Some players love combat and others adore hours roleplaying in town or on the road, but I fall squarely in the camp of loving combat that informs roleplaying and storyline. I need monsters with potential to afflict more than a single encounter - monsters whose effects on the party provide a martial and strategic challenge, but also create lasting psychological effects that will endure throughout the campaign. If there aren't as many tears as laughter at my table, I feel I'm not doing my job.  

Mordenkainen's Tome of Foes is the perfect resource for psychological Dungeon Master warfare. The APN Team is currently playing through Out of the Abyss and all the entities in this book are the perfect companion for our romp through the Underdark. Today, I'm going to break down my Top 10 adversaries, ranging from challenge rating 1/2 to 21!


In the Shadowfell, balhannoths make their lairs near places inhabited by creatures they hunt. They typically haunt well-traveled roads and paths, snatching people who come along. A balhannoth that has been captured and exploited by drow might lair in caves near Underdark passages and guard the ways in and out of a drow enclave.

Lair Actions

When fighting inside its lair, a balhannoth can use lair actions. On initiative count 20 (losing initiative ties), a balhannoth can take one lair action to cause one of the following effects; the balhannoth can’t use the same lair action two rounds in a row:

  • The balhannoth warps reality around it in an area up to 500 feet square. After 10 minutes, the terrain in the area reshapes to assume the appearance of a location sought by one intelligent creature whose mind the balhannoth has read (see Regional Effects below). The transformation affects nonliving material only and can’t create anything with moving parts or magical properties. Any object created in this area is, upon close inspection, revealed as a fake. Books are filled with empty pages, golden items are obvious counterfeits, and so on. The transformation lasts until the balhannoth dies or uses this lair action again.
  • The balhannoth targets one creature within 500 feet of it. The target must succeed on a DC 16 Wisdom saving throw or the target, along with whatever it is wearing and carrying, teleports to an unoccupied space of the balhannoth’s choice within 60 feet of it.
  • The balhannoth targets one creature within 500 feet of it. The target must succeed on a DC 16 Wisdom saving throw or the balhannoth becomes invisible to that creature for 1 minute. This effect ends if the balhannoth attacks the target.

Regional Effects

A region containing a balhannoth’s lair becomes warped by the creature’s unnatural presence, which creates one or more of the following effects:

  • Creatures within 1 mile of the balhannoth’s lair experience a sensation of being close to whatever they desire most. The sensation grows stronger the closer the creatures come to the balhannoth’s lair.
  • The balhannoth can sense the strongest desires of any humanoid within 1 mile of it and learns whether those desires involve a place: a safe location to rest, a temple, home, or somewhere else.

If the balhannoth dies, these effects end immediately.

Anne's notes: These guys are great for a few reasons. In the Underdark, players are prone to madness. It's a cruel Wonderland-esque setting and I'm reserving this creature for a time when a player finally succumbs to their madness roll. They might find the balhannoth's illusions quite convincing. I also love to provide creatures that can be present foes or future solutions. If they could manage to enslave this creature just as the drow do, it's possible players could turn their monster's strengths into a boon.

A wizard who tries to become a lich but fails might become a boneclaw instead. These hideous cackling undead share a few of the lich's attributes - but where liches are immortal masters of the arcane, boneclaws are slaves to darkness, hatred, and pain. 

The most important part of the transformation ritual occurs when the soul of the aspiring lich migrates to a prepared phylactery. If the spellcaster is too physically or magically weak to compel the soul into its prison, the soul instead seeks out a new master - a humanoid within a few miles who has an unusually hate-filled heart. The soul bonds itself to the foul essense it finds in that person, and the boneclaw becomes forever enslaved to its new master's wishes and subconcious whims. It forms near its master, sometimes appearing before that individual to receive orders and other times simply setting about the fulfillment of its master's desires. 

Limited Immortality. A boneclaw can't be destroyed while its master lives. No matter what happens to a boneclaw's body. It re-forms within hours and returns to whatever duty its master assigned. The boneclaw can serve only evil. It its master finds redemption or sincerely turns away from the path of evil, the boneclaw is permanently destroyed. 

