Guide to Urgathoa: Pathfinder’s Goddess of Disease, Physical Excess & Undeath

“Moderation is a fatal thing. Nothing succeeds like excess.”

-Oscar Wilde

For all people, there is the temptation to indulge in the darker appetites of their personality. They wish to eat and drink and indulge themselves beyond the point of sanity.

For most, this temptation is just that: a small temptation that is dismissed as quickly as it arrived.

For a certain few though, this temptation becomes an all-consuming obsession. For those few, the goddess known as Urgathoa is all too ready to assist them in their goals. All they have to do is offer their slavish devotion.

Urgathoa’s Deific Lore

Urgathoa is one of the most infamous deities in Golarion. She represents dark desires and horrible blights. Those who serve her are often reviled as monsters but are sometimes secretly envied.

Urgathoa is Neutral Evil by nature. She doesn’t really care for law or chaos but revels in evil and darkness.

Her favored weapon is the scythe, and her favored colors are red and green.

Urgathoa’s symbol is a stylized fly with a skull face on its back. Her favored animals are carrion eaters like vultures and hyenas and also moths and flies.

Urgathoa is also known as Lady Despair or the Pallid Princess.

Personal History

Urgathoa’s personal history is not really widely known.

Legend has it she was once a mortal woman, infamous for her hedonistic tendencies and wanton desires. When she died, she journeyed to the Boneyard, the plane of Pharasma.

Rather than being judged for her misdeeds in life, Urgathoa escaped the Boneyard and made it back to the mortal plane.

She became the first Undead and arose to Godhood. She is the only being known to have escaped the Boneyard and defied Pharasma.

Legend also has it that her disruption of the natural law is what brought disease to the mortal world.


When artists depict Urgathoa, they typically show her as a gorgeous human woman with pale skin and long black hair.

From her waist down, her skin begins to rot like a zombie until she is nothing but a blood-soaked skeleton. She is often shown wielding a large scythe as well.

When she chooses to manifest to mortals, Urgathoa will have this exact appearance. However, she sometimes conceals it with a long black robe stained with blood and muck.

Home Plane

Urgathoa makes her home in the hellish realm of Abaddon on the shores of the Sea of Lamentation. Her divine realm is known as the Bloodrot and manifests as a vase necropolis and undead breeding ground. 

She made a deal with the Archdaemon Charon for her realm, and therefore, his daemons leave her and her minions alone.

Allies and Enemies

Most of Urgathoa’s relationships with other deities is pretty straightforward. Almost all the other deities in Golarion hate her for one reason or another.

Erastil, Sarenrae, Pharasma, Gozreh, and Abadar are all her direct enemies as Urgathoa represents everything they (and their followers) hate.

Calistria and Urgathoa often come into conflict as they compete for the same kind of followers much of the time. 

Urgathoa often gets annoyed and frustrated by Irori and his followers because their asceticism specifically runs counter to her goals.

Gorum and Urgathoa are often at odds. This is mostly because Gorum sees death by disease to be the most honorless and lowest form of dying.

Lamashtu and Urgathoa are often at odds as rivals as well. Urgathoa would rather the world be dominated by undead rather than Lamashtu’s monstrous brood.

Urgathoa has her allies as well as enemies. 

Zyphus’s divine realm exists inside of the Bloodrot, so the God of Accidental Death owes his loyalty to Urgathoa.

Lady Despair is also in the process of attempting to corrupt the lesser deity and servant of Shelyn known as Naderi, whose belief in love beyond death sometimes interacts with Urgathoa’s domain.

The Whispering Way as well as the demon lords Kabriri and Zura are all connected to the concept of Undeath and are therefore allies to the Pallid Princess.

Finally, some mad followers of Groetus often find themselves allied with Urgathoa, but Groetus’s followers are often confused why anyone would want to languish on as an Undead when oblivion is preferable.


The Pallid Princess has many servants, directly or indirectly. Almost all thinking Undead (Liches, Vampires, Revenants, and the like) revere Urgathoa in some way and serve her when she calls.

