Altitude Elemental | Free 5e and PF2 Monster

Altitude Elemental | Free 5e and PF2 Monster

Written by Claire Martin

Some who live in the alpine biome seek out the thin air and steep slopes, who climb mountains for the thrill, discovery, accomplishment, or the view. Some of these people have coalesced into a group called the Summit Creed. Its members are mountain climbers, explorers, and locals who discovered a higher purpose upon cresting the peak; they encountered an altitude elemental, a being that could enhance their aptitude for surviving and thriving at high elevations, in exchange for their loyalty and devotion.

Versions for both 5e and Pathfinder 2e are included.

By the way, if you're looking for more drag-and-drop creatures like this or other 5e and PF2e resources, check out our entire collection of Lair Magazine issues. This particular monster came from the March 2024 issue, Marvels & Moonlight, where you can find even more game master resources!

Climate Controllers. The altitude elemental is a cousin of the air elemental but characteristic of mountainous regions at high elevations where the air is thin. The lack of oxygen can cause dizziness, nausea, headaches, exhaustion, and even death in some cases. The elemental has control over this environment, either allowing creatures to grow hardier and more resistant to these conditions or weakening them through exhaustion.

A dark figure hovers above the ground, its form slowly roiling and crackling like thunderclouds. The twisting shapes divide and reunite across its body, sometimes fading out completely only to reappear once it collides into another puff, then clashes back into existence with lavender flashes. It sounds like the high-pitched ringing of an old radio, varying in its tone, and smells like a mix of stone and pure mountain air.

Altitude Elemental - 5e

Large elemental, neutral

Armor Class 15 (high altitude protection)

Hit Points 85 (9d10 + 36)

Speed 0 ft., fly 90 ft.







14 (+2)

16 (+3)

19 (+4)

11 (+0)

10 (+0)

7 (-2)

Damage Resistances cold, lightning, thunder; bludgeoning, piercing, and slashing from nonmagical attacks

Damage Immunities poison

Condition Immunities exhaustion, poisoned

Senses darkvision 60 ft., passive Perception 13

Languages Common, Auran

Challenge 5 (1,800 XP)   Proficiency Bonus +3

Air Form. The elemental can enter a hostile creature’s space and stop there. It can move through a space as narrow as 1 inch wide without squeezing.

High Altitude Protection. The altitude elemental has an AC of 15 while it is above 10,000 feet in altitude.

High Altitude Aura. Creatures who start their turn within 10 feet of the elemental must make a DC 15 Constitution saving throw. On a failure, the creature becomes dizzy, nauseated, and confused until the beginning of the elemental’s next turn. An affected target can’t take reactions and must roll a d10 to determine its behavior for that turn. On a 1-3, the creature doubles over and vomits. The creature doesn’t take an action this turn. On a 4-7, the creature is dizzy and has disadvantage on attack rolls this turn. On an 8-10, the creature can act and move normally.


Multiattack. The elemental makes two slam or oxygen extraction attacks.

Slam. Melee Weapon Attack: +6 to hit, reach 5 ft., one target. Hit: 12 (2d8 + 3) bludgeoning damage.

Oxygen Extraction. Ranged Spell Attack: +6 to hit, range 60 ft., one target. Hit: 16 (2d12 + 3) bludgeoning damage. On a hit, the target must make a DC 15 Constitution saving throw. On a failure, the target must immediately roll one of its unused hit dice, taking additional acid damage equal to the result of the roll. The die is considered expended. If the target has no remaining hit dice, this effect grants a level of exhaustion instead.

Altitude Sickness (Recharge 4-6). The elemental targets a creature within 30 feet. An unwilling target must make a DC 15 Constitution saving throw. On a failure, the elemental may add or remove a level of exhaustion from the creature.

Altitude Elemental - Pathfinder 2

Creature 5

N, Large, Elemental, Air

Perception +15

Languages Common

Skills Athletics +12, Acrobatics +12

Str +6, Dex +3, Con +5, Int +3, Wis +3, Cha -1

AC 22; Fort +15, Ref +12, Will +9

HP 72; Resistances cold 4, lightning 4, thunder 4, physical 4; Immunities bleed, paralyzed, poison, sleep

High Altitude Aura (aura, emanation) 10 feet. Creatures who start their turn within 10 feet of the elemental must make a DC 22 Fortitude saving throw. On a failure, the creature becomes confused. Once a creature recovers, it is immune to the high altitude aura for 24 hours.

Speed fly 50 feet

Melee [one action] slam +15, Damage 2d8+7 bludgeoning damage.

Ranged [one action] oxygen extraction +13 (magical, range increment 40 ft.), Damage 2d6+6 negative damage plus the target must make a DC 22 Fortitude save. On a failure, the creature is drained 1 (drained 2 on a critical failure).

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