Malignant Hearts were introduced in Season 1 of Diablo 4, and have stayed in the game up to Season 4. This time around, they are now used as a summon material that players will need to find and put together with other items to summon a powerful endgame boss.

These items can be obtained in lower World Tiers, but players won't have much use for them until they reach World Tier 3 at least. Even when playing in the higher World Tiers, players will need to know where to look for Malignant Hearts as they are not a random drop from just any enemy.

diablo-4-pinch-of-poison-quest-walkthrough
Diablo 4: Pinch Of Poison Quest Walkthrough

The reward for Pinch of Poison allows players to use two Elixirs at once in Diablo 4; here's how to complete this quest.

By 

Where To Get Malignant Hearts In Diablo 4

Malignant Hearts have a low drop rate across the board, rarely if ever dropping in World Tier 3 and even still rarely dropping in World Tier 4. The best method for obtaining Malignant Hearts is by fighting within the Helltide. By defeating enemies, your Threat level will increase and after the bar in the top right of the screen maxes out, powerful Hellbrone enemies will spawn to try and kill the player. While these enemies aren't a guaranteed drop, they as easy to make spawn as long as the player isn't dying often.

While in the Helltide and killing enemies, the Blood Maiden can be summoned through the Accused Ritual. This boss also has a good chance of dropping a Malignant Heart and will spawn dozens of enemies to also be killed and further increase your Threat Level. Local events can also have a chance of dropping Malignant Hearts upon completion, with Treasure Goblins being another but rare possibility. One of the possible rewards from the Tree of Whispers is the Collection of Chaos, which also has a decent chance of dropping Malignant Hearts.

The Player Approaching & Picking Up An Aberrant Cinders
Diablo 4: How To Farm Aberrant Cinders

Aberrant Cinders are a currency found and used in Helltides in Diablo 4; here's how to farm them.

By 

What To Use Malignant Hearts For In Diablo 4 Season 4

Season 4 gives a new use for Malignant Hearts in the Malignant Burrow, found right next to the Tree of Whispers in the eastern section of the map. In the Malignant Burrow will be the Malignant Alter, which can be used to summon Varshan and Tormented Varshan. Both forms of this boss can be summoned as often as players want and are great sources of high-end gear.

Materials For Varshan

Materials for Tormented Varshan
  • 1 Gurgling Head
  • 1 Blackened Femur
  • 1 Trembling Hand
  • 1 Malignant Heart

  • 2 Stygian Stones
  • 3 Gurgling Heads
  • 3 Blackened Femurs
  • 3 Trembling Hands
  • 3 Malignant Hearts

Rating block community and brand ratings Image
Diablo 4 Tag Page Cover Art
Diablo 4
Display card tags widget Display card system widget
Display card community and brand rating widget
9 /10
Display card open critics widget Display card main info widget
Released
June 5, 2023
Display card main info widget end Display card media widget start Display card media widget end

WHERE TO PLAY

SUBSCRIPTION
DIGITAL
Checkbox: control the expandable behavior of the extra info

Developer(s)
Blizzard
Publisher(s)
Blizzard
Franchise
Diablo
Genre(s)
Action RPG, Hack and Slash
Diablo 4 Press Image 1
5 Images