Want to make Bloodborne even harder? Instead of accepting the default two endings, ambitious Hunters can fight an extra final boss and unlock a third ending to the story.

Needless to say, there are going to be spoilers. Whether you’ve finished Bloodborne once before, want all the ending trophies, need more secret lore info, or just want to make life harder on yourself — this guide explains every step to unlocking the terrifying Moon Presence final boss fight. Bring plenty of Sedative to calm your mind and prepare for the last hunt.

If you’re in the market for new tools of the trade, check out our Bloodborne: Trick Weapons Locations Guide, or upgrade the arsenal with the Bloodborne: Firearms Locations Guide.

Hidden Final Boss & Third Ending Unlock Guide

Warning: Massive end-game spoilers ahead!

How to Get the Third Ending – Step-by-Step

Follow these steps to witness Bloodborne’s hidden third ending and fight the terrifying Moon Presence boss.

• 1. To reach the final choice, the Hunter must travel into the Nightmare of Mensis by channeling the corpse in Yahar’gul, Unseen Village. At the top of the castle, defeat Mergo’s Wet Nurse and a unique message will appear.
• 2. Return to the Hunter’s Dream. The door to the right of your spawn point is now open. Gerhman, the wheelchair-bound mentor is waiting by the great tree.
• 3. Before speaking with Gerhman, find and consume three unique hidden items called “One Third of Umbilical Cord” — one should be in your inventory already, a reward for defeating Mergo’s Wet Nurse. Keep scrolling down for more cord locations.
• 4. After consuming three Umbilical Cords, speak with Gerhman and select “Refuse” as your answer. He’ll stand up and initiate a fight.
• 5. Defeat Gerhman and the Moon Presence will appear. Defeating this extra optional final boss leads to the third “true” ending to Bloodborne.

One Third of Umbilical Cord – Locations Guide

Note: While it is possible to find more than three of the Umbilical Cord, only three are required to unlock the Moon Presence boss battle.

Three of the “One Third of Umbilical Cord” item must be used before the Hunter defeats Gerhman, The First Hunter. These can be used after the Gerhman battle has already begun. Each use also rewards the Hunter with three inspiration.

• 1. Old Abandoned Workshop – The earliest cord is found in a secret location beneath the Healing Church Workshop. Follow the instructions on our “Source of the Dream” Trophy Guide for exact instructions to this unique area.
• 2. 1st Floor Sickroom – Return to the sickroom after defeating Rom, The Vacuous Spider at the end of Byrgenwerth college, deep within the Forbidden Woods area. Use the hidden path through the poison mire cave to reach a back entrance to the 1st Floor Sickroom. Travel upstairs and defeat Iosefka, she should drop one of the cords.
• 3. Nightmare of Mensis – At the end of the nightmare, the Hunter will encounter a Great One called Mergo’s Wet Nurse. Destroy it to gain the one unmissable cord.
• 4. Cathedral Ward – Rescue Arianna in the lower Cathedral Ward just as you reach this location. Travel down from Oeden’s Chapel and enter the side alley to the right, near the entrance to the Forbidden Woods. Speak with her and send her to the Chapel for safety. Once Mergo’s Wet Nurse is defeated, return to the sewer beneath the Chapel. Kill Arianna and her new child to collect the last known cord.

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Kevin Thielenhaus is a freelance writer for The Escapist. Find him on Twitter here.