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Say that a character has 5 HP remaining and is dealt 10 damage from an attack. Of course, 5 - 10 = -5, so the character has dropped below 0 Hit Points and follows the rules for making death saving throws (provided they didn't get dealt enough damage for instant death). However, it's not clear to us if the character remains at -5 Hit Points or if they bounce back up to 0 Hit Points (like many rules in 5e, knowledge of past editions may be a hindrance to interpreting them).

If negative Hit Points exist, then characters will take longer to recover naturally (since stable characters recover at a rate of 1 HP per 1d4 hours). Also, a natural 20 on a death saving throw, which recovers one Hit Point, would not make them instantly conscious. Finally, it would mean that instant death is a greater possibility, as you need less to reach the threshold if you are attacked again.

However if negative Hit Points do not exist and characters bounce up to 0 after crossing the 0 HP threshold, then characters will always regain 1 HP and become conscious after waiting 1d4 hours or rolling a natural 20 on a death saving throw. Also, this would mean that instant death is far less likely because someone who attacks an unconscious character would always need to deal maximum HP damage or they don't kill you (and if they don't, then I guess their damage means nothing, which seems rather odd).

Unfortunately, the example provided with the basic rules isn't helpful because it describes someone taking enough damage for instant death, but not someone who got less than that. Furthermore, the rules describe "Dropping to 0 Hit Points", but not "Dropping Below 0 Hit Points" and seems to omit what happens when you take more damage than the HP you have remaining, but less than enough for Instant Death. Our group spent a while debating this when we played from the Starter Edition and we weren't sure given that some previous versions of D&D had them while others didn't. So do negative hit points exist or do characters "bounce up to 0 HP"?

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"someone who attacks an unconscious character would always need to deal maximum HP damage or they don't kill you (and if they don't, then I guess their damage means nothing, which seems rather odd)." - I've not read the rules in question but presumably by what you've said any further hit that does even one point of damage will take them below 0 and thus trigger another death saving throw or similar. So while the magnitude of the damage may not be relevant the hit is still relevant. –  Chris Jul 22 at 14:46
    
"Also, this would mean that instant death is far less likely because someone who attacks an unconscious character would always need to deal maximum HP damage or they don't kill you (and if they don't, then I guess their damage means nothing, which seems rather odd)." - Not true. If you take damage while at zero Hit Points, you automatically accrue failed Death Save. A critical hit at zero Hit Points accrues two Death Saves. –  Neil B Jul 23 at 9:53

4 Answers 4

up vote 27 down vote accepted

According to the Basic PDF (page 74)

A creature's current hit points (usually just called hit points) can be any number from the creature's hit point maximum down to 0.

So no, negative hit points do not exist in 5e. The archived development-poll blog post "A Close Call with Negative Hit Points" explains the history of negative hit points and part of the reasoning for the change in 5e.

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I see that I have unknowingly answered this very question another place on the Internet. My answer takes the form of a flowchart, hope that's ok. I'll drop it here in the hope that it can shed additional light on the whole below-zero-hp-case in D&D 5e.

enter image description here

(It's CC BY-NC-SA 4.0, feel free to print, revamp and redistribute)

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D&D 5th edition doesn't have the concept of negative hit points. When you run out of hit points you have zero left; at that point dying is modelled by death saving throws and the instant death from damage rule.

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Negative hit points don't exist per se, however the concept does remain to a certain extent.

From 5e PHB (page 197):

Instant Death

Massive damage can kill you instantly. When damage reduces you to 0 hit points and there is damage remaining, you die if the remaining damage equals or exceeds your hit point maximum.

In other words, if you drop to negative hit points equal to your hit point total you die right away.

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This doesn't involve negative hit points at any stage. The calculation is simply that if you receive damage, and you are at or hit 0, take the remainder: if it's >= your maximum health, you die. (If it isn't, nothing special happens here: your hit points are still 0.) No concept of negative hit points is invoked at any point during that calculation. –  doppelgreener Aug 20 at 14:01
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@doppelgreener It's conceptually related. And in D&D, its heritage is in fact directly related. –  aramis Sep 27 at 18:08

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