Blood Surge Necromancer Endgame Guide

Last Updated: August 18th 2023

Season 1 - Malignant

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The Blood Surge Necromancer is an AoE focused Overpower build that manages to output great DPS and continuous healing. This walking bulwark is nearly unkillable and excels in all types of content.

To properly pilot the build you need to understand Overpower and how the stat in Diablo 4 work. We don't care about Critical Strike Damage, Vulnerable Damage, or most other modifiers in the game. Ignore +xx% While Fortified, Healthy, Close, Distant etc. All you care about is Maximum Life, Fortify, Willpower and a motley crew of random global multipliers.

The Blood Surge Necromancer rewards the player for having a deep mechanical knowledge of the game, and a willingness to grind for the gear you need to make it shine.

While the starter version of the build invests more heavily into the base Skill's damage, as you transition to the endgame, your gear and Skills become much more specialized.

Blood Surge Necromancer Endgame Gear


Blood Surge


Corpse Tendrils

Bone Storm

Blood Mist

Skeletal Warriors - Skirmishers

Skeletal Mages - Bone

Golems - Blood

This build guide assumes you have a Level 50 Character and finished the Campaign. Level up with our Blood Surge Necromancer Leveling Guide. If you are looking for a different Necromancer play style, check out all of our Necromancer Guides

Super Tanky
Unique Play Style

Fast Paced Gameplay
Great For Nightmare Dungeons ✔

Complex Skill Rotation
Specific Gear Dependent
Poor Single Target Damage
Unintuitive Mechanics And Stats

Season 1 - The Malignant

Players on the Eternal Realm should ignore this section of the guide. This build is designed to work without Caged Hearts, though it can be enhanced by them.

Diablo 4 Season 1 introduces a new questline to hunt Malignant Monsters across Sanctuary. Defeating them drops Caged Hearts that are placed in Jewelry infested sockets to gain build-altering powers. Check out the full Season 1 The Malignant guide from Chewingnom to learn more!

  • There are 32 Caged Hearts divided into 4 different colors. The first 3 must be socketed into their respective infested socket color, while the 4th can be placed into any infested socket.
  • Once socketed, they cannot be removed. Instead they can be broken down to craft Invokers and target farm the Caged Hearts you want inside Malignant Tunnels.
  • Higher powered Caged Hearts drop at higher levels.

With this in mind, let's look at the top 3 best Caged Hearts (and alternatives) for this build:

Best-in-Slot Caged Hearts

  1. Caged Heart of The Barber - Allows your Overpower Damage to effectively "Critically Strike" by transforming it into a new damage source that then applies in an AoE, drastically increasing our clear speed.
  2. Caged Heart of the Decrepit Aura - Maintains a permanent Decrepify aura that applies to monsters within a Close range, without needing to use the Skill yourself.
  3. Caged Heart of the Sacrilegious - Procs Corpse Tendrils once every 6 seconds on Close Corpses, without using your Cooldown. In the early game it also casts Corpse Explosion for extra damage and Essence generation.

Alternative Caged Hearts

  1. Caged Heart of the Malignant Pact - Great early game option that helps with Essence maintenance as well as survivability and overall damage output.
  2. Caged Heart of Revenge - Fanstastic option to swap in over the Decrepit, when you need more survivability. Requires you to manually cast Decrepify, which you should already do in higher Nightmare Dungeons.

Barber Setup

Luckily, on the Necromancer the Caged Heart of The Barber does not negatively impact a lot of our Lucky Hit and proc abilities. The exception is Lucky Hit: Up to a 5% Chance to Restore +xx% Primary Resource. Look for +xx% Critical Strike Chance instead, on gear that has this Affix recommended.

