Malignant Hearts are Diablo 4’s version of unique gemstones. If you have ever played Diablo 3, this is very similar to their legendary gems.

In Diablo 4, these hearts provide significant power to any build; some can even alter your current build completely.

These items drop in the form of “Caged Hearts,” and we’ll be here to talk about everything involving these Malignant Hearts, such as where to find them, tier lists, and more.

Seasonal Quest Line

You’ll be introduced to the Malignant quest line when you start your new character in season 1. This quest line will teach you most of the things you need to know about Malignant Hearts.

These quests have a green color to help players filter them out from the main story or side quests.

The full quest list is as follows:

  • Burning from Within
  • A Plague of Hatred
  • Holding Back the Flood
  • Answers in the Ashes
  • A Prayer for Salvation
  • Hope’s Guardian
  • Ruins of the Faith
  • The Cold Hard Truth
  • A Merciful Fate

These quests are easy to follow, but here is what you need to finish without them telling you to do it.

Before you transition to T3 or T4, you should craft an Invoker of Varshan. Once you have it, do Malignant Tunnels until you find the secret room. I suggest finishing the Ravening Pit because this secret room is completely random.

At the end of the dungeon, you’ll see two paths – one leading to overgrown hearts while the other leading to a dead end.

The dead end is where you’ll find the random secret room if it ever spawns. One marker of the secret room spawning is seeing a Healing Well here.

Once you see the secret room, open the door, and you’ll see a heart where you can use the Invoker of Varshan.

Once you beat Varshan, you’ll get a recipe for the next level (T3). Go to T3, craft the next level of Invoker, and repeat the process until you unlock the T4 recipe.

Malignant & Caged Hearts

There are four types of Malignant Hearts – Vicious, Devious, Brutal, and Wrathful.

All types of hearts have equal drop rates except for Wrathful. These Wrathful Hearts are hard to find, but you can farm them better in Malignant Tunnels.

Since dungeons or nightmare dungeons drop random hearts, they aren’t commonly found compared to the tunnels.

Once you see a monster (elite), you’ll see its modifiers. They will drop a heart on the ground if they have any of the four, Vicious, Devios, Brutal, and Wrathful, Malignant modifiers.

You have to activate this heart on the ground and it’ll spawn another monster. After defeating that monster, it’ll drop a “Caged Heart” to its respective modifier. If it is a Brutal monster, it’ll drop a Brutal Caged Heart.

Once you have the Caged Heart, you can insert it into your jewelry. They can only be equipped on your rings and amulet.

Not only that, the jewelry should have the appropriate color or type. For Wrathful Hearts, you can insert them in any color. However, you can only equip one Wrathful Heart at a time.

You cannot unsocket any Caged Heart from your gear, but you can replace the currently equipped heart and destroy the previous one.

Since Wrathful Hearts are rare, you should make sure that you have some replacements.

What to Do With Extra Caged Hearts?

There is no choice but to salvage these hearts for more ichors. Use these ichors to craft Tormented Invokers of Varshan (T4) to farm items and an additional chance to get a Wrathful Hearts at the end of a Malignant Tunnel.

Wrathful Hearts Farm

The best way to farm Wrathful Hearts is to form a 4-way group. However, let’s go for the solo farming method first.


The best way to target-farm Wrathful Hearts is through Malignant Tunnels. You don’t need to have an Invoker of Varshan or its upgraded tiers.

What you want to do is to clear the Malignant Tunnel as fast as possible and skip the extra heart event at the end.

Once you finish the tunnel, leave the tunnel and reset. Repeat the process until you find a Wrathful Heart.

Since you’ll be overloaded with Vicious, Brutal, and Devious hearts, you can skip these hearts when they drop. It takes a long time before they actually spawn, and it just eats up your time.

Group play

For group play, it allows you to quadruple your chances of getting a Wrathful Heart. Here is how you do it.

Form a 2-4 party group. Have each player farm a separate Malignant Tunnel and finish the tunnels with the method above.

Once everyone finishes their tunnel without a Wrathful Heart, everyone exits and the leader resets the dungeons/tunnels.

