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Patches should not be an overly difficult battle, and you only need to lower his HP to around half to have him surrender, which you should take him up on if you wish to pursue his Quest. For a full strategy guide, see our boss page here.
Generally speaking, you should not kill Patches in Elden Ring. If you do kill him, you’ll get a Spear +7 and some Leather Armor, which is a good gain in the short-term. But if you don’t kill him you much more in the long-term.
If you spare him he’ll become a merchant, with better goods for sale than Kale at the nearby Church of Elleh, including Margit’s Shackle. You’ll have to leave his chamber, then come back again for him to become a merchant.
Also if you kill Patches, then at least one key quest won’t spawn later in the game, and you won’t be able to get the Great Horned Targoth’s armor set, which is one of the best armors in the game.
I’m Patches. Patches the Untethered.
During combat, when Patches reaches low health, he will offer to surrender. If the surrender is accepted he will open up a shop in Murkwater Cave.
Beastman of Farum Azula (Limgrave) • Bell Bearing Hunter (Limgrave) • Black Knife Assassin (Limgrave) • Bloodhound Knight Darriwil • Crucible Knight • Deathbird (Limgrave) • Demi-Human Chief • Erdtree Burial Watchdog (Limgrave) • Flying Dragon Agheel • Grafted Scion (Chapel of Anticipation) • Grave Warden Duelist (Limgrave) • Guardian Golem • Mad Pumpkin Head • Margit, the Fell Omen • Night's Cavalry (Limgrave) • Patches (Boss) • Soldier of Godrick • Stonedigger Troll (Limgrave Tunnels) • Tibia Mariner (Summonwater Village) • Tree Sentinel • Ulcerated Tree Spirit (Limgrave)
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