Just like many high-tier Diablo 4 items, Bloodless Scream is not guaranteed to Diablo 4 Gold drop from any single source. Instead, Diablo 4 uses a randomized loot system, where item drops are determined by factors such as enemy type, location, difficulty level, and RNG (random number generation).

Here are the most efficient ways to obtain Bloodless Scream:

  1. Random Drops in the World

Bloodless Scream can drop from:

    Elite enemies and bosses

    World events and Helltide chests

    Treasure chests scattered throughout dungeons

    Breakable containers like urns and corpses

Though it's possible to stumble upon this scythe by accident, the chances are slim. This is especially true on lower difficulty tiers, where the loot pool includes fewer uniques and rare drop rates.

  1. Farm Echo of Varshan

If you want to actively target-farm Bloodless Scream, the most efficient method is by summoning and defeating Echo of Varshan. This endgame boss has a higher probability of dropping unique Necromancer gear, including the Bloodless Scream.

To summon Varshan, you'll need to collect Malignant Hearts and specific summoning materials obtained by completing seasonal or whisper tree content. Once summoned, defeating Varshan at higher world tiers greatly increases your odds of securing this powerful weapon.

This method requires preparation and coordination, but it offers the best shot at getting the scythe without relying entirely on random open-world drops.

  1. Play on Higher Torment Tiers

The Bloodless Scream can drop at any difficulty tier, but the drop chance scales with world tier. That means:

    World Tier 3 (Nightmare) introduces Sacred versions of items.

    World Tier 4 (Torment) offers the highest chance for Ancestral Unique items like Bloodless Scream.

If you're farming efficiently on Torment, not only do you increase your chance at scoring this scythe, but you'll also benefit from better XP gains, more loot overall, and a higher drop rate for other Diablo IV Items.