The Cave Leech is the reason for the long-running informational campaign across all DRG Space Rigs "Look Out, Look Up". It is an immobile, tentacled sack of grease found suspended from secluded ceilings within particularly dark caves, just waiting for anything meaty and unaware to walk past and become an unsuspecting snack. As Ranger Garfax says, says, and says again: "LOOK OUT. LOOK UP."
— Miner's Manual Description
Cave Leeches are stationary enemies that spawn in ceilings. They appear as a wide, pink fleshy half-sphere attached to a small crevice in the ceiling, with three small sharp-clawed tentacles for tearing captured prey apart, and one larger central clawed tentacle meant for reaching down and gripping potential prey. The central tentacle has a small bioluminescent bulb in the middle that is visible when reaching down to grab a Dwarf, and can help with spotting it before it grabs you. They generate with the cave while loading a mission, and do not respawn once killed. They generally spawn at a low rate, but their spawn rate is greatly increased by the Cave Leech ClusterMutator.
Pressing the [SHOUT] key ("X" by default) to shout for help will help your teammates find where you are, or will call Bosco to you.
When a dwarf enters a Cave Leech's range, the central tentacle will extend towards the target at a moderate pace. The attack can be stalled by attacking the claw or the base of the leech. The claw will emit a distinct sound when close to the player. If the claw touches a dwarf, it will pick them up and quickly lift them towards the ceiling. After the claw is fully retracted, the cave leech will begin to use its smaller tentacles to deal short bursts of heavy damage. Unlike a Mactera Grabber, Cave Leeches will not release their target until either the Cave Leech is killed or their target is downed. Once killed, the Cave Leech will lower the Dwarf back down, avoiding fall damage.