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Carapace of N'zoth, Healer Guide

Updated 3 years, 4 months ago for patch 8.3 by Preston. View the change log.

Carapace of N'zoth Dungeon Journal ModelThis page covers a healer-focused strategy for Carapace of N'zoth in Ny'alotha, the Waking City. 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 with the encounter, log information, and Dungeon Journal information. I'll continue to update it as-needed.

General Mechanics and Abilities

Normal and Heroic

All Stages

  • Players must keep their Sanity above 0 for as long as possible.
    • Sanity is tracked with the Alternate Player Power Bar UI element, just like in Horrific Visions.
    • This is made easier in the earlier stages with Wrathion's aid (detailed below).
    • Players that reach 0 gain Gift of N'zoth, dealing increased damage and healing for 20-seconds.
      • When the effect expires, the player becomes a Servant of N'zoth.
        • The player is Charmed and can be killed.
        • Interrupt Mental Decay to prevent the Sanity drain and light damage over time on other players.

Stage One - Exterior Carapace

This stage begins the encounter and ends when Fury of N'zoth reaches 50% health.

  • Wrathion is active during this stage.
  • Fury of N'zoth
    • The tanks will be dealing with Mandible Slam, which applies stacks of Black Scar and will force a tank switch.
    • When affected by Madness Bomb, move at least 10-yards away from other players.
    • Targets random players with Mental Decay, removing 5 Sanity (15 on Heroic) and dealing light damage over time.
    • Applies Adaptive Membrane to random enemies, causing them to absorb damage and be immune to crowd control effects and interrupts while active.
      • If the entire absorption amount is damaged through before it expires, the absorbed amount is dealt as damage to the affected enemy.
  • Avoid the impact location of Growth-Covered Tentacle.
    • Avoid the subsequent impact locations that spawn Nightmare Antigens.
      • Nightmare Antigen
    • All Horrific Hemorrhages on the Tentacle must be killed to prevent them from bursting and dealing critical damage to all players.
  • On Heroic, Gaze of Madness

Stage Two - Subcutaneous Tunnel

This stage begins when Fury of N'zoth reaches 50% health and ends when it reaches 40% health.

  • Wrathion is active during this stage.
  • Fury of N'zoth
  • On either side of the room are long paths that contain the following:
    • Mycelial Cyst
      • Slowly regenerates health with Regenerative Mass.
      • Coats the ground in Mycelial Growth, dealing light damage over time and slowing movement speed of players standing in it.
        • The coverage area is reduced as the Cyst loses health.
      • The Fury of N'zoth gains Mycelial Infusion while standing in Mycelial Growth, granting an increased damage dealt buff.
    • Synthesis Growth
      • Each Growth grants Fury of N'zoth Synthesis, healing over time and absorbing all damage taken.

Stage Three - Locus of Infinite Truth

This stage begins when N'zoth reaches 40% health and ends when it's killed.

Mythic Differences

All Stages

  • Players can now be targeted by Adaptive Membrane, which reduces healing received in addition to the prior effects.

Stage Two - Subcutaneous Tunnel

  • Wrathion is no longer active during this stage.
  • The stage now ends when all Synthesis Growths are killed.
  • Mycelial Cyst
    • No longer affected by Regenerative Mass
    • When killed, gains Reactive Mass, becoming untargetable and healing to 100% health when the effect expires.
      • Additionally, when the effect expires, be at least 15-yards away from the Cyst to avoid Regenerative Expulsion.
  • Synthesis Growth
    • Now spawn two Nightmare Antigens when killed.

Stage Three - Locus of Infinite Truth

  • Mycelial Cyst are now present in this stage, functioning the same as above.


Healing Notes

Quick Notes, All Difficulties

The notes below mostly pertain to progression difficulty, meaning if you out-gear the difficulty you're on or use extra healers they may not apply.

Debuffs to Track


  • Black Scar causes the tank to take additional damage from subsequent attacks.
  • Adaptive Membrane causes players to be immune to damage and take reduced healing.
  • Breed Madness causes the affected player to take critical damage over time.


 DBM Settings

Below are the DBM settings I'll be using for Carapace of N'zoth. You can set them up however you'd like, but these ones should work well as a starting point. Some settings may be Mythic only.

Healer DBM Settings for Carapace of N'zoth Thumbnail
Healer DBM Settings for Carapace of N'zoth

Comment on Carapace of N'zoth, Healer Guide

Changelog - View the last ten changes. - +

March 02, 2020 - 9:54 pm (The Prophet Skitra) - Updated intermission health breakpoints.

February 27, 2020 - 3:12 pm (Dark Inquisitor Xanesh) - Added heroic kill video, reviewed the guide but no changes needed.

February 25, 2020 - 7:03 pm (Ra-den the Despoiled) - Added heroic kill video.

February 24, 2020 - 1:25 pm (The Hivemind) - Added heroic kill video.

February 14, 2020 - 10:05 pm (The Prophet Skitra) - Added heroic kill video.

February 13, 2020 - 11:05 pm (Maut) - Added heroic kill video and made minor updates to DBM settings.

February 10, 2020 - 7:49 am (Wrathion, the Black Emperor) - Added heroic kill video and adjusted potion of replenishment time.

January 24, 2020 - 10:59 am (N'zoth the Corruptor) - Added DBM settings.

January 24, 2020 - 10:40 am (Carapace of N'zoth) - Added DBM settings.

January 21, 2020 - 2:38 pm (Il'gynoth, Corruption Reborn) - Added DBM settings.