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As classic monsters, Ghouls had their 4e debut on the first Monster Manual, and would end up making it into the Monster Vault as well. Here, the Monster Manual 3 gives us a few specialized ghoul variants that can compliment the ones on the MV.
The basic lore for ghouls remains the same. You can check out a description of it on my post about ghouls in the MM/MV.
The MM3 emphasizes that ghouls are creatures of pure evil, since they used to be individuals who practiced cannibalism or did other equally horrible things in life. It adds that they are not only driven by a hunger for flesh, but are also drawn to places where evil is powerful.
Ghouls will spontaneously show up at the home bases of evil cults, especially those who worship Orcus or one of his exarchs. These villains often secure the ghouls’ services by paying in live captives.
Ghouls will also seek out ruins and dungeons where great evil is entombed, sometimes digging for miles to reach these places if they happen to be deep underground. This attraction handily explains why the ghouls that live in these places prefer to hang out there rather than terrorizing the countryside.
Some adventurers like to use these ghoul tunnels and warrens as a way to reach their dungeons or the Underdark, but this is a risky proposition as any ghouls living in the tunnels will have a terrain advantage against the interlopers.
We get three different varieties of Ghoul here, none of which seem to be reprinted in the MV. They’re all Medium Natural Humanoids with the Undead tag. They have Darkvision, Immunity to disease and poison, Resist 10 Necrotic, and Vulnerable 5 Radiant.
Ghoul Flesh Seeker
This is a cultist of Orcus who has undergone a voluntary transformation into a ghoul. I guess the origin could be applied to any stat block, but this specific entry describes a stealthy bastitch. They sometimes hunt in civilized settlements, disguising themselves with heavy robes. When accompanying other monsters, they like to strike from ambush while the PCs are busy with their less stealthy buddies.
Flesh Seekers are Level 4 Lurkers with 45 HP. Their ground speed is an excellent 8, and their Shadow Skulk trait allows them to roll Stealth to hide in combat when they have partial cover or concealment (normally you need full cover or concealment).
Their basic attack is a Claw that damages and immobilizes (save ends) on a hit. They don’t have abilities to exploit this directly, but “standard” ghouls do.
They have two “lurker”-y special attacks. The first is Prepare For Sacrifice, which they can use against a creature from which they were hidden at the start of their turn. It does more damage than the claw attack, and on a hit the flesh seeker knocks the target prone and grabs it. The target can escape using the normal rules (Athletics DC 14 or Acrobatics DC 16) but takes a -2 penalty on the escape test and can’t stand up until the grab ends.
The second special attack is Render Unto Orcus, and it can only be used on a target grabbed by the flesh seeker. No special riders here, just a massive chunk of damage.
Tactics write themselves: Ambush -> Prepare For Sacrifice -> Render Unto Orcus. If someone pries you off your victim, hide and repeat.
Adept of Orcus
A cannibal priest of Orcus who died and returned as a ghoul. This one retains its memories, but since it already behaved like a ghoul in life the only way you can tell it’s because it can use magic.
Adepts are Level 6 Controllers with the Leader tag and 71 HP. Their speed is 8. They project an Uneasy Grave aura (5). Any non-minion ghoul ally that dies inside this aura comes back as a zombie rotter (a minion) at the start of its next turn.
The adept’s Claw damages and immobilizes, as typical for ghouls. It also has three spells, all ranged attacks. Grave Grasp (at-will) does no damage and restrains (save ends). Call to Feast (recharge 5+) immobilizes (save ends) and allows a ghoul ally adjacent to the target to make a free basic attack against them. And Grave Dust Cloud (encounter) is an area spell that does necrotic damage and creates a zone that does 5 necrotic damage to any enemy who enters it or ends their turn inside.
These things are extremely dangerous when paired with traditional ghouls, since they can paralyze from a distance and allow their buddies to do huge damage right away.
Ghasts are a monster as traditional as the ghoul. Basically, they’re stronger and stinkier ghouls. The MM and MV had Abyssal Ghouls to fill this role, but they were level 16. This official Ghast entry is appropriate for mixing in with standard ghouls.
Ghasts are what happens when a ghoul goes for too long without eating the flesh of the living. Instead of starving, they rot from the inside and become even more desperate and voracious. This rot is what gives them their horrible stench.
Ghasts are Level 6 Brutes with 85 HP. They’re a bit slower at speed 6, and their Stench of Death aura (1) slows any living creatures that start their turns inside.
Their basic attack is a bite that damages and immobilizes for a turn. They can use a Devouring Bite against an immobilized creature, which does huge damage and keeps recharging until they hit with it. After the bite hits and is spent, they can use their Rabid Claws, to make two melee attacks against immobilized creatures. Each one does slightly less damage than the basic bite, but if the two hit they hurt more overall.
Encounters and Final Impressions
These new ghoul types can fit into the same types of encounter group as the ones from the MM/MV, which means they pair well with Orcus cultists and other undead. And now you have enough ghoul stat blocks to make a large variety of all-ghoul encounters.
As for my impressions… I like ghouls as opponents, and I would like to repeat my warning from the original article to prefer the MV ghouls over the MM1 ones. The ones from this book pair well with the MV versions.