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Sanguinomancy

Sanguinomancy shapes a character's supernatural focus, training, and power set.

Power index

Sanguinomancy Powers

42 powers, grouped by tier. The rules needed for quick reference are shown directly in each row.

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Tier 0

2

Hurl a twisting bolt of blood at one creature within range. Make a ranged power attack. On a hit, the target takes 5 (1d10) necrotic damage. If the target is bleeding, bloodied, or below half its maximum hit points, you gain temporary hit points equal to your WIS modifier.

Action: Action
Use: At-Will
Range: 90 ft.
Duration: Instant
Effect: 1d10
Type: Necrotic
Roll: Attack

Touch fresh blood, a wound, a bloodstain, or a creature with blood. You learn whether the blood is fresh or old, living or dead, diseased or clean, mortal or supernatural, and whether it belongs to the creature you are touching.

Action: Action
Use: At-Will
Range: Touch
Duration: Instant
Type: Blood / Detection

Tier 1

4

When you or a creature with blood within range takes piercing, slashing, necrotic, or bleeding damage, clot and bind the wound. Reduce the damage by 1d8 + your WIS modifier, and end one mundane bleeding effect on the target.

Action: Reaction
Use: At-Will
Range: 30 ft.
Duration: Instant
Effect: 1d8 + WIS
Type: Reduction / Blood

Mark one creature with blood within range. Until the effect ends, you know the target’s direction while it is within 1 mile, and the first time each round you damage it with a Sanguinomancy power, add your WIS modifier to one damage roll.

Action: Bonus Action
Use: At-Will
Range: 60 ft.
Duration: 1 Minute
Effect: WIS
Type: Blood / Tracking
Roll: Attack

When a creature within range takes damage, draw a thread of escaping vitality through its blood. Regain hit points equal to 1d8 + your WIS modifier. If the damage was a critical hit or reduced the creature below half its maximum hit points, gain temporary hit points equal to the same amount instead or in addition, your choice.

Action: Reaction
Use: At-Will
Range: 30 ft.
Duration: Instant
Effect: 1d8 + WIS
Type: Healing / Temp HP

Choose one creature with blood within range. The target must make a CON save, taking 2d6 necrotic damage and beginning to bleed on a failed save, or half damage only on a success. A bleeding target takes necrotic damage equal to your WIS modifier at the start of its next turn.

Action: Action
Use: At-Will
Range: 60 ft.
Duration: 1 Round
Effect: 2d6 + WIS
Type: Necrotic
Save: CON

Tier 2

4

Blood Puppet Tug

Tug the blood of one creature within range. The target must make a STR save, taking 3d6 necrotic damage and being pulled up to 10 ft. or knocked prone on a failed save, or half damage only on a success.

Action: Action
Use: At-Will
Range: 60 ft.
Duration: Instant
Effect: 3d6
Type: Necrotic
Save: STR

Blood Sacrifice

Sacrifice your own life force to empower your blood magic. Take 1d6 necrotic damage that cannot be reduced or prevented. For the duration, once per turn when you use a Sanguinomancy power that deals damage, one target takes an extra 1d6 necrotic damage.

Action: Bonus Action
Use: At-Will
Range: Self
Duration: 1 Minute
Effect: 1d6 / 1d6
Type: Necrotic
Roll: Attack

Touch a willing creature with blood. A red sigil forms beneath its skin. For the duration, the target gains temporary hit points equal to 2d8 + your WIS modifier and has advantage on the next CON save it makes against bleeding, poison, disease, or necrotic damage.

Action: Action
Use: At-Will
Range: Touch
Duration: 1 Hour
Effect: 2d8 + WIS
Type: Temp HP / Protection
Save: CON

Sanguine Secrets

Draw knowledge through the blood of one creature you can see within range. You learn its species or creature type, whether it is above or below half hit points, and whether it has resistance, immunity, or vulnerability to necrotic, poison, disease, bleeding, charm, or fear. The next attack roll or Medicine, Insight, or Intimidation check you make against it before your next turn has advantage.

Action: Bonus Action
Use: At-Will
Range: 60 ft.
Duration: 1 Round
Type: Blood / Detection
Roll: Attack

Tier 3

4

Heat or churn one creature’s blood. The target must make a CON save, taking 4d8 fire or necrotic damage and losing reactions until the start of your next turn on a failed save, or half damage only on a success.