Skill Tree

Active Skills

  • Hemorrhage has incredibly high Essence generation due to its bonus Attack Speed and allows us to spawn a ton of Blood Orbs to trigger various benefits.
  • Blood Surge has two damage components. The first one hits the entire screen and "drains" the targets, which empowers the second smaller AoE damage "surge".
    • Overpower does NOT scale with the Skill Damage by putting additional Ranks into the Skill. A Rank 1 Blood Surge does the same Overpower Damage as a Rank 5 Blood Surge.
  • Blood Mist is our get out of jail free card and a great mobility option later on with specific Aspects. It's used as a quick applicator of Overpower Damage against groups and single targets.
  • Decrepify Slows, reduces incoming damage, Stuns and reduces our Cooldowns via Lucky Hit mechanics.
  • Corpse Tendrils is the best total CC option in the game and also spawns a ton of Blood Orbs to trigger various benefits.
  • Bone Storm gives us a reliable source of Barrier to make the most out of our Fortified status, as well as additional Damage Reduction.
Final Skill Tree


  • Rathma's Vigor adds to our survivability and total damage output by increasing our Maximum Life. The added benefit is that it gives us another source of Overpower procs every 12 seconds.
  • Both Coalesced Blood and Tides of Blood increase our Overpower Damage.
  • Drain Vitality allows you to very quickly stack Fortify to double your Overpower Damage output as well as decrease incoming damage.
  • Memento Mori is important for increasing one of the biggest damage scalers you have available to you, which is the Bone Mage sacrifice bonus.

Book of the Dead

There are 3 different Minion types you can choose to summon or sacrifice, located in the Book of the Dead. The Blood Surge Necromancer chooses to sacrifice Skirmishers for the Critical Strike Chance bonus, Bone Mages for the MASSIVE increase to Overpower Damage and Blood Golem for Maximum Life bonus.

Skeletal Warriors - Skirmishers

Skeletal Mages - Bone

Golems - Blood

Learn more details and how to unlock this class specialization in our full Book of the Dead Guide.

Paragon Board

← Scroll to Level →

Level the Paragon Board by scrolling. Each step optimizes progression.


We need to level up our Glyphs to activate their Additional Bonus with surrounding nodes. For some Glyphs, we max our bonuses by allocating every relevant node in range, while on others we take the minimum required for the Additional Bonus only. Because Glyphs at level 15 increase their radius, we need to prioritize leveling them by completing Nightmare Dungeons. After that, we prioritize leveling our strongest glyphs to level 21.

Glyph Leveling Priorities

Level 15

  1. Dominate
    1. NOTE: This Glyph needs to be leveled to 15 to be functional and is your priority while progressing in WT3 and 4. This Glyph starts on Bloodbath and moves to Scent of Death after.
  2. Blood-drinker
  3. Amplify
  4. Control
  5. Essence
    1. NOTE: The secondary bonus that increases Critical Strike Damage works with Overpower scaling, similar to Aspect of Grasping Veins.

Level 21

  1. Dominate
  2. Amplify
  3. Blood-drinker
  4. Control
  5. Essence

There are a total of 225 Paragon Points. Starting with level 50 you gain 4 Paragon Points per level, plus 20 from Renown, and 4 from Altars of Lilith.


Blood Surge Necromancer lives and dies by the amount of density in a given area. The more targets it can hit at the same time, the more it can proactively heal through damage. Since you need to be in melee range for the Surge to hit targets, you're in danger for the majority of the fight. The gameplay loop seeks to minimize threats and maximize damage output.

