How to get Twisted Heart of Uhkeiros in Last Epoch and its Unique Affixes

In Last Epoch, the Twisted Heart of Uhkeiros stands out as a powerful and highly sought-after unique relic, especially favored by builds that lean into high health pools and defensive scaling. This item converts a portion of your life into a ward — a valuable protective buffer — allowing for a unique risk-versus-reward play style that suits both hybrid and tanky characters.

In this guide, we explore the unique affixes on the Twisted Heart of Uhkeiros, where you can acquire it, and which builds benefit most from its mechanics.

What makes the Twisted Heart of Uhkeiros so special?

Unlike typical relics in Last Epoch, the Twisted Heart of Uhkeiros transforms a portion of your current life into ward, letting you layer offense with a defensive shield during spellcasting.

Unique modifiers of Twisted Heart of Uhkeiros (Image via Eleventh Hour Games)

Unique modifiers on Twisted Heart of Uhkeiros:

(5% to 8%) of Current Health converted to Ward when you directly cast a Necrotic Spell
(5% to 8%) of Current Health converted to Ward when you directly cast an Elemental Spell
+1 to Level of Necrotic Spell Skills
+1 to Level of Elemental Spell Skills
+(10 to 16) Strength (each point of strength increases your armor by 4% and improve the skills which rely on raw strength)
(10% to 16%) increased Cast Speed (increase the number of skills you can cast per second)

This relic works especially well for classes that have health-costing skills or benefit from both Strength and raw HP scaling. The ward gain mechanic creates powerful defensive layering that rewards calculated aggression.

Also read: Last Epoch Season 2 tier list (All Classes and Masteries ranked)

Where to find Twisted Heart of Uhkeiros in

Last Epoch

Unlike some random world drops, the Twisted Heart of Uhkeiros is tied to a specific boss, meaning players must intentionally target it through certain content.

Emperor of Corpses (Image via Eleventh Hour Games)

Drop source

Boss: Emperor of Corpses (6% chance, up to 48% with increased item rarity)
Timeline: Reign of Dragons (Monolith of Fate system — Level 85)
Corruption Requirement: The item only drops from the empowered version of the timeline, and only when the timeline corruption is at least 200.

Finish the Drowned Thetima, Island Battlefield, and Eye of the Storm quests in the Reign of Dragons region. Call forth the Emperor of Corpses with the third quest stated. However, you need to finish the first two and have the right amount of Stability (400 in the Normal version and 850 in the Empowered version) to activate this quest.

Reign of Dragons in the Monolith of Fate system (Image via Eleventh Hour Games)

Farming tips

Boost Timeline Stability: Focus on completing echoes quickly to access the Emperor of Corpses boss fight more often.
Increase Corruption: Use Beacons and kill Shade of Orobyss to raise your corruption level over time.
Use Echo Rewards: Prioritize echoes with "Unique or Set Relic" rewards to potentially get a second drop chance.
Blessings Help Too: Equip blessings that increase unique item drop rate or relic drop chance.

This targeted farming method is your best bet to find this item, since the Twisted Heart won’t drop anywhere else in Last Epoch.

Best builds with Twisted Heart of Uhkeiros

Owing to its ward-on-health-cost mechanic, this amulet shines in builds that actively use life to cast skills or have large health pools to fuel ward generation.

1) Lich (health cost caster builds)

Liches naturally lean into sacrificing health to cast spells, making them ideal candidates for this relic. It pairs well with Soul Feast, Death Seal, or Transplant setups.

2) Forge Guard (strength-stacking builds)

Forge Guards benefit from extremely high strength scaling and durability. This relic gives both, plus ward generation for extra protection.

3) Void Knight (hybrid melee-tank builds)

If your Void Knight uses health-draining skills and stacks Strength, Twisted Heart grants consistent ward to help survive high-tier content.

Twisted Heart of Uhkeiros is not only rare, it introduces a gameplay twist few other items provide. Turning your own life into a shield opens doors to creative defensive builds, particularly for characters who already trade HP for power.

Whether you’re pushing empowered Monoliths or gearing for high corruption farming, this relic can be the centerpiece of a tanky yet aggressive build that thrives under pressure.

If you're looking to maximize survivability without compromising on your raw power, the Twisted Heart of Uhkeiros deserves a spot in your equipment slot. While its drop method is narrow and its requirements are steep, the reward is a one-of-a-kind item that can redefine how you approach the endgame in Last Epoch.

Keep your corruption high, your health full, and your build tuned, and you just might find the heart that beats for ward-based greatness.

Check out our other guides on Last Epoch:

About the author

Jagaran is an MMO and ARPG writer at Sportskeeda. His involvement in the gaming industry also includes working as a concept artist and as a narrative designer.
At age of nine, Halo: Combat Evolved kicked off his love for the medium. He looks back fondly on the times he visited cyber cafes, watching the older boys playing the game and shouting, "Master Chief!"
If given a chance to inhabit a game world, he would eagerly jump into the breathtaking world of Halo.
He admires Ben "CohhCarnage" Cassell for his engaging dialogue and gameplay as well as his critical thinking regardless of how much he loves the game, which encouraged him to spend countless hours in games and technically analyze them.
In his free time, he enjoys writing books, cooking, sketching, and the occasional game of football.

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Edited by Angad Sharma