Unable to act upon the world directly, he dispenses his power from cover identities and aspects, such as the Elder Elemental Eye responsible for the infamous Temple of Elemental Evil. Many cults are unaware that the entity that they worship is Tharizdun. Contact with the imprisoned Dark God is only possible in proximity to one of his remaining artifacts or forgotten unholy sites, and even then his blessings come at the cost of madness. Tharizdun's few followers are almost all insane, and those who are not are extremely dangerous. Despite Tharizdun's absence, his cults still persist, seeking ways to communicate with their dark master and free him to wreak havoc once more.