Skill Usage/Rotation

  • Initiate with Decrepify to start, so you don't miss any CD reduction procs. This also greatly reduces incoming damage and makes kiting monsters easier.
  • Rathma's Vigor ticks up every second that you are Healthy. You often can use Blood Mist as a massive AoE damage dump to start off a fight as well as create Corpses to target with Tendrils. This becomes more important against single targets and bosses.
  • The increase to Critical Strike Damage from Tendrils actually applies to your Overpower Damage and is almost certainly due to a bug. Until they fix this, it's one of your few damage scalers. Make sure to wait for the Tendrils to actually Pull, since that's when you have the full benefits of the Aspect.
  • Once a Corpse is formed, cast Corpse Tendrils on it and use Evade to make space between you and any threats while the Tendrils pull mobs into range.
  • Spam Blood Surge until you run out of Essence, or every enemy is dead. When needed, recast Corpse Tendrils and Decrepify.
  • You do not care about the base Skill damage of Blood Surge! Your only concern is cycling through to the guaranteed Overpower proc from the skill, or Rathma's Vigor. Ideally you leave every fight with a few casts already procced, so you can guarantee an Overpower earlier into the next fight.
  • Use Hemorrhage to regain Essence against 1-2 packs of enemies. Make sure to pick up any Blood Orbs to give it an AoE effect, which generates Essence for each target hit. This is incredibly important for Bosses as well.
  • Make sure to target a monster that is within the same range as high-value or high-threat targets. Focus any Damage Resistance Aura monsters, Elites or enemies that apply powerful Crowd Control effects. Neutralizing threats in scenarios where the pack isn't cleared out from the initial spam.

Resource Management

One of the most important parts of your endgame journey is acquiring enough Essence to destroy your enemies. Having a grasp of the essentials of how your Essence works is key to your progression. There are many ways of generating resources, but below are some of the most important and relevant ones for the Necromancer.


Hemorrhage is a fantastic tool for quickly generating Essence, at range, against single or small groups of enemies. It naturally gains Attack Speed when you are healthy, and picking up a Blood Orb causes it to damage enemies in an area. Every target hit generates more Essence.

Resource Aspect of the Umbral

Each Crowd Control effect that you inflict upon enemies triggers this aspect. This means that you can stack multiple different Crowd Control Effects in order to get incredible Essence generation. You need to find a 4 Resource version of it from a drop. Try to gamble rings at the Purveyor of Curiosities to get this item. Important effects that can trigger the Resource Aspect of the Umbral include:

  • Penitent Greaves Chill
  • Corpse Tendrils Slow, Stun, Pull
  • Decrepify Slow

Resource Aspect of Potent Blood

In the early game, it's reasonable to use this Aspect as well to gain some additional Essence whenever you pick up a Blood Orb. You can also rely on the Orbs left over from a fight to help top off while you move to the next pack. Skills that generate Orbs for you are:

  • Hemorrhage
  • Blighted Corpse Tendrils

Endgame Gear & Skill Progression

When you start diving into the Endgame, you don't have all the tools available to achieve the final build versions. Let us guide you through different progression points to give you a smooth transition from our Leveling Guides to the final build version.

Progression Goals

Many of your Skill choices depend on what Legendary Aspects and Unique items are available to you. While we can guarantee that everyone has access to the same Codex of Power Aspects, the progression might be different for everyone!

  1. Unlock the following Aspects in your Codex of Power:
  2. Find the following Legendary Aspects by farming in Dungeons, Nightmare Dungeons, Helltides, through the Tree of Whispers, or gambling with Obols:
    • Aspect of Shielding Storm: Powerful source of Barrier for dangerous fights.
    • Aspect of Rathma’s Chosen: Grants Attack Speed after we successfully Overpower.
    • Aspect of Explosive Mist: Decreases the Cooldown of Blood Mist so we can use it proactively, more often.
    • Sacrificial Aspect: Acts as additional multiplier for our Sacrifice bonuses from the Book of the Dead.

Learn more details and how to farm Legendary Aspects and Uniques in our General Farming Guide.

Progression Setups

Early Endgame
Late Endgame

Once you have completed the leveling guide, only the Codex of Power Aspects are guaranteed. With this setup you can farm the Legendary Aspects and Unique items you need for the next progression point.


Coming from World Tier 2, you can already have a good array of Legendary Aspects imprinted on key gear pieces to help smooth out gameplay and set you up for success.

