Several human and animal ghouls are forced to first drink the blood of the vampire who seeks to create a Vozhd, then to drink each others' blood to begin the process of binding them to each other and to their master. They are then melded together by dark magical powers and rituals, their flesh and bone reshaped to flow into one another to form one enormous beast with many limbs, multiple digestive tracts and toothed maws, tentacles, horns, claws, stingers, and fangs in places that most natural creatures don't even have places. The process drives all of the creatures involved irretrievably insane, and while they can understand very simple commands such as "turn left" and "attack that guy first", "stop" is one term they never seem to grasp. They are generally restrained and sedated until needed, and then unleahsed and pointed in the general direction of the enemy to cause as much damage as possible.
The Sabbat used them frequently during the Dark Ages to sow terror among mortals and counter the numerical superiority of their foes in the Camarilla, but even then Vozhd were a two-edged sword. Entirely apart from the difficulty in getting a Vozhd to tell one's own allied forces from those of the enemy, while the Vozhd are undeniably fearsome and terrifying in combat, few things can unite the Camarilla and independent clans against the Sabbat like the sight of a Vozhd tearing through a town, killing off vampires and their food sources indiscriminately, and making it practically impossible to maintain the Masquerade.
Since the 20th century, Vozhd have been used rarely if at all, as modern weaponry such as tanks and rocket launchers render the melee-based weaponry of a Vozhd obsolete. However, several of them were used during Gehenna and in defense of Wilke's Star during the War of Blood. There are even unconfirmed reports of one or two being used by small Sabbat packs on planets being invaded by the Vin Shriak or Bugs, but the handful of survivors of such incidents are usually too shell-shocked to take all of their claims seriously. The most recent use of Vozhd on a large scale was during the Battle of the Round Table at the end of the Ascension War, when several Vozhd supported by a large force of shovelheads were unleashed to keep Imperial Bodyguard and other military forces busy on the surface while the joint Sabbat/Federation assassination team went underground to find and kill Vin Dane. House Mallorea is rumored to currently have several Vozhd in reserve as part of their retainers, but no one knows for sure.