We already lightly touched upon medusas on the entry for gorgons (which, in D&D, are entirely unrelated). They’re based on Greek Myth, where Medusa was an individual, the only mortal among the semi-divine Gorgon sisters. I see them on the Rules Cyclopedia, so they’ve been around since at least BECMI and probably since the beginning.
As is common with creatures based on singular entities from Greek Myth, D&D medusas are an entire species of humanoids with snake-like features. Females have the iconic hair snakes, and their gaze can petrify victims. Males are completely bald, and their gazes can “poison the mind and body”.
The Monster Manual portrays medusas as a haugthy and ambitious people. They live in small groups, but their ambition drives them to seek money and power in the societies of others. Evil medusas turn up as assassin guild masters or terrifying nobles, but you also get nicer ones working as eccentric veiled scholars and alchemists. Eberron has medusas make up part of the elite in the monster nation of Droaam, so you can have medusa ambassadors and such.
The Monster Vault, as usual goes a bit harder on the evil angle and says that medusas are universally regarded as unnatural by all the other sapients. Rumors and myths abound about their origins, and run along two main lines. One says they were wholesome/wicked people who got punished/rewarded by Zehir with their current forms. The other says they were the result of yuan-ti genetic experiments, originally meant to serve as a slave race. Villainous medusas do often worship Zehir, the snake god of treachery and snakes, and they often have cordial relations with yuan-ti, who are one of the few other peoples they are said to truly respect.
Medusas like to decorate the area around their lairs as demarcation and warning. There’s the classic statue gardens, of course, and males also like to paint the walls with the blood of their victims.
The Monster Vault also turns them into another of those evil matriarchies where males are oppressed, with only those few who are immune to petrification being singled out for special treatment. The Monster Manual makes no mention of this, and says every medusa is immune to petrification regardless of gender.
In combat, medusas use weapons, with a preference for swords and bows. Their blades and arrows are often coated in poison derived from the their own saliva or blood. Someone who has been petrified by a medusa can be brought back to life by the application of a few drops of that medusa’s blood to the victim’s lips. While the text assumes you’ll kill the medusa to get that blood, I don’t think that’s a hard requirement. If you do kill it, you must apply the blood to the victims within 24 hours.
Medusas are Medium Natural Humanoids. All are immune to petrification, and have some degree of poison resistance. They also have a gaze attack, which can be either petrification or venom depending on the individual.
Gaze mechanics are different in both books. MM gazes are standard action attacks, to which blind creatures are immune. It’s up to the PCs to decide whether it’s safer to fight an elite paragon medusa blindfolded or to risk its gaze.
MV gazes are triggered actions, which means the monster doesn’t need to choose between using its weapons or its gaze in a turn. Also, blinding yourself won’t save you from these gazes.
Medusa Archer (MM)
This lady is has the closest stat block to the classic medusas of editions past. She’s a Level 10 Elite Controller with 212 HP. Her speed is 7 and her poison resistance 10.
She fights in melee with her Snaky Hair, which does a bit of physical damage plus 10 ongoing poison damage, and also inflicts a -2 penalty to Fortitude (save ends both). Her main ranged attack is a Longbow (range 20/40 vs AC) whose poison-dipped arrows trigger a secondary attack against Fortitude on a hit, causing the same rider effects as the hair.
The archer’s Petrifying Gaze is a Close Blast 5 vs. Fortitude. It slows on a hit, and this worsens to immobilized on the first failed save and to full petrification on the second. The first two conditions are (save ends), but petrification is permanent until cured. This is an at-will power, and the perfect thing to use on people already weakened by the poison from the other attacks.
Medusa Bodyguard (MV)
One of those poor oppressed MV males, this guy is a Level 12 Soldier with 123 HP. He is not immune to petrification and has Resist 10 Poison and Speed 6.
The bodyguard is armed with a broadsword and a longbow. The longsword marks for a turn on a hit, and both attacks have an ongoing 5 poison damage (save ends) rider. The bodyguard’s Mind-Venom Gaze triggers as an interrupt when a marked target ignores the mark. It’s a Close Blast 5 vs. Will that must include the triggering character. It does a good bit of poison damage to those it hits, and also stuns the triggering character if it hits them. The gaze recharges whenever the bodyguard hits with his sword, and blind creatures are not immune.
Medusa Venom Arrow (MV)
Venom arrows are non-elite versions of the MM Archers, being level 12 artillery monsters with 96 HP.
Like Archers, they fight in melee with their less-whimsically named serpent hair, which deals poison damage and inflicts a -2 to Fortitude for a turn. Their Range 30 bows do physical damage, ongoing 5 poison damage, and slow (save ends).
