How To Start the Ritual of Anguish in Diablo 4

Aside from hunting down Duriel, the Ritual of Anguish is one of the best ways to farm Mythic Unique items in Diablo 4. In this guide, I will outline how you can start the ritual and what you need to collect before you get there.

How To Complete the Ritual of Anguish in Diablo 4 (Andariel Summon)

To start the Ritual of Anguish, enter the Hanged Man’s Hall with at least two Sandscorched Shackles and two Pincushioned Dolls. Kill the monsters in either one of the hallways and then enter the main arena with the altar. When you interact with the Altar, the menu for the Ritual of Anguish will appear. If you want to commence the ritual, you need to place the shackles and the dolls into the bowl, which will consume them for good. After a couple of seconds, Andariel will appear and it’s time to take down a boss. If you’re lucky, you’ll end up getting a Mythical Unique item, but at least a few standard Uniques are guaranteed.

The Ritual of Anguish itself is just another name for summoning Andariel. Nearly all of the end-game bosses in Diablo 4 will have their own lair with two hallways that lead to an altar. That altar and the items needed for the bowl are what the game considers a ritual. This even applies to the Blood Maidens in the Helltides. Once you reach the end game for the season and you want better gear, the rituals will become a common part of the gameplay loop. For many players, it’s even the final purpose of their character.

After the standard Ritual of Anguish, there is a tormented version as well. This version of the ritual will require six Sandwcorched Shackles, six Pincushioned Dolls, and two Stygian Stones. If you scroll to the right on the altar menu, this option will appear. As long as you have all the listed items on hand, you can place them in the bowl for a level 200 version of Andariel. You can fairly easily get the standard version of this boss but you should ensure your gear is up to par for this. You don’t want to waste the Stygian Stones that can be a pain to farm. The Ritual of Anguish will always be there waiting, so there is no need to rush.

Diablo 4 is available now on PC, Xbox, and PlayStation.