Thrills and Chills: Adding Horror to your Game

Note: If you want to try your hand at implementing some horror, check out my one-shot, Isle of the Dying Moon, in which characters travel to a dark and dismal isle to face off against a horrific foe!

Intrigue did super well, so let’s delve into adding more Elemental Genres to D&D games. This week, Horror; eliciting fear from players despite the fact that they’re sitting around the table eating Doritos. Horror doesn’t happen in the realm of long-term plans and story threads; horror is here and now in the moments at the table.

Again, for the purposes of this essay, I’m going to assume that we don’t want this to become a full horror game. At their core, most D&D games are Action/Adventure, but we want to use horror as a spice to vary up the emotions our players experience.

In addition, I’ll repeat this warning with more nuance several times, but be wary when using horror elements. Know your players and respect their boundaries above all else.

Always keep Safety Tools in mind. See the [ TTRPG Safety Toolkit for more. Player safety is important above all else.

What is Horror?

Horror is defined as an intense feeling of fear, shock, or disgust. It comes from the Latin horrere, which means to tremble or shudder–an important distinction, because this means horror is visceral and often involuntary. Unlike Intrigue, Horror is a reaction, not a process.

A “Horror Campaign” will likely have a relentlessly grim tone and lots of gory monsters. While that sounds like an incredibly fun game to play in, we can use those elements to create moments of horror to punctuate otherwise upbeat campaigns.

Three Types of Horror

There are many kinds of horror, but for the sake of symmetry and simplicity, we’ll divide it into three rough categories, each eliciting a slightly different reaction.

Atmospheric Horror (the Unknown) taps into our primal fears about darkness and the things we cannot see. Visceral Horror (the Unpleasant) taps into our primal fears about our bodies and the “right” way for living things to exist. Surreal Horror (the Unfathomable) taps into our primal fears about the existence and fragility of our reality itself.

As we’ll see, these three categories often appear blended together or leading into one another. You might use Atmospheric Horror tactics to set up a big Surreal or Visceral reveal, for example. I’m using the categories to speak roughly on the tactics you can use for each.

Atmospheric Horror (the Unknown)

“Oh, cool. A dark basement. I was just thinking we should be doing this in a dark basement.”

-Jeff Winger.

Atmospheric Horror is achieved mainly through description: a swinging lantern, a discordant melody, an uncomfortable silence. Atmospheric Horror is looking out your window in the middle of the night and swearing that you see a figure in the yard. As a DM, this type of horror provides the most bang for your buck, because its power lies in the realm of description and suspense. Nothing is happening—yet. And the monsters that players imagine will always be worse than the monster you put in front of them.

Atmospheric Horror can be used alone just to set a mood, but it’s also an important setup for the other two types of horror discussed here. It’s also the most readily available and safest to use. At its core, atmospheric horror cannot hurt the players–if it does, then it stops becoming atmospheric, either becoming visceral horror or classic adventure combat. However, it may not be suitable for players with anxiety-related issues, so be wary.

Examples in Media: The Shining, It Follows, Get Out, A Quiet Place (mostly). Atmospheric Horror usually serves as a double-feature with other types of horror described below.

How to Use Atmospheric Horror

At the table, music can be a powerful tool to set the mood. Everything from subtle, ominous sounds to the Lavender Town theme song can be used to put players on edge.

When it comes to the story, description is king. Atmospheric horror involves darkness, the unknown, and a sense of claustrophobia as the world tries to restrict the characters’ movement. Moreover, it typically involves something out of place–not where it should be. Something isn’t quite right.


The door creaks open, revealing only a dim stone chamber. The steady drip, drip, drip of water meets your ear.

As you run your finger along the ground, a layer of grime clings to your skin. The wallpaper is yellow and peeling, drooping down toward you and making the room feel even smaller.

The trees sway softly in the wind. You draw closer and find the remains of a squirrel–squashed and torn apart–nailed to one of the trunks. The wind whispers through the branches, rustling leaves. And then, abruptly, all goes still.

Visceral Horror (the Unpleasant)

Visceral horror is your classic monsters, gore, and body horror. Fundamentally, it’s the horrible things that make us squirm. It’s the character’s first sight of a Beholder. It’s finding a dead dwarf with half his skull missing and the brain sucked out like an oyster. It’s jumpscare and the maggots and the flesh-eating ghouls.

Note: visceral horror runs the risk of becoming self-indulgent and genuinely upsetting for players. This type of horror requires a delicate hand, subtlety, and humility. Use with consent–knowing your players’ boundaries–and use it sparingly. For example: I generally have the stomach for most types of gore, but I get squeamish about bones. Anything remotely sexual is also a bad idea and has no place in TTRPGs.

Examples: Alien, first and foremost. Just about anything with gore–I won’t make any more specific recommendations, but plenty of gory horror movies and stories are out there.

How to use Visceral Horror

Sparingly. Once more, the key lies in the description. This kind of horror generally lies in the places where things have gone wrong, or in well-recognized symbols of fear. For example: a creature with mouths where its eyes should be, or an eye where its mouth should be. The Alien from Aliens in all of its glory. The Nazis at the end of Raiders right as they’re melting (or the Nazis at the end of Last Crusade, right as he’s aging). Leathery skin, exposed brains, tentacles, slime, etc.

A gelatinous cube isn’t scary if you just describe it as a ten-foot cube. But start describing its slow, crawling movement, the half-dissolved face of a screaming corpse trapped in the gel, and the rigid, burning gel that engulfs a character, impeding their movement and cutting off their air? That’s pretty scary.

Some DMs are masters of evocative word choice, horrifying sound effects, and grotesque metaphors. My style tends to be more direct; I imagine a horrifying image and then describe it in plain, straightforward language. Below are some examples.


