Dungeons & Dragons Fifth Edition campaigns come in all shapes and sizes. While some are large-scale epics of whimsy that span pastoral landscapes, others may be smaller-scale, tense mysteries within a fantastical city. Horror is a very popular spin for a D&D 5e campaign that feels different from anything else.
Horror can be implemented into Dungeons & Dragons elegantly, whether it's psychological torment, eldritch terror, or more straightforward zombie and monster fare. In amongst its cool, funny, or simply fearsome foes, D&D also has plenty who are nothing less than horrifying.
Updated October 11th by Isaac Williams: Horror campaigns are one of the most popular genres in D&D 5e, well-serviced by the game's many Monster Manuals. This list has been updated to give even more information about the scariest monsters for a horror campaign in D&D 5e.
15 Doppelganger
As this monster's name would imply, doppelgangers are monsters capable of assuming the form of other creatures. This provides them with an extremely convincing disguise that they can use to infiltrate any group, including the party.
Doppelgangers are ideal D&D 5e monsters for a horror campaign because they leave the players with nobody they can fully trust besides each other. With even a single doppelganger present, the PCs could unknowingly be talking to an enemy at any point, giving them a tense mystery to solve. With several, no situation is safe, raising the tension as the players and their characters fight paranoia.
14 Vampire
Vampires are some of gothic horror's most iconic monsters. However, that doesn't mean they're played out or cliche as D&D 5e horror monsters. Vampires can be some of the scariest monsters in D&D 5e. Aside from their worrying personal capabilities in a fight, they can wield arcane magics and rule over a region with both charm and fear.
D&D 5e vampires are fonts of charisma and corruption alike. Whether they lead a double life as an ordinary citizen and a monster of the night, rule over a land where everything is hostile, and no human is safe, or whisper their way into the ear of those in power, a vampire can ratchet up the threat and fear in any D&D 5e horror campaign.
13 Bodak
Bodaks have an advantage over classic horror monsters in D&D 5e. They're much less familiar than classics every player knows, and unfamiliarity aids horror. Some players may simply never fear a mind flayer, vampire, or mummy. More obscure monsters like the Bodak terrify in a way the better-known cannot.
The D&D 5e bodak has plenty frightening about it on its own merits. They're the husks of creatures destroyed by true evil, animated by nothing more than malevolent purpose. They're near-unstoppable hunters who can more than hold their own in a fight and kill with a look. For both its own merits and their relatively unknown nature, the Bodak can be a truly horrifying thing to fight.
12 Bagman
The entire D&D setting of Ravenloft is inspired by gothic horror. It's built from the ground up to let players and DMs tell perfect D&D horror campaigns. One of the more popular creatures introduced in Van Richten's Guide to Ravenloft, the Fifth Edition sourcebook for the setting, is the being known simply as the Bagman.
The Bagman is a creature potentially lurking inside any D&D 5e Bag of Holding. It seeks to lure people into the depths of its home and trap them there, leaving nothing but trinkets behind. It is designed to make parties uneasy and provide a hard-to-understand threat.
11 Gibbering Mouther
Gibbering mouthers are abominations comprising countless eyes, mouths, and tentacles. They only know how to do two things: consume others and drive individuals into mental despair. While gibbering mouthers aren't a source of deeply rooted psychological terror like other scary D&D monsters, they are gruesome sights to behold. They provide visual horror akin to creatures such as The Thing.
The sounds made by a gibbering mouther can make characters temporarily unstable and cause them to lash out and attack their own allied. It's one of the scariest monsters in D&D 5e because it devours adventures it kills, assimilating those adventurers unlucky enough to die into its fleshy mass.
10 Star Spawn
Star spawn are another nod to classic eldritch horror in D&D 5e. They're creatures made by malevolent outer space entities to spread their message or influence on other worlds, with close ties to the game's Elder Evils. Star spawn are capable D&D combatants who will be alien to even the hardiest and most well-traveled characters.
Star spawn are more than just monster fodder for a battlefield in D&D 5e. There are various types of star spawn with different purposes and strengths, rising in power. Players can go up against different types throughout a D&D horror campaign as an Elder Evil sets its sights on their world.
9 Sibriex
D&D 5e is home to plenty of creatures who are unpleasant and horrifying, but the sibriex is on another level above many of those. Appearing in Mordenkainen's Tome of Foes, a sibriex is a sentient balloon of pus and bile that can warp creatures and adventurers, turning them into abominations as well.
The combative abilities of a sibriex in D&D 5e are horrible to behold. Besides transforming its prey into abyssal wretches, it can charm targets and intimidate the party with immensely powerful, character-threatening spells like Feeblemind. It's a rare D&D 5e monster that is abjectly horrifying in both appearance and threat.
