You’ve probably spent hours agonizing over your ability scores. We all do it. You dump points into Strength for that sweet jump distance or Charisma so you don’t accidentally start a war every time you open your mouth. But then there’s Constitution. It’s the stat everyone knows they need but nobody wants to pay for. It’s the tax of Baldur’s Gate 3.
That’s where the Amulet of Greater Health enters the chat.
Honestly, it’s one of the most transformative items in the entire game. Once you put it on, your Constitution score instantly jumps to 23. It doesn't matter if you started with a measly 8 or a solid 14. You are suddenly a tank. But it isn't just about the hit points—though having over 100 extra HP on a squishy Wizard is hilarious—it’s about never dropping your Concentration again.
Where to find the Amulet of Greater Health
You can’t just stumble upon this in Act 1. This is end-game loot. You have to break into the House of Hope, which is basically the equivalent of a high-stakes supernatural heist. Raphael, our favorite flamboyant devil, keeps his best toys in his private museum in the Hells.
Getting there requires the Helldusk Helmet and some soul coins, but specifically, you need to head to the Archive. This is the room where Raphael displays his most prized possessions on pressure-sensitive pedestals. The Amulet of Greater Health is sitting right there, waiting for you to snatch it.
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Here is the thing: the moment you pick it up, the alarms go off. The Archivist is going to realize you’re a thief. The "Hope" in House of Hope becomes a lot more literal as you try to fight your way out. If you’re planning to grab it, make sure your party is rested. You aren't just walking out of there without a fight, especially if you also decide to grab the Gauntlets of Hill Giant Strength while you're at it.
Why 23 Constitution actually changes the game
In Dungeons & Dragons mechanics, which BG3 follows pretty closely, odd-numbered stats are usually "dead" numbers. A 23 Constitution gives you a +6 modifier. If you had a 22, it would still be +6. So why 23? Because it makes it almost impossible for your modifier to be lowered by certain debuffs or drains.
Survival for the Squishies
Usually, you’d give a health-boosting item to a Barbarian or a Fighter. In Baldur’s Gate 3, that’s actually a bit of a waste. Your Barbarian already has high health. Your Wizard? They probably have the durability of a wet paper towel. Giving the Amulet of Greater Health to Gale or a Sorcerer main character basically removes their only weakness.
Concentration is King
This is the real secret. If you’re a spellcaster, you’re likely casting Haste, Slow, or Wall of Fire. Every time you take damage, you have to roll a Constitution Saving Throw to keep that spell active. If you fail, the spell ends. With the Amulet of Greater Health, you get Advantage on Constitution Saving Throws.
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Advantage means you roll two dice and take the higher number. Combine that with a +6 modifier? You basically stop failing those checks unless a dragon breathes directly into your face. Even then, you’ve probably got the HP to soak the hit.
Respec your character for maximum efficiency
Once you have the amulet, go talk to Withers. Seriously.
Since the Amulet of Greater Health sets your Constitution to 23 regardless of your base stats, you no longer need to put points into Constitution during character creation or leveling.
- Take all those points out of Constitution.
- Dump them into your primary attacking stat (like Dexterity or Intelligence).
- Put the rest into Wisdom so you stop getting Mind Controlled.
- Equip the amulet.
You’ve essentially "cheated" the point-buy system. You now have the high-level offensive stats of a glass cannon but the physical durability of a raid boss. It’s the ultimate late-game optimization move.
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The Downside: What they don't tell you
Is there a catch? Sort of. It’s an amulet.
In Act 3, the neck slot is incredibly competitive. You might want the Spellcrux Amulet to get a free high-level spell slot back. Or maybe you’re using the Amulet of the Devout for that extra Channel Divinity charge. Choosing the Amulet of Greater Health means giving up those utility options.
Also, if you're relying on the amulet for your health and someone manages to unequip it or you enter a zone where magic is suppressed (which is rare but happens), your HP will plummet. It’s a weird feeling to see your health bar suddenly shrink by 60 points because you decided to try on a different necklace for a second.
Actionable Strategy for your Act 3 Run
If you’re currently staring at the portal to the House of Hope, here is how you handle the Amulet:
- Clear the room first. Don't just grab the item and run. Position your party near the exit of the Archive.
- Use Greater Invisibility. If you’re sneaky, you can try to swap it out, but the pressure plates in Raphael's house are notoriously fickle. Just assume the fight is coming.
- Check your Saving Throws. Look at your combat log after you equip it. You'll see "Advantage" popping up on every poison resistance or concentration check. It's beautiful.
- Respec Gale or your Sorcerer immediately. Don't leave those "natural" Constitution points sitting there doing nothing. Use Withers to move those points into Dexterity to boost your Initiative. Being a tank is great, but going first in combat is better.
The Amulet of Greater Health isn't just a gear upgrade; it’s a total shift in how you can build a character. It turns the fragile tactical layers of the game into a brute-force victory. Just make sure you're ready to face Raphael's singing voice once you steal it.