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I am playing in a 5E campaign as a player and after a first few encounters there is something I don't quite get.

Do monsters/enemies follow the same death rules that are used for PCs (i.e. not dropping below 0, making death saving throws etc.) or does hitting zero hit points mean instant death for them?

The reason I ask is because our last fight was against a group of humans in a tavern (bandits, not regular patrons). It was short due to players rolling high damage, basically dispatching a group of enemies in two rounds.

Do we get to make Medicine ability rolls to stabilize the adversaries to be handed to the authorities or are they already finely chopped and reduced to ashes?

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From Player's Basic pg 76

Most DMs have a monster die the instant it drops to 0 hit points, rather than having it fall unconscious and make death saving throws.

Mighty villains and special nonplayer characters are common exceptions; the DM might have them fall unconscious and follow the same rules as player characters.

Also, next section:

Sometimes an attacker wants to incapacitate a foe, rather than deal a killing blow. When an attacker reduces a creature to 0 hit points with a melee attack, the attacker can knock the creature out. The attacker can make this choice the instant the damage is dealt. The creature falls unconscious and is stable

So in general enemies die when you drop them to 0. Occasionally, a DM might want a villain that has the potential to pop back up and thus give them death saves (I'd recommend DMs tip this off somehow).

If you have need of an enemy after they are out, you can choose to drop them to 0 and have them be unconscious (technically, this only works with melee attacks, but really there's no reason to not allow it to work with all forms of attack).

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    \$\begingroup\$ There are also a few super villains such as the Mummy Lord and Liches that will regenerate... \$\endgroup\$ – Alexis Wilke Feb 11 '15 at 2:23
  • \$\begingroup\$ This rule also gives the DM a chance to use the "not quite dead" trope. Where after the heroes think everything is in the clear, the monster suddenly gets up and attacks again. \$\endgroup\$ – Sindri Traustason Feb 11 '15 at 14:25
  • \$\begingroup\$ The section quoted is actually a footnote at the end of the rules that explain how dying works. That section isn't even rules, as you can see it begins "Most DMs" and explains something that DMs sometimes do that explicitly is not the rules. This is not an optional rule, nor is it a variant rule. At best it's a houserule. \$\endgroup\$ – pwi Dec 6 '19 at 6:26
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    \$\begingroup\$ @jgn What's the difference between an optional rule and a houserule that is explicitly suggested by the PHB? \$\endgroup\$ – Mars Plastic Dec 6 '19 at 14:37
  • \$\begingroup\$ @MarsPlastic 5e contains 3 classes of rules: normal rules (stuff like how attacking works), variant rules (modifications to rules/add ons such as encumbrance), optional rules (usually entire systems, such as multiclassing). "Most DMs have a monster die the instant it drops to 0 hit points" is not a rule of any kind, it is just a footnote on how some DMs play the game. There is less consideration for balance/mechanics with optional/variant rules, and absolutely none for the way that DMs descide to houserule the game. \$\endgroup\$ – pwi Dec 6 '19 at 15:08
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According to the rules normal NPC's you can just kill without any death saving rolls, but named ones can get death saving rolls if it suits your adventure/campaign. There really is not much point to giving everyone death saving rolls since it just makes every encounter take twice as long.

Most DMs have a monster die the instant it drops to 0 hit points, rather than having it fall unconscious and make death saving throws.

