Gloomhaven Sawbones Guide – Cards, Builds, Perks, Enhancements & Items

Last Updated on June 14, 2025 by Samuel Franklin

This guide to the damage and healing focused Sawbones balances aid and pain to be a valuable contributor to every Gloomhaven team. Detailing the card decisions from level 1 to level 9, perks, enhancements for your cards and finally the item purchases to maximise the Sawbones (Saw) character and their unique medical packs.

Table of Contents:
Sawbones Cards, Perks, Enhancements and Items Overview
Sawbones Cards Detailed
Sawbones Perks Detailed
Sawbones Enhancements Detailed
Sawbones Items Detailed

Gloomhaven Sawbones Guide Overview

This overview section provides a reference guide for building your Sawbones with a balance of healing and damage.

Sawbones Cards Overview

  • Level 1: Remove Mobile Response, Battlefield Medicine and Teamwork to create your starting deck of cards
  • Level 2: Hamstring replaces Triage
  • Level 3: Precaution (level 2 card) replaces First Aid
  • Level 4: Do No Harm replaces Boost Shot
  • Level 5: Amputate replaces Bloody Saw
  • Level 6: Euthanize replaces Curative Mixture
  • Level 7: Surgeon’s Satchel replaces Precaution
  • Level 8: Gentleman’s Anger replaces Hand of the Surgeon
  • Level 9: Grisly Trauma replaces Syringe

Sawbones Perks Priority Overview

  • Remove two -1 cards (take twice)
  • Add one +0 refresh item card
  • Remove four zeros
  • Replace one +0 card with one +2 card (take twice)
  • Add rolling +2 card (take twice)
  • Add rolling stun card
  • Add one rolling heal 3 card (take twice)

Sawbones Enhancements Priority Overview

  • Add Jump to the bottom of Hamstring
  • Add Strengthen to the bottom of Do No Harm
  • Add Curse (or other debuff) to the top of Prevention is Key

Sawbones Items Priority Overview

  • Minor Stamina Potion
  • Boots of Striding
  • Minor Healing Potion
  • War Hammer
  • Iron Helmet

gloomhaven-sawbones-character-card

Gloomhaven Sawbones Guide Detailed

Learn more about the decisions for cards, perks, enhancements and items with some potential alternatives to adjust your Sawbones playstyle.

Sawbones Cards Detailed

The Sawbones has many powerful top and bottom actions available to balance and there are a few key level decision paths that can whift your focus to support or damage dealer as necessary.

  • Starting Cards: Removing cards with weak top and bottom actions is important to cleaning up our starting hand of 10 cards which sees us remove Mobile Response, Battlefield Medicine and Teamwork as each of these is lacking in either both actions or one action. If your team lacks movement Teamwork may slightly beat out Triage which focuses on giving us a large move card.
  • Level 2 Cards: Two powerful cards are available at level 2 although Hamstring is the priority given it provides our best move card that only grows in power when it is enhanced with jump and ensures we can get into the thick of combat at the cost of immobilising ourselves. Hamstring also gives us another attack action that we can use to immobilise and then step away from a melee enemy to prevent damage. Our other level 2 card is not weak by any means though with a fantastically low initiative of 9 that plays perfectly into the top action to shield our allies while the bottom gives us a way to provide medical packs to an ally without sacrificing the potential for a top attack.
  • Level 3 Cards: I recommend going back to the other level 2 card at this level as our level 3 options simply cannot compete. Regenerative Tissue’s top heal action is simply overkill for the Sawbones and lacks the flexibility of our similar strength heals as it is a self use only while the bottom action isn’t a significant amount of healing during your average scenario that it is worth burning a card for. Vital Strike is slightly better as an option with the top pairing with the bottom of Hold Back the Pain as a potential devastating attack although it can be difficult to achieve in practice.
  • Level 4 Cards: At level 4 it is hard to pass up the top action of Do No Harm which gives us that useful execute for when we don’t want to deal with a particular elite enemy towards the end of a scenario with the bottom move and heal being a powerful combination until then. Blood Transfusion simply can’t compete with the net 5 heal on top and the bottom attack and heal that lacks the same level of flexibility.
  • Level 5 Cards: Level 5 is the first divergent of the Sawbones playstyle with my default recommendation being Amputate for the raw upgrade to Bloody Saw by adding an additional attack value and the sometimes beneficial immobilise. With this being only a small upgrade the bottom of Research the Cure can be an invaluable boost to the tank hero in the party instead given the amount of damage it reduces over the course of a scenario to effectively reduce every attack by 1. For this reason your decision will be party dependent with teams that have only one dedicated damage absorbing tank likely to benefit more from Research the Cure.
  • Level 6 Cards: The winning option of our level 6 cards is Euthanize which we can combo with our own attacks and that of our allies for another source of execute and simply beats out the alternative in Prescription. While it can be tempting to treat Euthanize as a straight upgrade to Syringe you actually want to keep Syringe around as the two cards are the perfect combination to trigger the execute.
  • Level 7 Cards: Surgeon’s Satchel is an easy upgrade to Precaution with the same bottom action, similar initiative and flexible top action that makes our level 7 option an easy one in comparison to the healing focused Master Physician that is not needed given our abundance of healing already available.
  • Level 8 Cards: Bedside Manner is an interesting card with a bottom action that creates some deadly combinations with certain mercenaries that can be repeated several times when factoring in equipment like the minor stamina potion that allows us to continually play it although unfortunately the top is a burn action with little value. While Gentleman’s Anger gives players another flexible disarm or a long ranged bottom attack if they find themselves on the edges of the battlefield that make it a core card.
  • Level 9 Cards: Like many Gloomhaven decisions at level 9 players will find some interesting Sawbones mechanics between Prep for Surgery and Grisly Trauma. The top of Prep for Surgery once again pushes the Sawbones heavily on healing mechanics to the point that it is simply not necessary albeit an interesting mechanic given it turns basically every single card into a heal while the bottom stun is okay but we have other ways to inflict similar status effects. Grisly Trauma on the other hand has a strong situational top that relies on having both the right enemies in a scenario and a high enough party level so these enemies have high health values but is reusable. When waiting for such a situation we also get the powerful bottom movement and debuff infliction which can perfectly replace Syringe in our Euthanise combo.

