This humanoid creature has long, sharp teeth, and its pallid flesh is stretched tightly over its starved frame.

Ghast (CR 2; XP 600)
CE Medium undead
Init +4; Senses darkvision 60 ft.; Perception +9
Aura stench (10-foot radius, Fort DC 15 negates, sickened for 1d6+4 minutes)
AC 18, touch 14, flat-footed 14
(+4 Dex, +4 natural)
hp 17 (2d8+8)
Fort +4, Ref +4, Will +7
Defensive Abilities channel resistance +2
Speed 30 ft.
Melee bite +5 (1d6+3 plus disease and paralysis) and 2 claws +5 (1d6+3 plus paralysis)
Special Attacks paralysis (1d4+1 rounds, DC 15)
Str 17, Dex 19, Con —, Int 17, Wis 18, Cha 18
Base Atk +1; CMB +4; CMD 18
Feats Weapon Finesse
Skills Acrobatics +6, Climb +8, Knowledge (religion) +8, Perception +9, Sense Motive +9, Stealth +9, Swim +5
Languages Common
Environment ruins, urban
Organization solitary, gang (2–4), or pack (7–12)
Treasure standard
Special Abilities
Disease (Su) Ghast Fever: Bite—injury; save Fort DC 15; onset 1 day; frequency 1/day; effect 1d3 Con and 1d3 Dex damage; cure 2 consecutive saves. The save DC is Charisma-based. A humanoid who dies of ghast fever rises as a ghast at the next midnight. A humanoid who becomes a ghast in this way retains none of the abilities it possessed in life. It is not under the control of any other ghouls, but it hungers for the flesh of the living and behaves like a normal ghoul in all respects.

Ghasts are more powerful undead that haunt graveyards and eat corpses. Legends hold that the first ghasts were either cannibalistic humans whose unnatural hunger dragged them back from death or humans who in life fed on the rotting remains of their kin and died (and were reborn) from the foul disease—the true source of these undead scavengers is unclear.

Ghasts lurk on the edges of civilization (in or near cemeteries or in city sewers) where they can find ample supplies of their favorite food. Though they prefer rotting bodies and often bury their victims for a while to improve their taste, they eat fresh kills if they are hungry enough. Though most surface ghouls live primitively, rumors speak of ghast cities deep underground led by priests who worship ancient cruel gods or strange demon lords of hunger. These “civilized” ghast are no less horrific in their eating habits, and in fact the concept of a well-laid ghast banquet table is perhaps even more horrifying than the concept of taking a meal fresh from the coffin.