When someone finds a Wrathful Heart, everyone teleports to the specific player.

Here is the important part:

When a player encounters a Wrathful monster, you still have to eliminate it and it’ll drop a Wrathful Heart. This Wrathful Heart still needs to be activated to spawn the monster again and it’ll drop the Caged Wrathful Heart.

In this process, you cannot wait for a long time until all your party members teleport to you. In about 1 minute, the Wrathful Heart on the ground disappears.

The workaround is activating the heart, even if not all members are present yet. You can kite the monster until everyone gets in. It will not drop a Caged Heart for the member who doesn’t enter the tunnel at the exact time it was eliminated.

If you are thinking of doing the tunnels in separate parties, it’ll not work unless you initially kite the monster once you see it.

If the monster is eliminated and the Wrathful Heart drops, you cannot invite players and activate the Wrathful Heart. They’ll still see the monster but won’t get a Caged Wrathful Heart.

If your party members aren’t strong enough for a separate tunnel farm since they have more HP, you can do it separately but it is very risky.

The technique is to look at the lower-left of your screen (where your chat window is located) and read the modifiers as you encounter the elites.

Once you encounter a Wrathful modifier monster, kite them immediately while you wait for your other members.

Malignant Hearts Tier List

Tier STier ATier BTier C
The BarberVile Apothecary (Rogue – Wrathful)Prudent HeartAll the other hearts
Tempting FateMalignant Pact
Tal Rasha (Sorcerer)Omnipower (Sorcerer)
Ignoring Pain (Barbarian – Wrathful)
Creeping Death (Wrathful – DoT builds)
Decreipt Aura (Necromancer)
Sacrilegious (Necromancer)
Inexorable Force (Druid)

Tier S

The Barber deserves to be alone in S Tier just because it can be used by every class, and it gives an absurd amount of damage for almost any build out there.

It does have some confusing interactions with some lucky hit mechanics, but most of them work. Since The Barber stores any damage (even party members) the monster has taken, the damage will go up as you do more damage.

Once it explodes, it almost chains the damage to all nearby enemies causing a massive damage increase for AoE.

Since you can only equip one Wrathful Heart at a time, only the greatest Wrathful Hearts will make it to Tier A.

Tier A

Vile Apothecary is definitely an S Tier heart, but it’ll be down to A just because it is a Wrathful one and The Barber exists. This Wrathful Heart allows Rogue to free up an additional skill on the bar since you’ll be able to apply all imbuements with the heart already.

It can free up an additional skill slot for Twisting Blades builds, and you can add another CC break while increasing your damage with this single Wrathful Heart.

Tempting Fate is essential to all builds that can cap or almost cap critical strike chance. It is in Tier A because it greatly boosts damage for those builds, even if it is quite niche.

Sorcerers always have at least two elements active for their builds. Whether it is through Fire Bolt enchantment or Frost Nova, you’ll be getting at least two damage bonuses from the Tal Rasha.

Ignoring Pain is insane for survivability, especially for Barbarians who are screaming for survivability buffs.

Revenge is a great defensive heart available for all classes.

Creeping Death gives an absurd amount of damage (roughly 70+% increase in damage) to damage over time builds.

Decreipt Aura and Sacreligious are staples for Necromancers. They give great quality-of-life improvements as well as clear speed.

Inexorable Force is another staple but for the Druid class. It helps pull everyone close so you can clear the dungeons faster than a Druid.

Tier B

Prudent Heart is good for survivability if you have a free slot on your jewelry. It is an important heart for those playing hardcore, as it gives you the ability to block one-shot mechanics.

Malignant Pact is just a “filler” as you level up. Since it is useful for all classes and it drops really early in the game, you will use this until you get the better Wrathful Hearts that only drop in T4 difficulty.

Omnipower can be experimented on Sorcerer builds, but it is quite hard to find the perfect build to implement it on. The only build that comes to mind is the Frozen Orb and Chain Lightning build.

Note: Tested it out on the Chain Lightning build and The Barber beats it by a wide margin.