Mighty villains and special nonplayer characters are common exceptions; the DM might have them fall unconscious and follow the same rules as player characters.
(Basic Rules, p. 79)

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    \$\begingroup\$ It's usually a good idea to quote the relevant parts of the rules you're mentioning in your answer or at least the book(s) and page number(s) where the rules can be found. \$\endgroup\$ – Purple Monkey Feb 9 '15 at 13:00
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    \$\begingroup\$ Damn that edit time limit... To tag onto the end of my previous comment; this provides a quick reference so that people don't have to go pouring through, potentially dozens, of books to find something they obviously couldn't find before and/or so that people can confirm the information you've given them. \$\endgroup\$ – Purple Monkey Feb 9 '15 at 13:11
  • \$\begingroup\$ Oh thanks, I'm new here so I'll remember to quote in the future! ^^ \$\endgroup\$ – nicksgen Feb 9 '15 at 17:29
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    \$\begingroup\$ @nicksgen: You can (and should) still edit the citation into your existing answer. \$\endgroup\$ – V2Blast Mar 15 '18 at 19:46
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When damage reduces a monster to 0 hp and there is damage remaining that equals or exceeds their max hp, or if they are reduced to 0 hp then fail 3 death saves, the monster dies.

The Basic Rules has a section called Dropping to 0 Hit Points which details how this works:

When you drop to 0 hit points, you either die outright or fall unconscious, as explained in the following sections.

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.

For example, a cleric with a maximum of 12 hit points currently has 6 hit points. If she takes 18 damage from an attack, she is reduced to 0 hit points, but 12 damage remains. Because the remaining damage equals her hit point maximum, the cleric dies.

Falling Unconscious

If damage reduces you to 0 hit points and fails to kill you, you fall unconscious. This unconsciousness ends if you regain any hit points.

Death Saving Throws

Whenever you start your turn with 0 hit points, you must make a special saving throw, called a death saving throw, to determine whether you creep closer to death or hang onto life. Unlike other saving throws, this one isn't tied to any ability score. You are in the hands of fate now, aided only by spells and features that improve your chances of succeeding on a saving throw.

Roll a d20. If the roll is 10 or higher, you succeed. Otherwise, you fail. A success or failure has no effect by itself. On your third success, you become stable (see below). On your third failure, you die. The successes and failures don't need to be consecutive; keep track of both until you collect three of a kind. The number of both is reset to zero when you regain any hit points or become stable.

Rolling 1 or 20. When you make a death saving throw and roll a 1 on the d20, it counts as two failures. If you roll a 20 on the d20, you regain 1 hit point.

Damage at 0 Hit Points. If you take any damage while you have 0 hit points, you suffer a death saving throw failure. If the damage is from a critical hit, you suffer two failures instead. If the damage equals or exceeds your hit point maximum, you suffer instant death.

Stabilizing a Creature

The best way to save a creature with 0 hit points is to heal it. If healing is unavailable, the creature can at least be stabilized so that it isn't killed by a failed death saving throw.

You can use your action to administer first aid to an unconscious creature and attempt to stabilize it, which requires a successful DC 10 Wisdom (Medicine) check.

A stable creature doesn't make death saving throws, even though it has 0 hit points, but it does remain unconscious. The creature stops being stable, and must start making death saving throws again, if it takes any damage. A stable creature that isn't healed regains 1 hit point after 1d4 hours.

Too many rules?

If this all sounds a bit complex to track for every monster, there is a footnote that gives details what some DMs houserule*:

Monsters and Death

Most DMs have a monster die the instant it drops to 0 hit points, rather than having it fall unconscious and make death saving throws.

And then that footnote has a footnote for a houserule that some DMs use as an exception to the previous houserule:

Mighty villains and special nonplayer characters are common exceptions; the DM might have them fall unconscious and follow the same rules as player characters.

Beware using houserules, and inconsistent rules. Be clear about what houserules you are going to use, and be clear when there will be an exception. If your players are not aware of your houserules then they will be surprised or annoyed when they discover the enemy they thought wasn't dead, is dead - or the enemy they thought was dead, isn't.

*Note: This is not an optional rule, nor a variant rule, and it definitely is not an official rule of any kind. It is purely a houserule. The game doesn't even suggest you use this rule, it just explains that it exits.

You should consider how using a houserule like this would change mechanics and balance. On this site there is a lot of confusion that arises from this houserule, make sure you know the official rules well enough to be able to fall back when you need to resolve a problem.

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