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Spare the Dying states:

You touch a living creature that has 0 hit points. The creature becomes stable. This spell has no effect on undead or constructs.

Given the Strict interpretation of RAW it would seem that you would have to have exactly 0hp to benefit from Spare the Dying. Is this correct, or does it stabalize creatures with less than 0hp as well?

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There is no concept of below 0 Hit Points in 5e. You are either above 0 or at 0.

If you read through the Damage and Healing section in the PHB you will note that it constantly refers to creatures dropping to 0HP but never below.

As such, Spare the Dying works exactly as stated:

You touch a living creature that has 0 hit points.

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I think you might be getting confused with previous editions of DnD. In 5th edition, characters can never drop below 0 HP, and the concept of negative hit points for PCs does not exist. When your character takes damage that exceeds their HP or while they are unconscious, they are subject to the rules of either Instant Death or Damage at 0 Hit Points:

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 (PHB pg. 197).

Damage at 0 Hit Points

When 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 (PHB pg. 197).

In conclusion - since a character can never have less than 0 hit points, you would never have to use Spare the Dying on someone with less than 0 hit points.

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  • \$\begingroup\$ indeed I was. I started playing D&D in 4th... never even occurred to me that they would remove negative hit points in 5th, so I just quickly scanned those sections before running my 5th edition campaign. I have run 5th since the last round of D&D next playtests, and have played in many games and everyone uses negatives. This will be interesting to tell my group of D&D friends for sure. \$\endgroup\$ – MC_Hambone Aug 3 '15 at 7:25
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Yes you have to have exactly 0hp to use Spare the Dying, however, given that hit points can only be 0 or positive this is not a major problem. If your hp are 0 then the spell will work, if they are positive then you don't need it and if they are negative you are playing a different game from D&D 5e.

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