Action: Action
Use: At-Will
Range: 60 ft.
Duration: 1 Round
Effect: 4d8
Type: Fire / Necrotic
Save: CON

Name or touch a blood sample from one creature. For the duration, you can track that creature by blood scent, pulse, or hidden stains if it is within 1 mile and on the same plane. You have advantage on Survival, Medicine, and Investigation checks made to follow it or identify where it was wounded.

Action: Action
Use: At-Will
Range: Self
Duration: 8 Hours
Effect: 1 mile
Type: Blood / Tracking

Crimson Harvest

A wave of blood sweeps out from you. Creatures of your choice in the emanation must make a DEX save, taking 4d10 necrotic damage on a failed save, or half on a success. If at least one creature with blood fails, you or one ally in the emanation regains hit points equal to half the damage roll.

Action: Action
Use: At-Will
Range: Self (15 ft.)
Duration: Instant
Effect: 4d10
Type: Necrotic / Healing
Save: DEX

Life Transference

Sacrifice your health to mend another creature. You take 4d8 necrotic damage that cannot be reduced or prevented. One creature of your choice within range regains hit points equal to twice the necrotic damage you take.

Action: Action
Use: At-Will
Range: 30 ft.
Duration: Instant
Effect: 4d8 x2
Type: Necrotic / Healing

Tier 4

4

Create a malignant blood-parasite in one creature with blood within range. The target must make a CON save or become infected for the duration. Once per turn when a creature hits the infected target with a weapon or power attack, the attack deals an extra 4d6 necrotic damage, and the attacker gains temporary hit points equal to half the necrotic damage dealt. The target repeats the save at the end of each turn.

Action: Action
Use: At-Will
Range: 60 ft.
Duration: Concentration, 1 Minute
Effect: 4d6
Type: Necrotic / Temp HP
Roll: Attack
Save: CON

Harden your blood into armor beneath or around your skin. For the duration, gain temporary hit points equal to 4d8 + your WIS modifier. While these temporary hit points remain, you have resistance to necrotic damage and advantage on CON saves against bleeding.

Action: Bonus Action
Use: At-Will
Range: Self
Duration: 1 Minute
Effect: 4d8 + WIS
Type: Temp HP / Necrotic
Save: CON

Choose one creature with blood within range. The target must make a CON save, taking 6d8 necrotic damage and beginning to hemorrhage on a failed save, or half damage only on a success. While hemorrhaging, the first time each turn the target moves more than 10 ft., attacks, or uses a power, it takes 2d8 necrotic damage. It repeats the save at the end of each turn.

Action: Action
Use: At-Will
Range: 90 ft.
Duration: 1 Minute
Effect: 6d8 / 2d8
Type: Necrotic
Save: CON

Sacrificial Siphon

Touch one creature and lay a blood-curse that drains its vitality. The target must make a CHA save. On a failed save, it subtracts 1d4 from attack rolls and ability checks. Once per round when it takes damage, you may gain 10 temporary hit points. The target repeats the save at the end of each turn.

Action: Action
Use: At-Will
Range: Touch
Duration: Concentration, 1 Minute
Effect: 1d4 / 10 THP
Type: Curse / Temp HP
Roll: Attack
Save: CHA

Tier 5

4

Seize one creature’s blood and lock its movement. The target must make a CON save or become restrained for the duration. While restrained, it takes 5d8 necrotic damage at the start of each of its turns. It repeats the save at the end of each turn, ending the effect on a success.

Action: Action
Use: At-Will
Range: 90 ft.
Duration: Concentration, 1 Minute
Effect: 5d8
Type: Necrotic
Save: CON

When you or an ally within range fails a saving throw or takes damage, pay in blood to alter the outcome. You take 3d8 necrotic damage that cannot be reduced, then add 1d8 to the failed save or reduce the target’s damage by 5d8 + your WIS modifier.

Action: Reaction
Use: At-Will
Range: 60 ft.
Duration: Instant
Effect: 3d8 / 1d8 / 5d8 + WIS
Type: Necrotic / Reduction

Drive your body with blood magic. For the duration, your speed increases by 10 ft., you have advantage on STR and CON checks, and once per turn when you deal necrotic damage or take self-sacrifice damage from Sanguinomancy, you gain temporary hit points equal to your WIS modifier.

Action: Bonus Action
Use: At-Will
Range: Self
Duration: 1 Minute
Effect: WIS
Type: Temp HP / Blood

Commune with blood from one willing creature, corpse, bloodstain, or bloodline relic. Ask up to three questions about lineage, cause of injury, poison, disease, emotional state at bleeding, kinship, or the direction to the nearest living blood relative. Answers arrive as bodily impressions, not full speech.

