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Let's suppose a player character wants (at least) an additional hand & arm in order to, for example, wield a shield while using a two-handed weapon, or to wield a two-handed weapon while still being able to grapple with a free hand. Is there a way for said character to gain an additional hand...

  1. Temporarily? (wild shape, polymorph, etc.)

  2. Permanently? (mutation, curse, magic item, etc.)

I know that a GM can houserule anything he desires, but I'm seeking an answer relying on existing material.

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Wild shape and polymorph are limited to Beasts, most of which have no usable hands at all, let alone three or more. Shapechange could turn you into a Marilith or some such, but it's a self-only spell, so unless you're a caster who can manage a 9th level spell, it's off the table too, but True Polymorph is an option -- still, that is again a 9th level spell, so not available until you're very high level, and you'd be stuck with the new form's combat stats for the duration (which may be lower than your normal form's by that point).

I'm not aware of any official effects that could add an arm, or even a prehensile tail, permanently.

Honestly? An animated shield (DMG p151 or 5e SRD) might be the easier solution.

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    \$\begingroup\$ @Conduit added link to my answer \$\endgroup\$ Commented Dec 1, 2017 at 17:57
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    \$\begingroup\$ Personally I always prefer SRD links (when available) :) \$\endgroup\$
    – Conduit
    Commented Dec 1, 2017 at 17:59
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    \$\begingroup\$ @GaelL Dancing sword, then? But seriously, I know what you're getting at, there's just not really a way to do that in RAW. I created an item a while back to do something like this -- it can't do shield, but it can use a light weapon -- and it wasn't even powerful enough to be particularly rare. It just hasn't been done officially. \$\endgroup\$ Commented Dec 1, 2017 at 18:03
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Aside from the proverbial "mad wizard", there are limited options. True Polymorph is the most straightforward option, being turned permanently into a: Thri-Kreen, Girallon, Chitine, Draegloth, Glabrezu, or Marilith. As far as I know, that's the only method by the RAW that works.

Otherwise, you're stuck trying to persuade your DM to bend/break the rules to (a) let you reincarnate as a Thri-Kreen, or (b) wildshape or polymorph into a Girallon. If you start as a winged race (Aarakocra, Winged Kobold, etc.), your basic arrangement of limbs includes six, so you might try to talk your DM into letting a character of one of those races use Alter Self to become a Thri-Kreen or Girallon, making the wings into extra arms.

Chitines and Draegloths are both created by arcane Drow magic involving fusion of humanoids, spiders, and demons -- maybe your DM would let you research/discover something along those lines.

Demon magic -- becoming a Fiend Warlock and/or otherwise making a pact or selling your soul to become a Glabrezu or Marilith.

All of this stuff but the True Polymorph is firmly in the realm of homebrewing with your DM. Anything is possible with magic, and a willing DM.

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You could get a wizard to cast true polymorph on you, turning you into a marilith. Mariliths are CR 16, which isn't too shabby and might well be better than your normal fighter form.

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As far as I'm aware, 5e has no direct solution. Using an animated shield as stated in another answer is certainly viable, but doesn't solve grappling.

That said, if you are willing to homebrew a bit... 3.5e does have a solution. The solution is "Grafts." Long story short, additional/replacement body parts, functioning along the same rules as magic items. These include arms, wings, legs, tentacles, eyes, etc.

The different types of grafts are spread across various sourcebooks, depending on which type you want, but just researching 3.5e Grafts for a bit will get you some preliminary results and references (there is one place with a full detailed list, actually, but I'm uncertain if I can list it here).

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