A ray of sickening greenish energy lashes out toward a creature within range. Make a ranged spell attack against the target. On a hit, the target takes 2d8 poison damage and must make a Constitution saving throw. On a failed save, it is also poisoned until the end of your next turn.

At Higher Levels. When you cast this spell using a spell slot of 2nd level or higher, the damage increases by 1d8 for each slot level above 1st.

Casting Time: 1 action
Range: 60 feet
Components: V, S
Duration: Instantaneous
School: 1st-level necromancy

Player’s Handbook, pg. 271

Ray of Sickness 5e

Ray of Sickness is a straightforward ranged spell attack with a chance of poisoning a creature for one round. While its damage and effects seem decent at first glance, a few things conspire to make this 1st-level spell a bit underwhelming.

We’ll cover why most spellcasters opt to skip the sick, as well as options for re-flavoring/re-balancing the spell for DMs and players.

Who Can Cast Ray of Sickness in 5e?

The following classes have Ray of Sickness on their spell list:

  • Wizard

  • Sorcerer

The following subclasses get Ray of Sickness for free:

What Does Ray of Sickness Do in 5e?

Ray of Sickness is a ranged spell attack that deals 2d8 poison damage if it lands. Ranged spell attacks are just a d20 roll that you add your proficiency modifier and spellcasting ability modifier (Intelligence for Wizards and Artificers, Charisma for Sorcerers) to. If the number equals or exceeds the target’s AC, the spell lands.

Ray of Sickness deals an average of 9 damage at 1st level.

If the attack lands, the creature must also make a Constitution saving throw against your spell save DC. If it fails, it becomes poisoned until the end of your next turn.

“A poisoned creature has disadvantage on attack rolls and ability checks” (PHB 292). If Ray of Sickness lands and poisons the creature, it’s an effective offensive and defensive spell.

What Are the Rules for Ray of Sickness 5e?

The rules for Ray of Sickness in DnD 5e are as follows:

  • Ray of Sickness must target a creature. While some spells explicitly allow the caster to target objects (like Fire Bolt), Ray of Sickness is explicit about targeting creatures only. So no, RAW, you cannot poison food or drink with Ray of Sickness.

  • Being immune to poison refers to both the damage and the condition, if a feature doesn’t specify otherwise. Like Monk’s Purity of Body, for example.

  • The poisoned condition doesn’t affect saving throws. So Ray of Sickness isn’t all that great for setting up wombo-combos with big-damage saving throw-based spell attacks like Toll the Dead or Fireball.

  • The poisoned condition does give disadvantage on shoves and grapples. Because shoving and grappling both involve ability checks, a poisoned creature will have disadvantage in both scenarios.

  • A poisoned creature has disadvantage on all attack rolls. If a creature has multiattack, the disadvantage applies to every attack they make for the entire round.

  • Sorcerers can used Twinned spell with Ray of Sickness. Ray of Sickness meets all the requirements to be twinned — it targets only one creature and doesn’t have a range of self (PHB 102). This is an effective way for a Sorcerer to potentially debuff two enemies at once for just a first-level spell slot and one sorcery point.

lich casting ray of sickness 5e

How Do I Use Ray of Sickness 5e?

While Ray of Sickness is a simple spell to use, here are a few ways to get the most mileage out of it:

  1. Target creatures with multiple attacks. If you’re able to apply the poison effect to your target, it’s most beneficial to poison targets that will make multiple attack rolls on their turn. They’ll have disadvantage on each and every attack, multiplying the effectiveness of Ray of Sickness.

    Although you may not always know which enemy creatures have multiattack capability, you can figure it out if you pay attention to what the DM is doing on their turns in combat. Poison these guys, and you’ll be the hero of the party.

  2. Follow up with shoves or grapples. While it’s usually not possible to get an offensive advantage out of the poisoned condition, there are two exceptions; shoving and grappling.

    Because both require ability checks and because poison gives a creature disadvantage on ability checks, your allies (or you, on your next turn) will have an easier time shoving or grappling poisoned enemies. This makes Ray of Sickness that much more potent with something like a control Barbarian in your group.

