How did Ruby die in Peaky Blinders? Season 6's most devastating loss

Ruby Shelby — daughter of Tommy (Cillian Murphy) and Lizzie (Natasha O'Keeffe) — died of consumption (tuberculosis) at the age of seven. She died in hospital in Season 6, Episode 3 ("Gold"). The infection started in one lung and spread to both. Doctors tried everything available in 1933 — collapsing the lung, gold-based treatment — but nothing worked.

The curse

Tuberculosis was the medical cause. But the show makes it clear there's a second layer — and Tommy believes in it completely.

The trail goes like this:

• Season 3: Tommy gets a sapphire from Russian associates. Gives it to his wife Grace. A guest warns him it's cursed. That same night, Grace is shot and killed.
• After Grace's death: Tommy gives the sapphire to a Romani woman, Bethany Barwell, hoping to be rid of it. Bethany passes it to her sister, Evadne.
• Evadne puts the stone around the neck of her seven-year-old daughter Connie. Connie dies the next day.
• Evadne's revenge: she curses Tommy — his own daughter will die at seven, just as Connie did.

The warning signs

Before Ruby's health collapsed, she was showing disturbing symptoms that went beyond a physical illness:

• Chanting the Romani phrase "tickna mora o'beng" — roughly, "the devil"
• Seeing visions of a grey man with green eyes who she said was coming to take her away
• Coughing blood

Tommy sought help from Esme Shelby Lee (John's widow), who confirmed the sapphire's history and the curse. It didn't save Ruby.

The aftermath

After Ruby's funeral, Tommy tracks down Evadne and takes a brutal revenge. But the damage is done — and it ripples through the rest of Season 6:

• Tommy's already-fragile mental state fractures further
• Lizzie, devastated and unable to forgive, eventually leaves him
• Tommy's son Charlie asks to go with Lizzie rather than stay with his father

Ruby's death is the moment Tommy Shelby — a man who bent empires and outsmarted every enemy — finally hits something he has no power over.