Dark Reflections. A boneclaw's master might not want such a servant or even know it has one. Boneclaws bind to petty criminals, bullies, and even particularly cruel children. Even if the master is unaware of its new horrid bodyguard, tis local area will be plagued by disappearances and grisly murders, tied together by the common thread of the master's envy or hunger for revenge.

Anne's notes: If you have a PC who is constantly making questionable choices, it's important that they understand that such things may have a cost to their very souls. While you can absolutely reserve these creatures for the kinds of masters outlined above, these are my go-to if I need to send a message to a more anti-hero based group that their self serving trickery may have a cost if they go too far down a dark path.

Anne's notes: Disease is fun both in and out of combat. Contamination horror is a favorite of mine and sometimes there are fates worse than death. I'm of the mind that PC death should mean something whether in heroic sacrifice or in providing a personal drive for the rest of the party avenge the demise of their ally. What better inspiration for a vendetta than watching your friend die and be transformed into an abyssal wretch? 

Screen Shot 2018-07-16 at 10.56.06 AM.png

An alkilith is easily mistaken for some kind of foul fungal growth that appears on doorways, windows, and other portals. These dripping infestations conceal the demonic natuer of the alkilith, making what should be a dire warning appear strange but otherwise innocuous. Wherever alkiliths take root, they weaken the fabric of reality, creating a portal throug which even nastier demons can invade. 

Symptoms of Doom. The appearance of an alkilith in the world heralds a great wrongness and an imminent catastrophe. An alkilith searches for an aperture wuch as a window or a door around which it can take root, stretching its body around the opening and anchoring itself with a sticky secretion. If left undisturbed, the opening becomes attuned to the Abyss and eventually becomes a portal to the plane. 

Spawn of Juiblex. Alkiliths spring fromt he cast-off bits of Juiblex's hideous, shuddering body, then gradually become self-aware and set out to find their way onto the Material Plane. Since most cultists consider them too risky for summoning - they can, after all, create portals to the Abyss - alkiliths must find other escape routes out of their native plane. 

Anne's notes: These are great "harbinger" challenges. If you know your crew is going to be dealing with demon lords hailing from the abyss, these are a great adversaries that give mid level player characters a look at how vast the planes are as well as the constant threat that demons and fiends could break through into the prime material plane at any moment. Even their appearance doesn't mean they necessarily are going to be destroyed until the characters discover what they truly mean. 

Screen Shot 2018-07-16 at 11.03.27 AM.png

The appearance of the Dark Prince is a warning that not all beautiful things are good. Standing nearly nine feet tall, Graz’zt strikes the perfect figure of untamed desire, every plane and curve of his body, every glance of his burning eyes, promising a mixture of pleasure and pain. A subtle wrongness pervades his beauty, from the cruel cast of his features to the six fingers on each hand and six toes on each foot. Graz’zt can also transform himself at will, appearing in any humanoid form that pleases him, or his onlookers, all equally tempting in their own ways.

Graz’zt surrounds himself with the finest of things and the most attractive of servants, and he adorns himself in silks and leathers both striking and disturbing in their workmanship. His lair, and those of his cultists, are pleasure palaces where nothing is forbidden, save moderation or kindness.

The dark Prince of Pleasure considers restriction the only sin, and takes what he wants. Cults devoted to him are secret societies of indulgence, often using their debauchery to subjugate others through blackmail, addiction, and manipulation. They frequently wear alabaster masks with ecstatic expressions and ostentatious dress and body ornamentation to their secret assignations.

Although he prefers charm and subtle manipulation, Graz’zt is capable of terrible violence when provoked. He wields the greatsword Angdrelve, the Wave of Sorrow, its wavy, razor-edged blade dripping acid at his command.

Graz’zt’s Lair

Graz’zt’s principal lair is his Argent Palace, a grandiose structure in the city of Zelatar, found within his Abyssal domain of Azzatar. Graz’zt’s maddening influence radiates outward in a tangible ripple, warping reality around him. Given enough time in a single location, Graz’zt can twist it with his madness. Graz’zt’s lair is a den of ostentation and hedonism. It is adorned with finery and decorations so decadent that even the wealthiest of mortals would blush at the excess. Within Graz’zt’s lairs, followers, thralls, and subjects alike are forced to slake Graz’zt’s thirst for pageantry and pleasure.

