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In discussions for exhaustion (like this one or this one), bandwidth is spent on what happens if exhaustion would exceed six levels.

The definition of exhaustion also says:

An effect can give a creature one or more levels of exhaustion, as specified in the effect’s description.

However, I was not able to find any effect that would add more than one level of exhaustion at a time in the core rules. Is there any published effect (from a spell, magic item or monster, or any other source) that is able to do this?

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2 Answers 2

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Be tired and thirsty

There's a weird little rule tucked away in the food and water rules in the PHB (Chapter 8 > The Environment > Food and Water) which says that if you already have any exhaustion, you suffer two levels of it from lack of water.

If the character already has one or more levels of exhaustion, the character takes two levels [of exhaustion].

Run yourself into the ground

This requires a bit more setup and lands into a slightly ambiguous territory, but using the chase rules from the DMG (Chapter 8 > Chases) it's possible to gain two levels (or more) at the end of your turn. In short, if you've already taken a bunch of dashes in that chase, each one you take forces a Con save with failure gaining you an exhaustion level at the end of your turn. So, if you Dash twice on a turn (eg. rogue, monk, fighter) you will be subjected to two such saving throws, for as many levels of exhaustion.

There's some ambiguity as to how simultaneous this is. Both levels are gained at the end of the same turn, though behind separate saving throws. Whether they're fully simultaneous will depend on what goal they need to simultaneous for. You can certainly jump from exhaustion 4 to dead without getting stuck at that pesky speed of 0, if that was your goal for some reason.

Hot teeth

Teeth of Dahlver-Nar is an artefact from Tasha's Cauldron of Everything. Skipping over how the item works, we want effect number 19 which allows us to make a whopper breath attack at the low-low cost of two exhaustion levels.

as an action, you can exhale fire in a 90-foot cone. Each creature in that area must make a DC 24 Dexterity saving throw, taking 26d6 fire damage on a failed save, or half as much damage on a successful one. After using the breath weapon, you gain 2 levels of exhaustion.

Break a Vow

The Broken Vow sample curse (in the Horror Adventures chapter) from Van Richten’s Guide to Ravenloft includes:

The character gains 3 levels of exhaustion that can’t be removed until the curse ends.

Adventures and Monsters

I'll cover these briefly as they're already covered by Tobias F's excellent answer.

  • A Loup Garau's lycanthropy being lifted (Van Richten’s Guide to Ravenloft)

    On a success, the curse is broken, and the target returns to its normal form and gains 3 levels of exhaustion.

  • The Mystery Mine from The Wild Beyond the Witchlight includes after failing a sufficient number of saving throws

    the character must succeed on a DC 12 Wisdom saving throw after finishing a long rest or gain 1d3 levels of exhaustion.

  • The Zikran’s Zephyrean Tome from Candlekeep Mysteries includes exhaustion as the fail state for a specific climbing check

    On a failed check, the character still makes it to the top but gains [...] 2 levels of exhaustion if the check fails by 5 or more.

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    \$\begingroup\$ Should have guessed that Ravenloft had even more to offer for cursing people, given its nature :D \$\endgroup\$
    – Tobias F.
    Mar 8, 2022 at 9:24
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    \$\begingroup\$ Great items, in particular the first ones that are even part of the core rules! \$\endgroup\$ Mar 8, 2022 at 9:27
  • \$\begingroup\$ I have found something my bbeg might get their hands on with the teeth... \$\endgroup\$
    – Tobias F.
    Mar 8, 2022 at 9:31
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    \$\begingroup\$ in response to double-dashing, you could theoretically dash more if you had haste and/or an action surge..... any way to get more actions. \$\endgroup\$
    – goodguy5
    Mar 8, 2022 at 14:14
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    \$\begingroup\$ @goodguy5 so if you have haste and action surge: Dash normally, bonus action dash, hasted action dash, action surge dahs => 4 dashes then? \$\endgroup\$
    – Tobias F.
    Mar 8, 2022 at 21:52
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Yes, there are effects and monsters causing more than one level of exhaustion at a time

I could find one monster ability, and two effects from pulished adventures than can give you more than one level of exhaustion at a time:

Loup Garou

The lycanthrophy caused by a Loup Garou can only be ended under very specific conditions (emphasis mine):

Loup Garou Lycanthropy

A Humanoid who succumbs to a loup garou’s lycanthropy becomes a werewolf [...] Once a loup garou is slain, a remove curse spell cast during the night of a full moon on any afflicted werewolf it created forces the target to make a DC 17 Constitution saving throw. On a success, the curse is broken, and the target returns to its normal form and gains 3 levels of exhaustion. On a failure, the curse remains, and the target automatically fails any saving throw made to break this curse for 1 month.

If you are under these conditions and succeed on the saving throw, you are freed from being a werewolf and gain 3 levels of exhaustion.

Mystery Mine in The Wild Beyond the Witchlight

As the characters see a number of illusions they have to make wisdom saves to not scream. If they fail three or more of theses saves, they are haunted by nightmares (emphasis mine):

Any character who fails three or more of the ride’s saving throws is haunted by nightmares for 1d8 days. Until the nightmares end, the character must succeed on a DC 12 Wisdom saving throw after finishing a long rest or gain 1d3 levels of exhaustion.

Climbing a mountain in one of the Candlekeep Mysteries adventures

In one of the adventures contained within the book

Zikran’s Zephyrean Tome

The adventure specifies how a character may gain exhaustion depending on how they perform (emphasis mine):

Toward evening, the characters come to a 40-foot-high, slanted cliff face that they must climb to reach their destination unless they use magic to complete the ascent. Each character must make a DC 14 Strength (Athletics) check to climb the cliff face. On a failed check, the character still makes it to the top but gains 1 level of exhaustion, or 2 levels of exhaustion if the check fails by 5 or more.

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    \$\begingroup\$ I used a search on DNDBeyond to find these, it is possible there are more - let me know if someone find other cases. \$\endgroup\$
    – Tobias F.
    Mar 8, 2022 at 8:39

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