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Blood Queen

This hideous monstrosity looks like an enormous curled maggot, varicolored like deeply bruised flesh. Three flailing tentacles adorn each side of the thing’s huge, pulsating mouth, and five more arch from its hindquarters.

Blood Queen CR 23

Source Isles of the Shackles pg. 44
XP 819,200
CE Gargantuan outsider (native)
Init +4; Senses blindsight 120 ft., surrogate senses; Perception +39


AC 38, touch 6, flat-footed 38 (+32 natural, –4 size)
hp 471 (23d10+345); regeneration 10 (good)
Fort +28, Ref +9, Will +24
DR 15/epic and lawful; Immune disease, electricity, mindaffecting effects, poison, sonic; SR 34


Speed 10 ft.
Melee bite +29 (2d6+10), 5 stings +29 (2d6+10/19–20 plus 2d6 electricity), 6 tentacles +24 (2d8+5/19–20 plus grab)
Space 20 ft., Reach 20 ft.
Special Attacks horrifying bellow, swallow whole (15d6 acid damage, AC 26, 47 hp), unholy gestation
Spell-Like Abilities (CL 23rd; concentration +36)
5/day—cacophonous call (DC 25), deeper darkness, dispel good (DC 28), inflict critical wounds (DC 27)
3/day—greater command (DC 28)
1/day—mass suffocation (DC 32)


Str 30, Dex 11, Con 40, Int 20, Wis 29, Cha 37
Base Atk +23; CMB +37 (+41 grapple); CMD 47
Feats Alertness, Awesome Blow, Bleeding Critical, Critical Focus, Improved Bull Rush, Improved Critical (sting), Improved Critical (tentacles), Improved Initiative, Iron Will, Lightning Reflexes, Power Attack, Vital Strike
Skills Bluff +39, Diplomacy +39, Heal +32, Intimidate +39, Knowledge (arcana) +28, Knowledge (history) +28, Knowledge (planes) +31, Knowledge (religion) +31, Perception +39, Sense Motive +39, Spellcraft +31
Languages Abyssal, Aklo, Common, Draconic, Kuru, Undercommon; telepathy 100 ft.
SQ blood link


Environment any
Organization solitary
Treasure triple

Special Abilities

Blood Link (Su) Three times per day as a standard action, the Blood Queen may psychically link to up to 23 Hit Dice of kuru within 100 feet of either itself or one of its kuru surrogates; it may choose which specific kuru it would like to affect with this ability, but HD that are not sufficient to affect a creature are wasted. Any kuru linked to in this way must succeed at a DC 28 Will save or be forced to carry out the Blood Queen’s telepathic commands to the best of its ability. In addition, a linked kuru gains a +4 morale bonus to Strength and Constitution and is immune to mind-affecting effects. The blood link lasts for 1 minute or until the Blood Queen ends the effect (a free action). When the blood link is broken, the affected kuru takes 1 point of Intelligence damage and cannot be linked to again for 24 hours. The save DC is Charisma-based.

Horrifying Bellow (Su) Three times per day as a standard action, the Blood Queen can release a terrifying bellow that affects a 30-foot-radius spread. Any creature within the affected area must succeed at a DC 34 Will save or be paralyzed for 1d4 rounds. The save DC is Charisma-based.

Surrogate Senses (Su) In addition to its blindsight, the Blood Queen can constantly see and hear through its unholy kuru surrogates as though with a permanent clairaudience/clairvoyance spell. If at any time one of the Blood Queen’s surrogates is killed, it is dazed for 1 round.