When Priestesses of Urgathoa die, they are often resurrected as beings known as the Daughters of Urgathoa. They are horrifically beautiful, each one being unique in its twisted and unholy form. All are irredeemably evil.

Some of her more specific servants are:

  • Illcayna Alonnor is a very powerful Daughter of Urgathoa. She is in command of an army of undead Wights and is sometimes called the Wight Mother of Isger.
  • The Sarcovalt are Urgathoa’s divine servitor race. They resemble the worst parts of both a carrion fly and a vulture. They serve as guards and messengers for Urgathoa and her followers. They often spread disease wherever they go.
  • Barasthangas is a Devourer who owes his existence to Urgathoa. She is extremely thin and emaciated with almost translucent skin. She is often called upon by the faithful to offer magic knowledge and spells, but for every piece of knowledge offered, she asks someone to pay with their soul.
  • Fjarn was once a barbarian Linnorm King, but he was forced to slaughter and devour his own honor guard. In shame and anger, he committed suicide. After his death, he rose as a Ghast and now serves Urgathoa.
  • The Mother’s Maw is Urgathoa’s herald and is a giant winged skull surrounded by flies. She is a lich and is cunningly intelligent. She wants only to indulge in the excesses she once did when alive.
  • Olix is a vampire priest of Urgathoa. He is a powerful spellcaster and a master at the use of Shadow Magic.

Urgathoa’s Church

The Church to the Pallid Princess is not a monolithic organization but rather a widely dispersed collection of cults organized in a small self-sufficient cell.

Since most Good and Righteous groups choose to hunt Urgathoa’s followers, they have to keep to the shadows and make sure to keep a low profile.

The church is organized mostly as a matriarchy with women being in almost all positions of power. 


Undead are sacred to Urgathoa as are the creation of undead. They are a transgression on the natural order, just like when Lady Despair herself escaped Pharasma’s judgment.

Disease is the blessing of the goddess and should be spread to all her enemies.

Curing disease, destroying undead, and denying your own appetites is anathemic to the tenets of Lady Despair.

Edicts: Become undead upon death, create or protect the undead, sate your appetites

Anathema: Deny your appetites, destroy undead, sacrifice your life


Worshipers of Urgathoa are organized into two casts: the Ghula and the Famished.

The Ghula are the top cast who have proven themselves to their congregation and are worthy members. The Famished are those still seeking approval and must serve the Ghula in all ways.

Among the faithful are those known as Antipaladins. They are typically fallen paladins whose passions overwhelmed their oaths.

In the case of Antipaladins who follow Urgathoa, they are often gluttons who feast on the best while leaving death and disease in their wake. 

Antipaladin Code

The antipaladins of Urgathoa are creatures of the night, plague-bearers, and bringers of death. They seek to spread Urgathoa’s gifts by the sword and by emulating their goddess. Their tenets include the following affirmations.

  • The grave opens to us all. We hasten the living on their inevitable path.
  • The deathless are the true expression of existence, for they are beyond life and death. I will emulate their ways and destroy those who would defile their timeless perfection.
  • I have no duty but to my hunger and my goddess.
  • Existence is hunger. Both life and death feed on life. I am an instrument of transition.


The Pallid Princess’s Priesthood is mostly filled by Clerics and Necromancers with a great many multiclassing into both. The great majority of the clergy is female as it is a matriarchy.

The Priests are often dressed in loose-fitting robes of dark gray or bone white. The bottom half of the robes are typically rotted or shredded in some way to reflect the appearance of the goddess. 

Temples and Shrines

Temples to Urgathoa are often hidden away in dark places like old graveyards and despoiled churches.

They are often furnished and decorated as feast halls, which is what almost every ceremony in Urgathoa’s honor will eventually evolve into. 

Many of these temples are guarded by mindless undead under the control of the chief priest. The most well-known temples are guarded by demons.

Holy Text

Serving Your Hunger is the (un)holy text for Urgathoa’s cult. It was penned by her first Antipaladin by the name of Dason.

