A baleful doll is a powerful figure that is linked directly to the spirit of the target. This doll must be hand-crafted, and is only finished when it has been painted with the blood of the necromancer and dressed in some article of clothing from the victim (which should be unwashed for a better connection). Once the doll has been cursed, the vampire can use it to cause physical damage to the target. If the doll is injured (often with pins or other items), the victim takes six dice of bashing damage. If the doll is destroyed, the target suffers six dice of lethal damage.

The necromancer must craft the doll, using ritual chants throughout the process. This normally takes four to five hours. The player rolls Stamina + Crafts (difficulty 8) to succeed in this part of the ritual — a doll that does not resemble its victim is useless for the purposes of this ritual, though some necromancers sell failures as “authentic voodoo dolls” to tourists.