Unholy Gestation (Ex) Whenever the Blood Queen swallows an unconscious humanoid or renders a humanoid unconscious with its swallow whole ability, it moves the victim through its digestive track, where the victim no longer takes damage, but rather begins to gestate within the Blood Queen’s transformative stomach for 1d4 rounds. After the creature has finished gestating, it is regurgitated from the hindquarters of the Blood Queen, encased in an opaque mucous pod. Any attempt to remove a gestated humanoid from its pod causes massive system shock, and the humanoid takes 6d6 points of damage unless it succeeds at a DC 25 Fortitude save or those releasing it succeed at a DC 25 Heal check. As a swift action, the Blood Queen can send strong telepathic emanations to any pod within 100 feet, causing it to violently explode. The resulting spray of bilious ooze deals 6d6 points of acid damage to the creature encased in the pod and to any creatures in a 15-foot-radius burst.

Alternatively, the Blood Queen may allow an encased humanoid to continue to gestate for at least 24 hours, and after that duration may release the fully metamorphosed creature from its pod at any point. When released, the victim completes its transformation into a kuru surrogate (see the Kuru Surrogate section below). The Blood Queen may create any number of pods, but can only possess up to six kuru surrogates at any one time (if the Blood Queen releases a seventh kuru surrogate from its mucus pod, the oldest surrogate immediately dies no matter where it is and the Blood Queen is dazed for 1 round). The save DCs are Constitution-based.


Millennia ago, when the repugnant cyclops empire of Ghol-Gan populated the Shackles, its foul and alien gods sent powerful servants from beyond to act as their intermediaries, guiding and corrupting the empire until its ignominious collapse, at which point the gods and their minions fled Golarion altogether. However, one of these vile servants remained even after Ghol-Gan’s collapse, a wretched horror known as the Blood Queen. It has dwelt for centuries in its foul subterranean chamber in a ruined Ghol-Gan temple called Ganagsau in the Cannibal Isles, and it was this blasphemous being who transformed the kuru into the degenerate race they are today, convincing them that it is a living goddess worthy of their veneration. The Blood Queen has a kuru high priest who goes by the name Bukrugsor, and this devoted thrall sees to it that his dark patron is brought regular sacrificial victims and offerings of blood.

The Blood Queen has no eyes, per se—rather, what look like angry pustules all over its bloated body act as sensory organs. In addition, it is able to see and hear the world through the various kuru surrogates its followers have interspersed throughout the Cannibal Isles. Its grotesque mouth is capable of articulating a number of languages, though if it deigns to speak with a creature it usually does so via its telepathy. While the Blood Queen uses the short tentacles that extend from its mouth to devour prey and sacrificial offerings, the tentacles that emanate from its hindquarters are long, muscular, and tipped with bonelike stingers that allow it to manipulate objects and electrify victims.

The Blood Queen is nearly immobile, being a massive, swollen beast that sits in the middle of a huge underground temple chamber in its ruined cathedral. While it may slowly undulate its bulk in one direction or another, in the years since its appearance on Golarion, the Blood Queen has grown far too large to fit through any of the limestone chamber’s exits. Only the Blood Queen’s high priest, those destined to become surrogate kuru, or sacrifices to the behemoth monster are allowed within this foul throne room. Sometimes unwilling sacrifices are dropped into the chamber from a hole in the ceiling and the exits are sealed so that the Blood Queen may toy with its food before it feeds. A being of monumental evil, the Blood Queen expresses its rage at its divine abandonment by spreading as much pain and havoc as it can. Whether it ever escapes its ancient, self-made prison remains to be seen, though all right-thinking creatures that know of its existence shudder at the prospect.

Kuru Surrogates

The Blood Queen’s favored deacons are known as kuru surrogates, and such monstrosities are created when the horror digests a creature and entombs the victim in one of its paralytic sacs for long enough. The creature that emerges is essentially brain-dead, having been completely stripped of its wits and nervous system. A kuru surrogate remains in its vegetative state until it starves, is killed, or is affected by a heal spell or a similar effect of equal or greater power. Kuru surrogates are revered among the Blood Queen’s devout, who transport the immobile things around the Cannibal Isles, perpetually caring for the “blessed” individuals. The Blood Queen acts through these surrogates and uses them to augment and command its kuru followers, linking with its minions in order to capture any who oppose it or its wicked cult of cannibals.