Once-Proud. The pallid creatures known as ghoul regents are in fact once-proud elven lords and ladies forced into a troglodytic existence. They once followed and worshipped Doresain, the first ghoul, and serve as its clergy. As undead, they have devolved to become something far fouler and more hate-filled than their brethren, their physical appearance soon came to reflect their miserable condition, turning them into hunched and grotesque monstrosities. However, ever since the downfall of their demigod, these ghouls have been shunned and hunted down by gnolls and demons of Yeenoghu and forced into exile. Ghoul lore hearkens back to a land sacred to ghouls called the White Kingdom. Though ghouls bound to the mortal plane sometimes create lesser versions of what they believe the White Kingdom to be, it is accepted that the true incarnation of the White Kingdom can be found on the layer of the Abyss where the ghoul regents once ruled. Since their demise, the ghoul regents await the return of the King of the Ghouls, Doresain, and the coming of the night where they would enact a dire vengeance and retake the White Kingdom at the head of shambling undead armies.

Grotesque Court. Packs of flesh-eating ghouls are attracted to these dismals and often form grotesque courts around them. Grave robbers, and those who steal from the bodies of the fallen, have learned well that they must practice their depraved crafts in the twilight and be home before nightfall. Under cover of darkness, different breeds of scavengers fall on these places of death. From their catacomb, haunted wood, moss-covered ruin and forgotten places of the world, ghoul regents spy on their enemies, the servants of Yeenoghu, and on their lost past, the elven courts, reminded of what they lost, bitterness and envy gnawing at their minds. In their desolation, many of them lost their sanity completely and became pathetic parasites, wary of attracting attention.

Instinctive Necromancy. Even if most of them have to some degree lost their minds during their exile, the ghoul regents still possess many powerful abilities. They can tear to shreads a victim in the blink of an eye, and their authority over the ghouls is strong. Their immortal body become as hard as iron and regenerates at heighten speed, coursing with the sustaining power of necromancy. Such dark magic must to be dispelled to destroy the creature. They can innately use necromancy, but they do so in their own instinctual way. Their magic is less subtle than the forms of necromancy practiced by other elevated undead, but in the cut and thrust of combat, their savagery gives them a definite edge.

Doresain's Plague - Ghoul Fever

Those infected by the diseased bite of a ghoul may contract Doresain’s Plague, more commonly known as ghoul fever. Those who perish from this rotting illness rise at the next midnight as ghouls themselves. In this way, some undead recruit the formerly living into their shuffling ranks:

• When the ghoul hits a creature with a bite attack, it must succeed on a DC 15 Constitution saving throw or contract a disease. Until the disease is cured, the target can't regain hit points except by magical means, and the target's hit point maximum decreases by 13 (3d8) every 24 hours. If the target's hit point maximum drops to 0 as a result of this disease, the target dies. This reduction to the target's hit point maximum lasts until the disease is cured. A humanoid killed by this disease rises at the next midnight as a ghoul, unless the humanoid is restored to life or its body is destroyed.

A ghoul regent always establishes a place of worship to the King of the Ghouls and only underground. Small shrines can sometimes be found in underground mausoleums or at the catacomb’s center, but fully functioning temples are erected only in the deepest subterranean realms, surrounded by a community of ghouls the size of a small city.

Lair Actions

On initiative count 20 (losing initiative ties), the ghoul regent can take a lair action to cause one of the following magical effects; it can't use the same effect two rounds in a row:

• The ghoul regent causes ghoulish glyphs to appear on a surface in a 10-foot-radius sphere that it can see within 100 feet of itself. The glyphs last until initiative count 20 on the next round. Each creature in that area when the glyphs appear must succeed on a DC 18 Wisdom saving throw or be paralyzed until the glyphs disappear.
• The ghoul regent targets a humanoid within 30 feet of it that has been dead for no longer than 1 minute and died violently. The target rises as a ghoul. The ghoul is under the ghoul regent's control.
• All ghouls within 90 feet of the ghoul regent that can hear it are enraged, causing them to have advantage on melee weapon attack rolls and causing attack rolls to have advantage against them until initiative count 20 on the next round.
• The ghoul regent chooses a ghoul type creature (such as a ghoul, ghast, crypt horror or a similar creature) of its choice in the lair to become its conduit. It needn't see the target, but it must be aware that the target is in the lair to choose that creature. Until the ghoul regent uses this lair action again, it can cast spells as though it were in the conduit’s space, can see through the conduit’s eyes and hear what it hears, gaining the benefits of any special senses that the conduit has, and speak through the conduit with its own voice. If the conduit is destroyed, the ghoul regent takes 22 (5d8) psychic damage and is stunned until the end of its next turn.