Action: 1 Minute
Use: At-Will
Range: Touch
Duration: 10 Minutes
Effect: 3 questions
Type: Divination / Blood

Tier 6

4

Create a 20-ft. radius sphere of red mist centered within range. The area is heavily obscured to enemies. Hostile creatures with blood that start there must make a CON save, taking 6d8 necrotic damage and becoming unable to regain hit points until the start of their next turn on a failed save, or half damage only on a success.

Action: Action
Use: At-Will
Range: 120 ft.
Duration: Concentration, 1 Minute
Effect: 6d8
Type: Necrotic / Blood
Save: CON

Choose one creature with blood within range. The target must make a CON save or be partially controlled by its own blood. On each of your turns for the duration, you may use a bonus action to move the target up to half its speed or force it to make one weapon attack against a creature within its reach. It repeats the save at the end of each turn.

Action: Action
Use: At-Will
Range: 60 ft.
Duration: Concentration, 1 Minute
Type: Blood / Control
Roll: Attack
Save: CON

Mass Transfusion

Move vitality between willing creatures with blood within range. Choose any number of willing targets. Each donor may take up to 6d8 necrotic damage that cannot be reduced. Divide twice the total damage taken as healing among other chosen targets.

Action: Action
Use: At-Will
Range: 60 ft.
Duration: Instant
Effect: 6d8 x2
Type: Necrotic / Healing

Sanguinomancy Dominion

Your Sanguinomancy powers ignore necrotic resistance from creatures with blood. You can sense creatures with blood within 30 ft. unless they are behind total cover, and you know whether a visible creature is below half its maximum hit points.

Action: Passive
Use: At-Will
Range: Self
Duration: Permanent
Effect: 30 ft.
Type: Blood / Senses

Tier 7

4

Bloodline Curse

Touch fresh blood from a creature and curse that creature’s bloodline connection. The target must make a WIS save if on the same plane. On a failed save, it has disadvantage on saves against your Sanguinomancy powers and cannot hide from your Blood Trail for the duration. Close blood relatives may feel a harmless omen or nosebleed.

Action: 1 Minute
Use: At-Will
Range: Touch
Duration: 24 Hours
Type: Blood / Curse
Save: WIS

Crimson Revival

When a creature with blood within range would drop to 0 hit points, force its blood to keep moving. The target instead drops to 1 hit point and gains temporary hit points equal to 7d8 + your WIS modifier. You take necrotic damage equal to half the temporary hit points gained, which cannot be reduced.

Action: Reaction
Use: 1/Long Rest
Range: 60 ft.
Duration: Instant
Effect: 7d8 + WIS
Type: Temp HP / Necrotic

Rip vitality from one creature with blood within range. The target must make a CON save, taking 10d10 necrotic damage on a failed save, or half on a success. If the target fails and is below half its maximum hit points, you may also move it up to 20 ft. and cause one ally within 30 ft. of it to regain hit points equal to your WIS modifier.

Action: Action
Use: At-Will
Range: 90 ft.
Duration: Instant
Effect: 10d10
Type: Necrotic / Healing
Save: CON

Choose two creatures with blood within range. Each must make a CON save, with disadvantage if they are within 30 ft. of each other; either can willingly fail. If both fail, they are linked for the duration regardless of distance on the same plane. Whenever one takes damage, the other takes the same damage. Whenever one regains hit points, the other regains the same amount. If either drops to 0 hit points, the effect ends on both.

Action: Action
Use: At-Will
Range: 60 ft.
Duration: Concentration, 1 Hour
Type: Blood / Link
Save: CON

Tier 8

4

Blood Homunculus

Shape your blood or willing donor blood into a Small crimson homunculus. It can scout, squeeze through 1-inch gaps, deliver touch-range Sanguinomancy powers, and communicate pulse-impressions. If destroyed, you take 4d8 necrotic damage that cannot be reduced.

Action: 1 Minute
Use: At-Will
Range: Touch
Duration: 8 Hours
Effect: 4d8
Type: Summon / Necrotic

A storm of red droplets and vital force fills the emanation. Hostile creatures with blood that start there must make a CON save, taking 8d10 necrotic damage and becoming restrained by their own blood until the start of their next turn on a failed save, or half damage only on a success. Allies in the area have advantage on death saves.

