The party is trudging through a snowy mountain pass. The going is slow; the difficult terrain has increased travel-time by multitudes beyond what had originally been expected–or provisioned–for.
The food has run out, the hunting is bleak, and the party is scraping by on Goodberries and Create Water spells for sustenance, but the cold is creeping into their bones.
Roll a Constitution saving throw for Exhaustion.
How Exhaustion works
There are plenty of ways to reach Exhaustion in D&D 5e, the most obvious of which is by going through a physically and mentally exhausting ordeal, such as delving too long and too deep into a pitch black dungeon, running for hours on end to reach a location in time, or trudging through less than ideal conditions.
Xanathar’s Guide to Everything states that going for 24 hours without sleep results in a DC 10 Constitution saving throw, with a failure resulting in a level of exhaustion. Staying awake for longer results in a harder DC, increasing by 5 for each 24 hours you go without long resting.
Exhaustion is also a result of specific spell (Sickening Radiance, Tensor’s Transformation in a way), or of an enemy ability (Gingwatzim’s Energy Drain, the Sibriex’s Warp Creature, the Corrupted Giant Shark’s Bite, and the Kalaraq Quori’s Mind Seed, to name a few), or just an environmental condition such as extreme cold, heat, or dread.
Exhaustion levels
Exhaustion is a series of six levels, going from bad to worse to, eventually, dead.
Level 1: Disadvantage on ability checks
Level 2: Speed halved
Level 3: Disadvantage on attack rolls and saving throws
Level 4: Hit point maximum halved
Level 5: Speed reduced to 0
Level 6: Death
These stack, by the way, which means by the time you’ve reached Level 5 of exhaustion, you can’t move, you’re max hit points are halved, and you have disadvantage on attach rolls, saving throws, and ability checks.
So you reaaaally better hope one of your allies is planning on helping your sorry ass out, because at that point there’s not much more you can do for yourself.
Getting rid of Exhaustion
As for getting rid of exhaustion? Well, that’s a lengthy, resource-intensive process. The easiest, if you’ve got the time to spare, would be taking a long rest, though that will only remove one level of exhaustion at a time. So yes, it will take the better part of a week to fully recover from 5 levels of exhaustion.
A few spells will also do the trick, though they’re not cheap. Greater Restoration, a FIFTH level spell, can be used to reduce just one level of exhaustion. The 9th level Wish spell can be used to duplicate Greater Restoration, but you could probably also just, you know, wish to not be exhausted at all and we’re sure your DM will allow it.
You’d think a spell named Heal (at 7th level, at that) would be able to do something about exhaustion, but that is unfortunately not the case.
Okay, but what happens if I die from Exhaustion/die while Exhausted?
Ahh, good, young grasshopper. You have asked the right question.
So reaching Level 6 of Exhaustion causes death. But this is D&D we’re talking about, where death is a relatively easy ailment to overcome. In fact, given the rules of D&D, it is actually harder/more resource intense to cure a level of exhaustion than it is to cure death!
Say you reach the sixth level of exhaustion. You die. But what do you know?! You’re Paladin friend knows Revivify, and gets to your side within the minute of your exhausting demise. They cast the spell and badda bing badda boom you’re back up to 1hp, alive, and…. still at 5 levels of exhaustion?
Well obviously Wizard of the Coast couldn’t make the answer to multiple levels of exhaustion just “Kill the guy and bring him back and he’ll be good as new.”
So what gives?
In a version 2.0 errata of the Player’s Handbook, published November 2018, it states that “being raised from the dead reduces a creature’s exhaustion level by 1.”
So if you’re at Level 2 exhaustion, die (from something other than exhaustion), and then are brought back to life with a 3rd level Revivify spell, you’ll come back at level 1.
…Which also means that the whole idea of killing your buddy a few times and spamming Revivify instead of Greater Restoration to save spell slots is, technically, a valid strategy.
That is, so long as your DM doesn’t institute some sort of RP or mechanical penalty for dying and being brought back to life so many times (which, in our opinion, they totally totally should).
In conclusion…
Exhaustion is one of those mechanics that is very much left in the hands of the DM. Given that it can be the result of not just magical abilities and spells but also of the environment/how the party is in regards to health and #selfcare, it can be an exciting addition to already tense situations. But it is kind of a pain in the ass to get rid of, so we’d suggest implementing it sparingly.
Unless you happen to be in Avernus. Or playing on Hard Mode. Then have at it.