  • Blood-bathed Aspect causes our Surge to echo again. The damage reduction does NOT affect Overpower damage!
  • Offensive Aspect of Grasping Veins on an amulet gives a massive amount of Critical Strike Chance and a decent damage multiplier that actually applies to Overpower as well.
  • Ghostwalker Aspect is the only reliable movement speed boosting Aspect we can employ at this early stage. You can quickly spam Blood Mist on then off to gain 10% Movement Speed for 4 seconds.
  • Aspect of the Umbral generates a lot of Essence during a fight when our CC effects trigger.
  • Aspect of Potent Blood helps to manage Essence and naturally synergizes with Hemorrhage.
  • Make sure to upgrade your Weapon, Boots and Amulet at least 3 times to help buff high-priority stats.
Starter Gear

Skill Tree

On the Starter Skill tree you need to focus on Blood Surge base damage, since you cannot easily stack high amounts of Overpower. This requires four more Skill points in the Skill itself. When your Overpower damage is twice that of your base damage, you can consider redistributing those Skill points into the Endgame Skill tree setup.

Corpse Explosion helps to maintain more consistent damage against tanky packs of Elites and Bosses. It greatly improves your Essence maintenance with Grim Harvest.

Starter Skill Tree

Build Scaling & Stat Priorities

The answer to many questions can be found in the following section.

Build Scaling

Learn all you need to know about how to scale the Blood Surge Necromancer in the endgame.

  • Overpower: This damage type doesn't play well with others. It cannot Critically Strike (Although Aspect of Grasping Veins does empower it due to a bug), it isn't affected by Vulnerable and it doesn't scale off any additives damage bonuses except Blood Skill Damage. It reads your current Life and Fortify value to calculate its bonus damage. So stacking Maximum Life and Fortify Generation are keys to outputting your maximum damage. Click Here for an exhaustive list of everything that scales Overpower!
  • Crowd Controls: CC'ing monsters and Pulling them becomes a direct damage scaler. Not only does it maximize our paragon board bonuses, but it also grants us more time to apply more attacks before Overpower procs.
  • Attack Speed: Increased Attack Speed increases the rate we generate Essence, by reducing the animation length on our generators. It decreases the length of time before Tendrils is on the field and how quickly we can spam cast Blood Surge. It's arguably the highest value stat on our gear and Paragon after Maximum Life.

Stat Priorities & Gear Options

There are many stats and status effects that generate on gear, but many are not important for your build. Some stats may block others from rolling or only appear on certain gear slots. See below for a general breakdown as well as a per slot priority list in the list.

Put in the following Gems into your gear:

  • Helmet / Body Armor / Pants: Royal Ruby
  • Weapon / Off-Hand: Royal Ruby
  • Jewelry: Royal Skulls

This build benefits a lot from the following Consumables:

  • Elixirs: Heady Crushing Elixir for bonus Overpower damage.
  • Incense: Reddamine Buzz for Maximum Life, Song of the Mountain for Damage Reduction or Sage's Whisper for a slight damage and survivability boost.

Refer to the table below to see the best rolls for every slot ranked in order of importance:

Blood-bathed Aspect1. Overpower Damage
2. All Stats
3. Intelligence
4. Ultimate Skill Damage
Aspect of Audacity1. Maximum Life
2. Resource Generation
3. Lucky Hit: Up to a 5% Chance to Restore xx% Primary Resource
4. Essence Cost Reduction
5. Lucky Hit Chance
6. Damage Reduction (Any Relevant Option)
Helm1 of:
Aspect of Disobedience
Aspect of Might
1. Maximum Life
2. Total Armor
3. Cooldown Reduction
4. Willpower
5. All Stats
6. +xx Ranks to Decrepify
Chest1 of:
Aspect of Disobedience
Aspect of Might
1. Maximum Life
2. % Total Armor
3. Damage Reduction (Any Relevant Options)
4. Willpower
5. All Stats
GlovesSacrificial Aspect1. Overpower Damage
2. Attack Speed
3. Lucky Hit Chance
4. Lucky Hit: Up to a 5% Chance to Restore xx% Primary Resource
5. Critical Strike Chance
5. Willpower
6. All Stats
PantsAspect of Shielding Storm
Implicit: Potion Grants Barrier
1. Maximum Life
2. % Total Armor
3. Damage Reduction (Any Relevant Options)
4. +xx Ranks to Blood Mist
5. Willpower
6. All Stats
BootsGhostwalker Mobility AspectImplicit: Max Evade Charges
1. Movement Speed
2. Essence Cost Reduction
3. +xx Ranks to Corpse Tendrils
4. Willpower
5. Movement Speed After Killing an Elite
6. All Stats
AmuletAspect of Rathma’s Chosen1. Essence Cost Reduction
2. +xx Ranks to Tides of Blood Passive
3. +xx Ranks to Coalesced Blood Passive
4. Movement Speed
5. % Total Armor
6. xx% Willpower
7. Cooldown Reduction
8. Damage Reduction (Any Relevant Options)
Ring 1Aspect of Potent Blood
Aspect of the Umbral
1. Maximum Life
2. Overpower Damage
3. Resource Generation
4. Lucky Hit Chance
5. Critical Strike Chance
Ring 2Aspect of Grasping Veins1. Maximum Life
2. Overpower Damage
3. Resource Generation
4. Lucky Hit Chance
5. Critical Strike Chance