  3. Twin it. Sorcerers have the ability to use the Twinned Spell metamagic to target two enemies with Ray of Sickness instead of one. This obviously makes the spell twice as likely to land and potentially twice as strong. This is especially worthwhile if you’re able to poison multiple creatures that are able to multiattack.

  4. Bring it against humanoid baddies. As we’ll get to below, one big problem with Ray of Sickness is that poison is a very common immunity in DnD 5e. However, this weakness is not as pronounced against humanoids.

    So if you’re a Wizard with Ray of Sickness, only prepare this spell on occasions where you’re certain it’ll be useful against most of the most-likely bad guys. Humanoids are almost always susceptible to poison, so it’s typically a good option against them.

Who Can I Target With Ray of Sickness 5e?

You can target any creature in range with Ray of Sickness, but you cannot target objects.

Is Ray of Sickness 5e a Good Spell?

No, Ray of Sickness is not a good spell in comparison to other first-level options available to Wizards and Sorcerers. While an average of 9 damage on a ranged spell attack is decent (definitely not great) for a 1st-level spell, poison damage is considered the worst in the game.

As Reddit user RocksInMyDryer found with his incredibly useful spreadsheet, poison is the most common immunity in DnD 5e, with roughly 1/4 of creatures having poison immunity. That goes for both the condition and the damage, making Ray of Sick essentially useless against 25% of the monsters you’ll be up against.

On top of that, the 3/4 of creatures that are even eligible targets have Constitution as their highest average stat (15) — a stat I owe to another rad Reddit user, Fontanapink and their dope spreadsheet.

Additionally, actually landing Ray of Sickness’ poison requires two consecutive rolls in your favor, which makes it that much less reliable as a readily applicable condition.

Overall, Sorcerers and Wizards have many first-level spells that outclass Ray of Sickness in damage, consistency, and utility.

Ray of Sickness 5e DM Tips

Ray of Sickness is a straightforward ranged spell attack, so you probably won’t have much trouble adjudicating rules for this spell. If you want to allow a clever player to poison food with Ray of Sickness, feel free to break the rules as written in favor of the “rule of cool.”

As for making Ray of Sickness a more attractive spell, you have a few options:

  • Make Ray of Sickness’ damage type necrotic instead of poison. The logic behind this is simple — necrotic resistances and immunities are a whole lot less common than poison. This at least ensures players can use this spell for damage (if not the poison condition) against +20% of the 5e’s creatures.

  • Make Ray of Sickness’ poison effect land automatically on a successful ranged attack. This might be a bit more controversial, as the poisoned condition is quite strong and can make some big-bad-evil-gals feel a whole lot less threatening.

  • Change Ray of Sickness to a Constitution saving throw-based attack. This is the less powerful alternative to the fix mentioned above. Since Constitution saving throws are very often high for creatures, this keeps Ray of Sickness’ relative power level the same but makes the application of the poisoned condition more consistent.

    This makes Ray of Sickness a better niche pick-up for casters who thematically want to roll with necromantic magic.

Which brings us to our last DM tips for Ray of Sickness — flavoring the spell. While the spell description gives some help — “a ray of sickening greenish energy lashes out” — it still leaves it up to you (and the player casting it) to decide how this spell actually hurts/poisons the creature and appears to onlookers.

Does the sickening energy simply slap the target and make them feel queasy if it slaps them extra hard? Or does it produce a rancid stench that has the target bent over and gasping for air? Perhaps the creatures’ veins bubble with the green, acidic energy of the spell, turning their very blood to poison.

Whatever it is, make it cool — players often pick up spells like Ray of Sickness to thematically build a necromancer-themed character rather than to min/max their potency. Reward them with extra-cool roleplaying elements around the spell.

Simple Ray of Sickness 5e Spell Text

Ray of Sickness: (1st-level necromancy, 60 feet, V/S) Make a ranged spell attack. On hit, deal 2d8 poison damage and target must make a Constitution saving throw. On a failed save, it is also poisoned until the end of your next turn. | +1d8 per slot level above 1st.