit Die by class (baseline):

• d12 — Barbarian
• d10 — Fighter, Paladin, Ranger
• d8 — Bard, Cleric, Druid, Monk, Rogue, Warlock
• d6 — Sorcerer, Wizard

Example: Fighter (d10 max) + Con +3 → 13 HP at level 1.

Leveling up (later HP)

Each level after 1, you gain one Hit Die roll’s worth of HP, or the fixed average your class offers, plus Constitution modifier each time.

You choose roll-or-average each level in the normal rule (tables vary; ask your DM if they mandate average).

Temporary hit points (the buffer that isn’t healing)

Temporary hit points soak damage first.

Key habits:

• They don’t stack by adding pools: if you have temp HP and gain more, you decide whether to keep your current pool or take the new one (whichever fits your situation, usually you pick the higher number).
• Healing still repairs real HP underneath, temp HP aren’t “missing HP you can Cure Wounds.”
• Many sources expire on rests unless the feature says otherwise, track them separately.

Healing (common sources)

• Potions — standard Potion of Healing is 2d4 + 2; drinking is often an action unless a rule lets you chug faster.
• Spells — cure wounds, healing word, later mass tools; pay attention to action economy (healing word is famously bonus action).
• Hit Dice on a short rest, spend dice, roll each, add Con mod, heal that much (until dice run out).
• Long rest — regains all lost HP (and returns some spent Hit Dice—half your total, rounded down).

Rest details live in short rest vs long rest.

Dropping to 0 HP (the drama floor)

When damage reduces you to 0 HP, you fall unconscious (and start dying rules for PCs unless a rule says otherwise).

Death saving throws

At start of your turns while 0 HP and dying, roll a d20:

• 10+ → one success
• 9 or lower → one failure
• Natural 1 → two failures
• Natural 20 → regain 1 HP and wake

Three successes → stable at 0 HP (unconscious, no longer failing).
Three failures → dead.

These aren’t normal saving throws, you don’t add modifiers unless a feature explicitly allows it.

Damage while down

If you take damage at 0 HP: usually one failed death save; critical hits against you while unconscious count as two failures (attacker within 5 feet).

Massive damage

If damage reduces you to 0 and leftover damage equals or exceeds your hit point maximum, you die immediately.

Healing while down

Any healing that brings you above 0 wakes you, often prone, which costs half movement to stand.

Stabilizing without magic

An action can attempt Wisdom (Medicine) DC 10 to stabilize a dying ally, no HP yet, but safe from death saves unless hurt again. A stable creature at 0 HP typically wakes with 1 HP after 1d4 hours unless tended.

Practical survival you can actually do

• Track temp HP separately, don’t pencil it into “current HP” without thinking.
• Hand potions before someone goes to 0 if your table allows item sharing rules you agree on.
• Know your party’s bonus-action heal, speed saves lives more than raw throughput sometimes.

See also

AC is the other defensive pillar: armor class. Concentration is the “don’t lose the buff” pillar: concentration.