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Pain Enhancer is a Legendary Gem in Diablo III. It can only be socketed into Amulets and Rings, and drops from Greater Rift Guardians.


Pain Enhancer (Diablo III)

Pain Enhancer
Legendary Gem

  • Critical hits cause the enemy to bleed for 2500% damage as Physical over 3 seconds.
    • Upgrade: +50% damage as Physical over 3 seconds (+10% per second) per Rank.
    • Max: 10,000% damage at Rank 150.
  • Gain Blood Frenzy, granting 3% increased Attack Speed for each bleeding enemy within 20 yards (Requires Rank 25)

Xiangyi, most beautiful of Xiansai master gem cutters, crafted this gem in honor of a former lover. The angrier she got, the faster she worked, and the gem was ready in no time. Only after she had tested its efficacy was she finally satisfied.


  • Each Critical Hit, regardless of Proc Coefficient, applies one bleed, but they do not stack, only being renewed to full duration. The effect can be applied by your pets/minions and follower.
  • At rank 25, it includes enemies that are under any Bleed effect (not just the Pain Enhancer's own Bleed) applied by that player, pets/minions, and follower. If an enemy bleeds from more than one source, it will still only grant one stack of Blood Frenzy.
  • The effect itself has a Proc Coefficient of zero, and cannot score a Critical Hit (increasing flat damage proportionally to the Critical Hit chance and damage instead).


  • This gem is of most use to Physical skill builds.