8 Hag
Most D&D 5e hags share a complete lack of regard for other creatures and possess powerful spellcasting capabilities. Although unlikely to threaten an entire region or the world, they can blight any community. Hags are ideal horror monsters for a smaller-scale D&D 5e campaign, perhaps kept to a low level.
Hags detest all that is good and beautiful within the world, and seek to destroy or corrupt all that they view as such. Each variety of D&D 5e hag has a different suite of terrible magical powers, and they are more than capable of forming covens or making more of their kind to increase their power further.
7 Intellect Devourer
Intellect devourers are aberrant creatures created by mind flayers, characterized by their ability to devour other creatures' minds. This doesn't just slay the being. It also gives the intellect devourer all of its knowledge. They're notorious among the D&D community for being far more lethal than their CR suggests, but their horror stretches beyond that.
When they consume a creature's brain, D&D intellect devourers take over the creature's body as its new brain. They can generate as much paranoia as many other creatures, with the added horrifying punch that those they replace are dead. Even most resurrection magic will struggle to bring them back.
6 Lich
The lich is one of D&D's most iconic monsters ever. It's an immensely powerful undead spellcaster that commonly keeps the sort of rare loot and ancient artifacts that player characters will happily kill for. Many players are used to facing off against them in epic showdowns for incredible rewards. However, liches have plenty of potential for horror as well.
Liches have to use the souls of others to sustain themselves in D&D. This can be horrifying if it happens to NPCs around the players. In addition, liches are highly skilled spellcasters and undead beings. They have many tricks up their sleeves to wield against the characters. Liches can easily be the villain of an entire D&D 5e campaign, with the players needing many adventures to face them.
5 Mind Flayer
Mind flayers are alien-like D&D 5e creatures that sustain themselves by devouring brains of others. They're feared by players far and wide for their ruthlessness and vicious combat prowess. Mind flayers are some of D&D 5e's scariest monsters. They're supremacists who believe that they are the dominant species and all others should be hosts, thralls, or food.
What also serves to set mind flayers apart in D&D 5e is their intelligence. They're not mindless beings. They act with purpose and seek to innovate, plan, and invent, usually to the detriment of all others. Smart, capable, and entirely uncaring, mind flayers can hearken back to classic mad scientists while being a monster in their own right.
4 Rakshasa
Rakshasa are fiends from D&D 5e's lower planes who are neither devils nor demons. They're duplicitous and remorseless sorcerers and manipulators who care only for their own selfish ends and the suffering of those who have wronged them. These are classic tropes for villains of any genre, but the rakshasa's abilities can take things to a more horrifying level.
D&D 5e Rakshasa have at-will usage of the Disguise Self spell to appear as anybody they like, alongside a natural Charisma and deception that can let them toy with the PCs as they like. When push comes to shove, they can also be an immense threat, being immune to all but the most powerful of spells. Little scares a D&D 5e player more than their tried-and-tested abilities not working.
3 Aboleth
Aboleths are some of D&D 5e's oldest and scariest aberration monsters. They don't just nod to gothic horror, they're also inspired by the primal fear of deep ocean. Unlike other potential boss monsters in D&D 5e, aboleths are mediocre in combat. They're a far greater threat outside combat, with illusions and psionic powers to subvert entire communities to their side.
If a D&D creature telepathically communicates with an aboleth, the aboleth learns all of that creature's deepest desires. Equally dangerous is an aboleth's mucus, which bestows a creature with the ability to breathe underwater but removes their ability to breathe air. Aboleths can be sinister masterminds in the shadows for an entire horror D&D campaign.
2 Oblex
An oblex is easily one of the most terrifying creatures that can be encountered in a D&D 5e campaign. They are another monster that can impersonate others, killing them in the process. Oblexes absorb other creatures and gain the ability to create a copy of them tethered to their original form by a thin trail of slime.
However, oblexes emphasize the horror in several ways in D&D. For one, their base appearance is unsettling, as they resemble a mass of red slime with the faces of their victims embedded. For another, they are absolutely devastating in combat, meaning that they can back up their menacing appearance with a credible mechanical threat.
1 Spawns Of Kyuss
Zombies in D&D 5e have plenty in common with their cousins in other fiction, except that they are not contagious. The primary way to create a zombie is to use a spell like Animate Dead, whilst their victims just stay deceased. The spawn of Kyuss changes things by being able to spread its infection to other victims.
Turning those killed by its worms into more spawns of Kyuss in minutes, even a single one can prove a major threat for a party if there are NPCs around to infect. Spawn of Kyuss can turn a small outbreak into a threat worthy of an entire D&D 5e campaign as the players attempt to curtail and wipe out a world-threatening infestation.