Pincushioned Dolls stand out as one of Diablo 4's most sought-after endgame materials, essential for tapping into Andariel's lucrative hoard in Torment difficulties. These lair boss keys drop from specific high-tier activities, with reliability scaling up in Torment I and beyond where optimized builds shine. Targeting the right locations maximizes your hourly yield, turning repetitive grinds into efficient loot pipelines.
The undisputed top spot for farming Pincushioned Dolls is the Glacial Fissure dungeon in Fractured Peaks, southwest of Kyovashad, home to the Beast in the Ice. Craft a Nightmare Sigil at the Alchemist using Sigil Powder and gold, then enter and offer 12 Distilled Fear—sourced from Tier 30+ Nightmare Dungeons—at the Frozen Altar to summon the boss. Defeating it and opening the hoard chest delivers a near-guaranteed doll drop, often one or more, making this the fastest loop for solo or group play. Expect 10-15 dolls per hour with sub-10-minute clears, bolstered by Torment's higher rates.
Lord Zir's Ancient's Seat dungeon in Fractured Peaks ranks second, accessible via a crafted sigil and summoning with 12 Exquisite Blood from Legion Events or Pit runs. His post-fight hoard offers solid doll chances, though less consistent than the Beast, positioning it as a perfect rotation filler when Fear stocks dwindle. Rotate between these two for balanced material farming, as Zir's drops complement Beast runs without overlapping resources heavily.
Kurast's Undercity during the Tribute of Titans event provides the third-best option, activated by a Tribute item from deep Pit clears. This timed challenge yields dolls alongside other keys at respectable rates, ideal for groups pushing high throughput. World Bosses sprinkle in rare drops during their six-hour cycles, but their unpredictability relegates them to opportunistic grabs rather than core farms.
Beyond locations, prime drops include Uber Uniques, runes, and crafting mats from the hoards themselves, but the dolls' true value lies in fueling Andariel chains—three per Hanged Man's Hall run. In Torment IV+, equip boss-damage gear and resource generation to sustain loops; only the summoner loots dolls, so clan rotations amplify gains. Prioritize these spots over scattered events for steady stocks, transforming your inventory into a gateway for Mythic progression.