A mindflayer wraps its tentacles around a duergar’s head as the dwarf twitches madly, his screams muffled. You hear a faint creaking sound, then a gut-wrenching snap. The duergar goes limp, followed by a loud sucking sound. The tentacles release and the body drops to the ground in a mangled mess.

The jagged, blood-stained teeth sit on the lumpy creature’s stomach, while its head is a smooth mash of grey flesh. It lumbers toward you with the uncertain steps of a newborn baby, fleshy hands dragging against the ground.

The hunched hag with mottled skin and ragged clothes has her back to you, revealing branches and rocks protruding from her flesh. Her head turns slowly to face you while the body stays in place. She grins madly. Suddenly she spins, bounding toward you, limbs flailing wildly as spittle flies from her teeth.

The line between visceral and atmospheric is blurry at best. Spiders scurrying on the walls might be considered atmospheric, while a swarm of spiders crawling on a character is likely to feel visceral.

Surreal Horror (the Unfathomable)

Surreal Horror is probably the most difficult form of horror to pull off–but the most rewarding if successful. It’s hard to pin down a definition. It’s when everybody on the street turns to stare at you for five seconds before going on their way like nothing happened. It’s when you trip on the street and fall into a non-Euclidean hellscape. It’s the moment when you realize reality as you understand it is fundamentally broken.

It is VERY hard to come back from true surreal horror that breaks reality, which is why it tends to work best in shorter-term games built expressly for that purpose (e.g. Call of Cthulhu). An easier option is to deploy a monster such as the False Hydra, which plays with memory and narrative itself. Deploying one such monster can irrevocably change the tone of a game, so be wary. Still, it’s the kind of mind-bending horror I’d love to explore someday.

Notably, this is also the form of horror closest to gaslighting, and so requires serious consideration and consent from players before engaging.

Examples in Media: The Matrix, Total Recall, The Nine Million Names of God, I Have No Mouth and I Must Scream. Many episodes of The Twilight Zone, such as Time Enough at LastThe Truman Show kind of falls into this.

How to use Surreal Horror

Surreal Horror is almost impossible to pull off alone; it’s best to use Atmospheric Horror tactics to set things up. Actually, I’ll just try to blend all three together in The False Hydra below…

The False Hydra

The False Hydra is an aberration that is blocked from the memory of anybody who hears its eerie song. When it wants to eat, the Hydra extends one of its enormous necks, briefly stops singing its song, and chooses prey to target. Those who are eaten are completely wiped from memory.

Other posts have effectively covered specific tactics to run the Hydra, so I’ll stick to big picture ideas. For one thing, I want this to end in a heroic battle rather than abject misery. That means the False Hydra needs to be something they can fight and defeat, which means the Surreal horror needs to hit before or during the creature’s reveal. To that end, visceral horror is probably the last type they’ll come across, making the monster truly repulsive.

The design of the Hydra is already terrifying. A pale, swelling creature with snake-like necks and almost-human faces is fucking horrible. I imagine that its source or seed is a bulbous, cancerous growth that cannot move; the Hydra is rooted where it was born, and only its necks can move. Once characters realize the trick, they can find and kill the source, but it’s going to be a vile and revolting process filled with bursts of yellow blood, rubbery skin, and the overwhelming stench of rotten flesh.

The moment of peak horror that I envision is this: once characters have pieced together the Hydra’s ability, one or more of them cover their ears or cast Silence. Directly in front of them, now visible, are the horrific visage and enormous neck of one of the Hydra’s heads–it has been watching and waiting the whole time. Alternatively, if the Hydra isn’t attacking, they cover their ears and look out the window, seeing for the first time a half-dozen enormous necks spreading around the town. This is the peak Surreal moment, when characters realize the truth of the reality around them.

How do we ramp up to this moment? We’ll do so by creating an unsettling Atmosphere. The post by /u/Rinse- above has some good tactics.

Hello Jack. I hope you’ve been well. Since you left Cobyr Square after HE your father’s death, the place has not been the same. I implore you to come and visit us once again. A IS bad case of insomnia has recently swept the city and it has affected WATCHING me as well despite my best efforts. I have not yet found a remedy for the ailment and I fear they it US may be a symptom for a larger problem. We could use someone with your expertise. God’s speed! Your friend, Tyrnan Altek.

I really love this tool because it sets up a dissonance in reality–two messages overlapping, one of them horrifying while the other is pleasantly plain. Other Examples:

  • The spot where the deaf beggar once sat is now long empty. His blanket and hat with a few silver pieces lie dormant. The party might notice how some folk will briefly stop at the site before walking on, confused only for a few seconds
  • Players hear a scream from around the corner! When they arrive at the scene they just see a woman casually picking up some fallen apples from the ground and continue on her way as if nothing has happened.

In this case, the horror doesn’t stem from the darkness or the grime–that is, it’s not just a bodily threat that the characters can’t see. The False Hydra hides from the players’ memories and perception of reality itself.

Why Use Horror?

Why have I even put this together? I don’t like horror movies.

Fear is one of those primal emotions in humans–the other being laughter. Both a panicked cry and a sudden laugh are involuntary physical reactions to a stimulus. When role-playing, we’re embodying a character to feel their triumphs and pains, but fear and laughter are the most potent.

Well-used horror ramps up stakes, slowly winding up the tension before allowing for some kind of catharsis at the end. That catharsis could be classic horror–total failure and death at worst, just barely surviving at best. For an average D&D game, catharsis probably should include an adventurous heroic battle that ends in victory, but that’s just personal taste. Regardless, horror elements make that epic catharsis feel more epic.

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