From PathfinderWiki
Titles The Eternal Source
Realm Earth
Alignment Neutral evil
Areas of Concern Disasters
Lost islands
Worshipers Insane cultists
Cleric Alignments (1E)
Domains (1E) Destruction, Evil, Madness, Water
Subdomains (1E) Catastrophe, Insanity, Nightmare, Oceans
Favored Weapon Morningstar
Symbol Waves parting around a rising jagged stone

Source: In Search of Sanity, pg(s). 67
Type Aberration
(chaotic[1], evil, Great Old One)
CR 29
Environment Any

Source: Black Stars Beckon, pg(s). 84–85

Ghatanothoa[2] is the Great Old One of disasters, lost islands, and sacrifice. It is imprisoned on an island on a distant planet, and its awakenings cause nightmares and great disasters to follow.[3]


Ghatanothoa is trapped in an immense structure on a sunken island on Earth, a planet in a star system distant from Golarion, where it arrived in ancient times from the Dark Tapestry.[3]


Numerous similarities exist between Ghatanothoa and Cthulhu, and evidence points to Ghatanothoa being Cthulhu's spawn. Cultists of Ghatanothoa consider this claim blasphemous and regard Cthulhu's cultists as enemies, while Cthulhu's followers consider Ghatanothoa's beneath notice.[3]


Ghatanothoa's form, consisting of an abhorrent tangle of organs, is capable of shifting its composition at a whim but always retains a definite shape. A mere glance at Ghatanothoa or one of its perfect images is enough to transform one instantly into a desiccated, living corpse capable of seeing and feeling time but unable to move or interact with the world outside.[3][4]


Ghatanothoa counts few human followers, but has long been worshipped by several mi-go sects, who build stone temples on desolate islands. They are said to be able to raise islands from unknown oceans on distant planets that serve as portals for their patron.[3][4]


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  1. It is very unusual for a neutral evil creature to have the chaotic subtype, but this is confirmed in the text.
  2. Original Source: H. P. Lovecraft and Hazel Heald, "Out of the Aeons", 1935; James Jacobs. (2016). The Elder Mythos. In Search of Sanity, p. 67. Paizo Inc. ISBN 978-1-60125-882-3
  3. 3.0 3.1 3.2 3.3 3.4 James Jacobs. (2016). The Elder Mythos. In Search of Sanity, p. 67. Paizo Inc. ISBN 978-1-60125-882-3
  4. 4.0 4.1 Benjamin Bruck, Jim Groves, and James Jacobs. (2017). Bestiary. Black Stars Beckon, p. 85. Paizo Inc. ISBN 978-1-60125-919-6