When you reach World Tier 3 (Nightmare difficulty) you’ll start finding Sacred-tier gear, which, for various reasons, tend to have higher stats than normal gear. Once you reach [World Tier 4], however, Sacred gear will be supplanted by Ancestral-tier gear. This page will discuss how to find Ancestral gear in Diablo 4, and what makes Ancestral gear different from normal and Sacred gear.
Ancestral gear generally has higher stat ceilings than Sacred gear.
What Are Ancestral Items in Diablo 4?¶
Ancestral items are the currency of power in [World Tier 4] (Torment difficulty) just like Sacred items are in World Tier 3 (Nightmare difficulty). Normal gear generally stops scaling at level 44~, which limits their stats compared to Sacred and Ancestral gear, so when you hit World Tier 3 you’ll want to swap out your normal gear for Sacred gear. Ancestral gear is to Sacred gear what Sacred gear is to normal gear, albeit both Sacred and Ancestral gear scale to your level (unlike normal gear).
Ancestral gear has higher stat ranges than Sacred gear, although the difference is somewhat less pronounced than between Sacred and normal gear. Notably the stat ranges on skill boosts (+2 to +3 to a specific skill on gloves, for example) and the DPS on weapons tend to be appreciably higher on Ancestral gear than Sacred gear, and upgrading these should be a priority.
In addition to rare and legendary drops - the vast majority of the Ancestral drops you’ll get - there are some Uniques that can only spawn as Ancestral quality items. If your primary purpose in Diablo 4 is to collect the best loot and make the most potent build possible, you’re going to need to be in World Tier 4, as Ancestral gear is, in most cases, the best of the bunch.
Sacred gear has a golden aura on its inventory icon while Ancestral gear has a blue-white aura.
(1 of 2) You can find Ancestral gear anywhere in World Tier 4,
You can find Ancestral gear anywhere in World Tier 4, (left), you can even buy or gamble Ancestral gear, but you must be at least level 73 for them to show up in shops. (right)
How to Find Ancestral Items in Diablo 4¶
Ancestral gear can drop from the usual sources of loot in World Tier 4 (Torment difficulty); killing enemies, opening chests, as rewards from Events or for clearing Nightmare Dungeons, Legion Events, and by spending 
Aberrant Cinders to open Tortured Gift chests during Helltide Events.
Basically you’re going to keep doing the same gameplay loop in World Tier 4 as you did in World Tier 3, you’re just going to look out for Ancestral drops now instead of Sacred drops.
It’s worth noting that you can also just buy or gamble for Ancestral gear, but these do not start appearing in shops until you hit level 73. Just look out for the aforementioned blue aura in merchant menus to confirm that something’s Ancestral quality (or in the case of gambling, as the chance to roll as an Ancestral item). Likewise you can also obtain Ancestral gear as rewards for completing tasks for the Tree of Whispers, but you must be level 73 for these to drop from reward caches.
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