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The Underrot, Healer Guide

Updated 2 years, 3 months ago for patch 8.3 by Preston. View the change log.

This page covers healer-focused strategies for The Underrot dungeon. While it's tailored for healers, other roles may also find the information useful. If you have any suggestions or feedback, you can leave a comment below or tweet @PrestonDvorak.

This guide has been updated and maintained based on my own experiences as well as Dungeon Journal information. I'll continue to update it as-needed.


Below are guides for the bosses in The Underrot, including their abilities, healer notes, and addon settings.

Elder Leaxa Dungeon Journal Model Elder Leaxa

  • Taking damage from any ability applies a stack of Taint of G'huun.
  • Interrupt Blood Bolt to prevent the heavy damage on random players.
  • Avoid the path of Creeping Rot.
  • Blood Mirror creates a Blood Effigy.
    • Blood Effigies use the same abilities as Leaxa.
  • On Heroic, move out of Sanguine Feast after Leaxa teleports.

 Healing Notes

  • Use Cooldowns when Blood Effigies are active.
  • Watch for players with high stacks of Taint of G'huun.
 Debuffs to Track

Healer DBM Settings for Elder Leaxa

Cragmaw the Infested Dungeon Journal Model Cragmaw the Infested

  • Infested causes Cragmaw's abilities to spawn Blood Tick Larva.
    • These must be stepped on before their Metamorphosis cast finishes or they'll turn into Blood Ticks.
      • Blood Tick
  • Don't be in front of Cragmaw to avoid Indigestion.
  • Targets random players with Charge, knocking back any players hit.
  • On Heroic, at 100% energy Tantrum deals moderate damage to all players and spawns Blood Tick Larva randomly around the room.

 Healing Notes

  • Use Cooldowns on Tantrum or if too many Blood Ticks are active.
 Debuffs to Track

Healer DBM Settings for Cragmaw the Infested

Sporecaller Zancha Dungeon Journal Model Sporecaller Zancha

  • Taking damage from any ability will apply a stack of Decaying Spores (dispel, disease).
  • Avoid the Spore Pods created by Boundless Rot.
    • These must be destroyed by players affected by Upheaval or by the tank using Shockwave.
  • At 100% energy, Festering Harvest detonates all Spore Pods, inflicting moderate damage to all players and applying a stack of Decaying Spores for each Spore Pod that was active.
  • On Heroic, Volatile Pods causes dozens of poison orbs to travel across the room, dealing light damage to any player hit.

 Healing Notes

 Debuffs to Track

Healer DBM Settings for Sporecaller Zancha

Unbound Abomination Dungeon Journal Model Unbound Abomination

 Healing Notes

 Debuffs to Track

Healer DBM Settings for Unbound Abomination


 Trash Mobs

Below are notes for the trash mobs in The Underrot. The Underrot has a relatively linear layout. The trash below is ordered as if you're completing the bosses in the order they're listed above. Some spells don't exist in the database and will be added as soon as they're available.

Entrance thru Elder Leaxa

  • Fetid Maggot
    • Don't stand in front of these when Rotten Bile is cast.
  • Underrot Tick
    • Deal moderate damage to all players upon death with Blood Burst.
  • Chosen Blood Matron
  • Fanatical Headhunter
  • Devout Blood Priest
  • Befouled Spirit
    • When targeted by Dark Omen, stay at least 4-yards away from other players and be prepared to use a personal defensive cooldown.

Elder Leaxa thru Cragmaw the Infested

  • Living Rot
  • Feral Bloodswarmer
    • Deals light damage to all players and interrupt spell casts with Sonic Screech.
    • Fixates on players with Thirst for Blood, dealing moderate to heavy damage.
  • Diseased Lasher
    • Interrupt or dispel Decaying Mind (disease) to prevent the stun and reduced healing absorption.
      • This effect can also be removed from the player by healing them for the absorption amount.
  • This area also contains Fetid Maggots, detailed above.

Cragmaw the Infested thru Sporecaller Zancha

  • Fallen Deathspeaker
  • Reanimated Guardian
    • Interrupt or dispel Bone Shield (purge) to prevent the damage absorption effect.
  • Grotesque Horror
    • Interrupt or dispel Death Bolt (magic) to prevent the stacking damage dealt to the group.
  • Bloodsworn Defiler
    • Interrupt or dispel Withering Curse (curse) to prevent the increased damage taken and reduced damage dealt debuff.
    • Interrupt Shadow Bolt Volley to prevent the damage dealt to the group.
    • Avoid standing near Spirit Drain Totems to avoid the critical damage dealt, if a player is hit and survives, dispel the Spirit Drain stun.

Sporecaller Zancha thru Unbound Abomination

  • Faceless Corruptor
  • This area also includes Grotesque Horror, Bloodsworn Defiler, Reanimated Guardian, and Fallen Deathspeaker, as detailed above.

 Trash Debuffs to Track

 Trash Addons

Healer DBM Settings for Underrot Trash

 Mythic+ Notes

In this section you'll find notes about certain interactions bosses and trash mobs have with the Mythic+ difficulty increase or certain affixes that make them more troublesome than normal.

Cragmaw the Infested

  • Having any Blood Ticks spawn with Fortified will deal significant damage to the tank.
  • Similarly, having Blood Ticks spawn with Necrotic will rapidly apply stacks to the tank.

Sporecaller Zancha

Trash Mobs

  • Underrot Tick
  • Chosen Blood Matron
    • The Warcry (enrage) these apply to themselves and nearby enemies is incredibly potent with Fortified.
  • Befouled Spirit
  • Feral Bloodswarmer


[S4] Mythic 10, 2 Upgrade Clear, Restoration Druid PoV

Below is a video of me clearing The Underrot on Mythic 10 difficulty in time for a 2 upgrade during Season 4.

Normal Clear, Restoration Druid PoV

Below is a video of me clearing The Underrot on Normal difficulty on the Battle for Azeroth Beta.

Comment on The Underrot, Healer Guide

Changelog - View the last ten changes. - +

February 11, 2020 - 1:10 am (Healer) - Added season 4 +10 clear video. Made some updates to the Mythic+ notes.

March 11, 2019 - 7:22 pm (Healer) - Reviewed guide for 8.1.5, no changes needed.

October 23, 2018 - 10:31 pm (Healer) - Completed a fill guide review and added mythic+ notes.

October 05, 2018 - 5:03 pm (Healer) - Added DBM settings to bosses and trash.

September 02, 2018 - 8:55 am (Healer) - Added Enrage effects to dispel and buffs to Purge to Trash Mobs.

August 20, 2018 - 12:00 am (Healer) - Added Thirst for Blood to Fearl Bloodswarmers, and Abyssal Reach to Faceless Corruptors.