Action: Action
Use: At-Will
Range: Self (60 ft.)
Duration: Concentration, 1 Minute
Effect: 8d10
Type: Necrotic / Blood
Save: CON

Become a living vessel of blood magic. For the duration, you have resistance to necrotic damage, advantage on CON saves, and your Sanguinomancy powers ignore necrotic resistance from creatures with blood. Once per turn when a creature takes necrotic damage from your Sanguinomancy power, you gain temporary hit points equal to your WIS modifier.

Action: Bonus Action
Use: At-Will
Range: Self
Duration: 1 Minute
Effect: WIS
Type: Blood / Temp HP
Save: CON

Crimson Panacea

Transmute blood into a perfect restorative medium. Touch one willing creature with blood. End all poison, disease, bleeding, exhaustion, and necrotic-healing-block effects of Tier 8 or lower on it, then restore 8d10 + your WIS modifier hit points.

Action: Action
Use: 1/Long Rest
Range: Touch
Duration: Instant
Effect: 8d10 + WIS
Type: Healing / Restoration

Tier 9

4

Bloodline Dominion

Touch a willing creature, fresh blood, or bloodline relic. For the duration, you can sense the direction to living blood relatives of that target within 10 miles, identify bloodline curses or inherited magic, and grant one willing blood relative advantage on saves against disease, poison, necrotic damage, or blood magic.

Action: 1 Minute
Use: At-Will
Range: Touch
Duration: 24 Hours
Effect: 10 miles
Type: Bloodline / Divination

Create a 60-ft. long, 20-ft. wide river of blood within range. The area is difficult terrain. Hostile creatures with blood that enter for the first time on a turn or start there must make a STR save, taking 10d10 necrotic damage and being knocked prone and pulled 20 ft. on a failed save, or half damage only on a success.

Action: Action
Use: At-Will
Range: 120 ft.
Duration: Concentration, 1 Minute
Effect: 10d10
Type: Necrotic / Blood
Save: STR

Sovereign Blood

Your Sanguinomancy powers ignore necrotic resistance and treat necrotic immunity as resistance for creatures with blood unless they are divine, Artifact-grade, or story-protected. You cannot be unwillingly bled, blood-cursed, blood-tracked, or controlled through your blood by effects below Tier 9.

Action: Passive
Use: At-Will
Range: Self
Duration: Permanent
Type: Blood / Immunity

Total Hemocontrol

Choose one creature with blood within range. The target must make a CON save or become controlled by its own blood for the duration. While affected, it is restrained, cannot take reactions, and on each of your turns you may use a bonus action to make it move up to half its speed or make one weapon attack. It repeats the save at the end of each turn.

Action: Action
Use: 1/Long Rest
Range: 90 ft.
Duration: Concentration, 1 Minute
Type: Blood / Control
Roll: Attack
Save: CON

Tier 10

4

Archsanguine Form

For the duration, you become an archsanguine vessel. You are immune to necrotic damage, bleeding, mundane disease, and poison in the blood. Your Sanguinomancy powers treat necrotic immunity as resistance for creatures with blood, and once per turn when you deal necrotic damage with Sanguinomancy, regain hit points equal to your WIS modifier.

Action: Bonus Action
Use: At-Will
Range: Self
Duration: 1 Minute
Effect: WIS
Type: Necrotic / Healing

Blood Moon Rite

Perform a rite that turns the area’s blood into a network of omen and power. For the duration, you know when creatures with blood die, are born, or spill significant blood in the emanation. Once per round, when a hostile creature with blood in the area takes damage, you may deal 6d10 necrotic damage to it or restore 6d10 hit points to a willing creature with blood within 120 ft. of it.

Action: 10 Minutes
Use: At-Will
Range: Self (1 mile)
Duration: 24 Hours
Effect: 6d10
Type: Necrotic / Healing

Choose one creature with blood within range. The target must make a CON save, taking 20d10 necrotic damage on a failed save, or half on a success. If it fails and is reduced to 100 hit points or fewer, its heart, pulse, or equivalent blood engine stops and it drops to 0 hit points instead.

Action: Action
Use: 1/Long Rest
Range: 120 ft.
Duration: Instant
Effect: 20d10
Type: Necrotic
Save: CON

The First Blood

Awaken a mythic blood working tied to a creature, bloodline, battlefield, wound, oath, birth, murder, or sacrifice. Define its principle with the GM: blood that binds a dynasty, blood that refuses death, blood that remembers truth, blood that curses a tyrant, or blood that heals a people. It can be ended only by Tier 10 blood magic, divine intervention, or a story condition set when created.

Action: Action
Use: 1/Ever
Range: Touch
Duration: Until Resolved
Effect: Unique
Type: Blood / Story
Roll: Varies
Save: Varies