gloomhaven-sawbones-perks

Sawbones Perks Detailed

The Sawbones perks are small in comparison to other Gloomhaven characters and have a number of rolling card choices which results in potentially high damage output. Your upgrade path is pretty typical by removing the negative cards, adding the powerful refresh item card, trimming your deck, adding some powerful +2 cards and then working in the rolling options.

For rolling perks +2 is a good initial choice as we always appreciate additional damage before adding in stun and healing that are likely to be useful in most situations. Of the remaining options I receommend wound and lastly the immobilise options even though this also offers a +1 modifier.

gloomhaven-enhancements

Sawbones Enhancements Detailed

Like most Gloomhaven characters the Sawbones has important core enhancement options and then plenty of additional options if we are flush with gold and want to push the Sawbones even higher. For foundations the jump on Hamstring is an absolute must as we often want to pair this with the likes of Prevention is Key which generally means going deep into enemy territory which the jump significantly assists with. Prevention is Key is also an attractive place to add another debuff to our kit given we’ll always want to use the top of this card and it’s all adjacent enemies targeting with curse being the ideal choice as we already have other debuffs in our kit. Last but not least your next best enhancement will be the bottom of Do No Harm as we’ll be using it for the majority of the scenario with strengthen a good choice to setup our own attacks although bless is also an option for healing cards with this card even able to support both.

Beyond these core other potential cards for enhancement include the top of Vaccine which is particularly nice at higher party sizes where we always hit three enemies and the top of Hold Back The Pain with bless/strengthen empowering the heal further.

gloomhaven-items-iron-helmet

Sawbones Items Detailed

Starting items for the Sawbones are typical of a melee fighter with the choices of Minor Stamina Potion, Minor Healing Potion, Boots of Striding, War Hammer and Iron Helmet providing everything that we need to save damage.

Just like our card choices from here on the items we take can focus either on empowering ourselves, the tank on our team or general team utility. With this in mind unlockable items with supportive healing, card recovery, additional debuffs, transform our attacks into area of effect ones and even allow us to generate elements if needed by our party.

For information and build guides on other Gloomhaven character options visit our Gloomhaven classes overview and the related Gloomhaven class tier list.

Written by
Samuel Franklin
Samuel Franklin is the founder and lead editor of the Games Finder team and enjoys video games across all genres and platforms.

As a seasoned Gloomhaven adventurer Sam has delved into both the physical board game and the digital adaption for hundreds of scenario hours. While he enjoys the camaraderie and social aspect of the tabletop experience the digital version conveniences make it his preferred way to play where he has unlocked all of the Steam achievements. Sam frequently commands the Spellweaver, an elemental spellcasting powerhouse that he finds immensely satisfying for the risky, high reward playstyle that the class offers.

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