Their Petrifying Stare is a triggered opportunity action. If an enemy starts they turn within 2 squares of the medusa, they’re subject to a gaze that hits automatically and slows them (save ends). This progresses to full permanent petrification just like the Archer’s gaze.
The possible cures for this petrification are specified here: the right power or ritual, a willing kiss from the medusa, or the afore-mentioned blood drops.
Medusa Warrior (MM)
We’re back in elite territory with these dudes, who are Level 13 Elite Soldiers with 272 HP. They fight with longswords and longbows as well.
The longsword attacks trigger a secondary attack against Fortitude on a hit, dealing ongoing 10 poison damage and slowing (save ends both). The arrows automatically inflict the ongoing damage if they hit (save ends).
As elites, warriors can use a standard action to make two sword attacks, and those deal extra damage against a dazed target. Their source of daze effects is their Venomous Gaze (Close Blast 5 vs. Will), which does poison and psychic damage, with “daze” and “weaken” riders (save ends both).
Warriors prefer melee, alternating between their gaze and their double sword attacks. If you have more than one, they’ll coordinate their actions to that effect as well.
Medusa Spirit Charmer (MV)
The lady medusa from the MV. She’s a Level 13 Controller with 130 HP, immunity to petrification and resist poison 10. This is more of a spellcaster or psion type.
Like the MM archer, she uses her serpent hair to fight in melee, doing poison damage on a hit and inflicting a -2 penalty to saves for a turn. Her main ranged attack is Spirit Charm (Close Blast 5 vs. Will), which does a bit of psychic damage and compels the target to approach the medusa. This isn’t a pull, but a choice: the victim must either end their next turn within 2 squares of the medusa, or it must take further psychic damage.
Once per encounter she can cast Swords to Snakes (Area Burst 1 Within 10 vs. Will), an illusion that makes people think their weapons and tools have become snakes. This prevents them from using weapon or implement powers (save ends).
The spirit charmer’s Signature Medusa Move is the Stony Glare, a reaction that triggers if an enemy ends their movement within 2 squares of the medusa. Which by the way can happen due to Spirit Charm! This is a Close Blast 2 that only affects the triggering enemy, targets Fortitude, and petrifies immediately. This is a (save ends) condition until the third failed save, in which it becomes permanent until cured.
The possible cures are the same as those of the Venom Arrow’s gaze.
Medusa Shroud of Zehir (MM)
A powerful Zehir-worshipping avenger or assassin. This lady is a Level 18 Skirmisher with 172 HP. She is immune to petrification and has 10 resistance to both acid and poison.
The Shroud fights with paired short swords, which do physical damage and ongoing acid and poison damage (save ends). She will often use a maneuver named Fangs of Death (recharge 4-6) which allows her to make two sword attacks and shift 3 squares between them. There’s a typo in her attack bonus, which is listed as +15 instead of the correct +23.
Her Snaky Hair is a minor action, with the right attack bonus and the same damage as a sword blow. It inflicts the same ongoing damage and a further -2 penalty to Fortitude (save ends both).
The Petrifying Gaze is here and works the same as the archer’s.
Shrouds spam those snake bites and use Fangs of Death whenever it’s charged, since it spreads the poison around and allows them more mobility. When it’s not charged, they use their gazes.
Sample Encounters and Final Impressions
There are a few on the MM.
Level 11: 1 medusa archer, 1 venom-eye basilisk, and a gaggle of snaketongue cultists.
Level 14: 1 medusa warrior, a bunch of grimlocks and 2 gargoyles.
Level 17: 2 shrouds of Zehir, 1 yuan-ti malison disciple of Zehir, and 3 yuan-ti abominations.
As you can see, medusas are probably the world’s premier basilisk owners, since they are completely immune to that monster’s gazes and they complement their own powers nicely. I imagine even good medusas subscribe to newsletters on the care and feeding of basilisks.
They also tend to associate with or employ other monsters who are similarly immune to their powers, like the blind grimlocks or gargoyles and other earth-elemental creatures. Also, if you feel like yuan-ti alone don’t give you enough options to stock a dungeon full of snake-people, you can add some medusas in. If you believe those MV myths, medusas are instinctively compelled to serve yuan-ti, probably the only instance where they would put themselves in the “servant” position.
Personally I like the image of the “archer medusa” a lot, and as with most other humanoids I’d probably include non-villainous medusa in my setting to go along with the usual antagonists. The stat blocks from both books seem to imply their gazes attacks are always entirely voluntary, which would mean a peaceful medusa wouldn’t even need those veils or dark goggles. Guess they might still wear them as a sign of goodwill, though, like sometimes knights will peace-bond their swords to show they mean no harm.