Lair Actions

On initiative count 20 (losing initiative ties), Graz’zt can take a lair action to cause one of the following effects; he can’t use the same effect two rounds in a row:

  • Graz’zt casts the command spell on every creature of his choice in the lair. He needn’t see each one, but he must be aware that an individual is in the lair to target that creature. He issues the same command to all the targets.
  • Smooth surfaces within the lair become as reflective as a polished mirror. Until a different lair action is used, creatures within the lair have disadvantage on Dexterity (Stealth) checks made to hide.

Regional Effects

The region containing Graz’zt’s lair is warped by his magic, creating one or more of the following effects:

  • Flat surfaces within 1 mile of the lair that are made of stone or metal become highly reflective, as though polished to a shine. These surfaces become supernaturally mirrorlike.
  • Wild beasts within 6 miles of the lair break into frequent conflicts and coupling, mirroring the behavior that occurs during their mating seasons.
  • If a humanoid spends at least 1 hour within 1 mile of the lair, that creature must succeed on a DC 23 Wisdom saving throw or descend into a madness determined by the Madness of Graz’zt table. A creature that succeeds on this saving throw can’t be affected by this regional effect again for 24 hours.

If Graz’zt dies, these effects fade over the course of 1d10 days.

Madness of Graz’zt

If a creature goes mad in Graz’zt’s lair or within line of sight of the demon lord, roll on the Madness of Graz’zt table to determine the nature of the madness, which is a character flaw that lasts until cured. 

Madness of Graz’zt

Screen Shot 2018-07-16 at 11.00.22 AM.png

Anne's notes: Have you ever been in a party with a lethario? That changes real quickly if their vice becomes a warning to the party that they may be suffering from demonic madness - just look at that table! I also love the effects that this demon's presence has on the area where he resides. I'm a huge fan of Bacchanalian horror as seen in Trueblood and The Magicians so this allows me to exercise my imagination in that direction as a storyteller. This is a villain straight outta Sailor Moon and all I want to do is transform the land around this evil into a charismatic fun house mirror hellscape. Graz'zt is such a great demon lord because he represents desire. His call is more subtle and he's extremely charming and extensions of him are going to be able to infiltrate the party over a period of time. If you were ever going to make a deal with a demon, it might be with this one. 

Anne's notes: There are several versions of the Oblex creature so you can bring them in to face the party at different challenge ratings. However, the second and third tier feature the "Eat Memories" ability. This can have a profound effect on the character. Memories and experience make you who you are. Consuming those parts of a person can spur some really incredible and tragic character development. 

Screen Shot 2018-07-16 at 11.07.56 AM.png

Death in Hellfire. A narzugon's lances are forged in hellfire. The soul of anyone killed by such a lance is shunted to the River Styx for rebirth as a lemure. Each lance is unique to its owner, bearing the marks of both the narzugon and its master. 

Anne's notes: Just when the party gets gold sickness and is excited to kill foes and loot magical items, it's important to remind them that some items are cursed. Imagine the story line that could be developed if a fighter or barbarian began using the lance of a narzugon and accidentally sending the souls of common enemies to the fiery depths of hell. 

The Demon Queen of Fungi, Lady of Rot and Decay, Zuggtmoy is an alien creature whose only desire is to infect the living with spores, transforming them into her mindless servants and, eventually, into decomposing hosts for the mushrooms, molds, and other fungi that she spawns.

Utterly inhuman, Zuggtmoy can mold her fungoid form into an approximation of a humanoid shape, including the skeletal-thin figure depicted in grimoires and ancient art, draped and veiled in mycelium and lichen. Indeed, much of her appearance and manner, and that of her servants’, is a soulless mockery of mortal life and its many facets.

Zuggtmoy’s cultists often follow her unwittingly. Most are fungi-infected to some degree, whether through inhaling her mind-controlling spores or being transformed to the point where flesh and fungus become one. Such cultists are fungal extensions of the Demon Queen’s will. Their devotion might begin with the seemingly harmless promises offered by exotic spores and mushrooms, but quickly consumes them, body and soul.