Hardcore Adjustments

Hardcore requires you to build into more defenses. Here are some tips to successfully navigate this build through potentially dangerous situations:

  • This build already prioritizes survivability above other stats on the majority of your gear. Make sure to ignore Damage affixes on your Amulet and Essence management on your Shield for more Damage Reduction options.
  • In the Paragon Boards, select additional Armor Nodes in Rare clusters whenever possible.
  • Only farm Nightmare Dungeon content that's 3 Levels above your Character until you're comfortable farming higher difficulty content.

Check out our dedicated in-depth guide to learn more survival tricks in Hardcore.

Level 100 Endgame Variants

You can optimize your build further for certain endgame activities, such as Speedfarming, Nightmare Dungeon Pushing, etc. Let's take a look at the changes you need to make to achieve the best results in them.

Nightmare Dungeon Push

The Speedfarming setup makes you more efficient in farming the Open World, Helltide zones, Tree of Whispers, regular Dungeons, and Nightmare Dungeons below Tier 45.


In every gear piece that makes sense, we add Willpower/All Stats (Increases Overpower damage) and additional Cooldown Reduction. More damage means less time on each pack, so you can keep running to the next pack.

  • Swapping to a Focus with Blood-soaked Aspect grants us a much higher bonus Movement Speed while in Blood Mist and turns it into a legitimate mobility option.
  • Swap Accelerating Aspect to maximize attack speed, since you shouldn't need the bonus Essence to clear.
Speedfarming Gear

There are no changes to the Book of the Dead, Gameplay, Skill Tree or Paragon Board and Glyphs.

Frequently Asked Questions (FAQ)

Once a guide is released, many players have questions on why and how we are approaching certain choices. In this section you can find the answers to the questions that have been asked the most.

What Works With Overpower?


Learn all you need to know about how to scale this build in the endgame.

Blood Surge

Video Guide

Blood Surge Necromancer Build Guide Video: ALWAYS Follow the Maxroll Written Guide, as it remains up to date through game changes.

Hungry for more Guides?


The Blood Surge Necromancer is incredibly nuanced and rewards the player for learning as much as you can about Overpower mechanics and how to maximize your Overpower procs. With your huge Maximum Life pool, Fortify and healing, you can survive damage that other builds could never conceive of!

  • Blood Surge can hit a target twice, as long as they're within range of the "drain" and the "surge". The "drain" hits the entire screen, while the "surge" only hits Close Enemies.
  • Overpower is a finicky damage stat that doesn't play well with others. Only worry about Maximum Life, Fortify, Willpower and Overpower Damage on gear to scale this efficiently.
  • Blood-bathed Aspect allows us to cheat out an extra "surge" for free. This Overpowerswhen the base Skill would. The damage value on the Aspect is irrelevant and does not reduce your Overpower damage.
  • Practice makes perfect! Don't be afraid to run slightly easier content of Nightmare Dungeons to get the flow of the gameplay loop.
  • In Bocca al Lupo!


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