Plagues have afflicted humanity for as long as historical records exist.

They have killed kings, toppled empires, and changed the course of major world events.

The idea of plague is burned so deeply into our collective consciousness that they even feature inDungeons & Dragonscampaigns.

An ooze fights a two headed creature.

Limbo Madness by Kent Davis

Bring some fresh blood into your D&D campaign.

Thankfully, history and fiction are packed with illustrative examples of how plagues work and how they are fought.

Check with your players to ensure that they’re alright with Plagues as a theme before you introduce it.

A group of adventurers chart together a detailed plan around a meeting table

Stick Together by Dave Greco

This situation should play out similarly in D&D.

Be prepared for your players' quick attempts to fix the issue.

(A constitution check usually works best.)

Image of a DND party in a dark cave with red haired girl holding a map and an orc behind her.

Stick Together by Dave Greco

What debuffs to stats occur when the plague is contracted?

Page 257 of the Dungeons Masters Guide (DMG) lists some diseases.

you gotta signal that people are very sick to make your players nervous about the plague.

Dungeons & Dragons monk in a temple

Temple Thief by Evyn Fong

As a plague progresses, more and more sick people congregate at temples and churches.

Have rich folk fled to country estates?

Are they locked high in their towers with food and water carefully stashed?

A massive library in the distance of a coastal area in D&D.

The Great Library of Candlekeep by Vincent Proce

Hunger does strange things to civilized people.

A hungry city should feel desperate and frightening.

Are quarantines in place?Has the city employed the services of any plague doctors?

Dungeons & Dragons image showing two Flaming Fist members placing recruitment posters.

Recruitment Drive by Diego Gisbert

Has the city’s food supply been affected by the plague?

Have the authorities responded in any way?

Unless these corpses are disposed of quickly, the sickness spreads and worsens.How far gone is the city?

A group of adventurers flee a village during the night in D&D art.

Fleeing Escapess in the Night by Brian Valeza

Are there still people taking the dead to funeral pyres?

Is law and order holding up, or has the militia gone rogue?

Who Benefits?

Four faction members walking through the streets of Sigil from Dungeons & Dragons

Faction Agents by Taras Susak

Your story should feature at least one faction that wants the plague to spread unchecked.

The malignant faction should look to take advantage of any weakness or power vacuums that the plague creates.

The discovery could start with a party member falling ill and then rushing to a town for a cure.

A party of adventurers in a wood terrified by something unseen from Dungeons & Dragons.

Once in town, the party realise that everyone around them is sick.

Best prefs For Plague Dungeons & Dragons

Plagues hit towns and cities hardest.

Population density plays an important role in the spread of disease.

Tabletop

Running a plague game in a city makes sense for these reasons.

The open sea could even offer temporary refuge, so long as you have enough food and water.

Present the players with unique challenges and situations depending on their location.

Dungeon & Dragons

But always keep the devastating results of the plague at the forefront.

Rolling with the punches?

Here’s how to use backup characters.