Sharing a layer of the Abyss with Juiblex, plus their mutual insatiable hunger, has made the two demon lords mortal enemies, each devoted to destroying and ultimately devouring the other.

Zuggtmoy’s Lair

Zuggtmoy’s principal lair is her palace on Shedaklah. It consists of two dozen mushrooms of pale yellow and rancid brown. These massive fungi are some of the largest in existence. They are surrounded by a field of acidic puffballs and poisonous vapors. The mushrooms themselves are all interconnected by bridges of shelf-fungi, and countless chambers have been hollowed out from within their rubbery, fibrous stalks.

Lair Actions

On initiative count 20 (losing initiative ties), Zuggtmoy can take a lair action to cause one of the following effects; she can’t use the same effect two rounds in a row.

  • Zuggtmoy causes four gas spores or violet fungi (see the Monster Manual) to appear in unoccupied spaces that she chooses within the lair. They vanish after 1 hour.
  • Up to four plant creatures that are friendly to Zuggtmoy and that Zuggtmoy can see can use their reactions to move up to their speed and make one weapon attack.
  • Zuggtmoy uses either her Infestation Spores or her Mind Control Spores, centered on a mushroom or other fungus within her lair, instead of on herself.

Regional Effects

The region containing Zuggtmoy’s lair is warped by her magic, creating one or more of the following effects:

  • Molds and fungi grow on surfaces within 6 miles of the lair, even where they would normally find no purchase.
  • Plant life within 1 mile of the lair becomes infested with parasitic fungi, slowly mutating as it is overwhelmed.
  • If a humanoid spends at least 1 hour within 1 mile of the lair, that creature must succeed on a DC 17 Wisdom saving throw or descend into a madness determined by the Madness of Zuggtmoy table. A creature that succeeds on this saving throw can’t be affected by this regional effect again for 24 hours.

If Zuggtmoy dies, these effects fade over the course of 1d10 days.

Madness of Zuggtmoy

If a creature goes mad in Zuggtmoy’s lair or within line of sight of the demon lord, roll on the Madness of Zuggtmoy table to determine the nature of the madness, which is a character flaw that lasts until cured. See the Dungeon Master’s Guide for more on madness.

Madness of Zuggtmoy

Anne's notes: Zuggtmoy's purview is decay, which - by nature - doesn't happen all at once. Her presence in a campaign can be like a seductive rot that overtakes characters or NPC's. The presence of her mind altering spores can also have a lasting effect. 

Skulks are the soulless shells of travelers who became lost in the Shadowfell, wandering its gray wastes until they lost all sense of self. They are so devoid of identity that tehy have become permanently invisible. Only children can see a skulk without the help of a mirror or special candle. On the rare occasions when a skulk is visible, it appears as a drab, featureless, hairless, humanoid.

Summoned Servants. A skulk can be summoned from the Shadowfell by performing a ritual. If the creature is given a portion of the summoner's identity, the skulk is bound to obey the summoner's commands for 30 days. If a skulk is visible, an astute observer might deduce who summoned it, because a skulk assumes a vague likeness of its master.

Cruel and chaotic, skulks carry out their orders in the most violent manner possible. A summoned skulk can't return to the Shadowfell until it dies, so it has every motivation to throw itself into creating bloodshed and mayhem.  

Hollow Lives. After killing a person in the material world, a skulk sometimes takes up a silent imitation of the person's life. In extreme cases, skulks have invaded villages, killed all the occupants, and turned the places into seeming ghost towns, where flavorless food is prepared daily, colorless clothes are hung up to dry, and livestock is shifted from pen to pen until it starves.

Anne's notes: These are great lower level foes for the party to face. I love the idea of a slowly rotting ghost town. What if this was a place the adventurers had visited before where the skulks took up the mantle of past friends? That's the kind of image that stays with a person rather than disappearing as soon as the imminent threat ends. 


Anne's notes: Even if some heroes survive, it's possible others may be consumed by an astral dreadnaught and thrust into a demiplane. If you don't manage to kill the creature, but your party survives, it's likely a PC could be incarcerated in the demiplane until the party can secure the wish spell. These beasts can be used by other powerful entities as living prisons to capture particular characters and bring them back to a lair. Let your imagination run wild! Scarring your party for life is fun.