The book contains secret mysteries and parables that are designed to jar the reader into a new frame of mind, as well as numerous recipes for extravagant meals (including some ways to cook undead flesh or intelligent humanoids) and spells for the creation of undead.


Urgathoa’s cult does not have normal holidays, but it does have a holy event known as the Reaping.

When the Reaping happens, the chief priestess of the cult will take up a large scythe and go on a killing spree to see how many she can kill before she is forced to return to the safety of their hidden temple.

Should Urgathoa be impressed or pleased by the Clergy’s efforts, she will grant a boon to the congregation.

Player Involvement

There are more than a few options for both characters and NPCs to show off their devotion to Lady Despair.

It should be noted that Urgathoa is an Evil deity. If players are wanting to worship her, GMs should be aware of the possible directions their games take and prepare accordingly.

Pathfinder 1st Edition


These archetype builds are perfect for those who want to devote themselves to the Pallid Princess:


Most characters involved with the worship of Urgathoa will have one of the following feats:

Magic Items

These magical items are connected to Urgathoa or her church in some way:


These monstrous creatures are all servants of Urgathoa. They can make powerful allies or deadly enemies:

Domains and Subdomains

Clerics of Urgathoa have access to the following domains and subdomains:



* Requires the Acolyte of Apocrypha trait.


Those who follow Urgathoa and cast magic will typically have one of these spells prepared:


Traits are a variant rule that help you to customize your character further beyond what the core Pathfinder rules offer.

A normal PC can only have one trait per campaign, so make sure to ask your GM if they are using traits before you decide on one:

Variant Rule

Below is a variant rule that devotees of Urgathoa can use.

Priests who cast remove disease may draw diseases into themselves as they heal their targets; they become carriers without suffering ill effects. Contagion spells cast by Urgathoa’s priests always use the caster’s spell DC for the disease’s secondary saves.

Source: Inner Sea Gods pg. 163

Pathfinder 2nd Edition

Devotee Benefits

Divine Intercession

Owing to ancient pacts and agreements, the deities of Golarion cannot take direct action in the material plane. To do so would undermine the free will inherent in mortals and also invite equal action from their enemies.

To get past this (and in addition to granting spells to their clerics), many gods use something called Divine Intercession.

They will grant boons or inflict curses on their mortal followers to encourage them to take actions that benefit the church and the Deity.

Some gods will offer boons to mortals who are about to undertake a great quest on their behalf or place a curse on them if they fail something particularly important.

Urgathoa interferes in mortal affairs to fuel her own self-gratification and obsession with observing new sensations.

Minor Boon: You feast on the spoils of life and death. You gain the benefits of the irongut goblin heritage, regardless of your ancestry. If you already have this heritage, the circumstance bonus increases to +4.

Moderate Boon: Urgathoa blesses you as one of her children. You gain negative healing.

Major Boon: When you contract contagions, you experience fever dreams filled with insight. Once afflicted with a disease, you gain the effects of foresight with yourself as the target until no longer afflicted with any disease.

Minor Curse: You must overindulge or partake in forbidden feasts before you find yourself even remotely sated. You need to eat 20 times as much food as normal to avoid starvation, though you always feel hungry regardless of how much you eat. If you dine on the flesh and blood of sapient creatures, you need to eat only the normal amount of such meals and your hunger abates.

Moderate Curse: Urgathoa cuts you off from positive energy without granting you the blessing of undeath. You are harmed by positive effects and don’t recover Hit Points from them as if you were an undead or had negative healing, but you are still harmed by negative effects as normal.

Major Curse: Urgathoa teaches you that pointless lives in slavery to death and morality are bound to end in tragedy. You develop an incurable wasting disease that leaves you clumsy 2, enfeebled 2, and unable to move except by Crawling. This disease never progresses further to kill you, but it passes to your friends and loved ones merely by sight, wasting them away unto death before your eyes and causing them to rise as undead to haunt you.

Source: Gods & Magic pg. 49 2.0