Where to Find the Sacrificial Heart in Path of Exile 2

The Sacrificial Heart only drops during Act 3, making it a mid-game objective. 
After completing the Temple of Kopec and defeating Ketzuli to Path of Exile 2 Currency unlock the time machine, you'll be sent back in time to Utzaal, an ancient city filled with Vaal enemies. This is where your hunt for the Sacrificial Heart begins.
The item drops from Vaal Goliaths, massive red-skinned enemies that tower over other foes. 
When the item finally drops, you'll know immediately. The Sacrificial Heart emits a distinctive sound effect upon hitting the ground and appears in green text, marking it as a quest-related item.

If you clear Utzaal without finding the drop, continue to Aggorat, the next area along the main quest line. Aggorat also spawns Vaal Goliaths, so there's no need to backtrack.

Pro Tip: Equip strong Path of Exile 2 Items before heading into these zones - Vaal enemies deal heavy area damage and can overwhelm underprepared players. If you need to boost your character's gear quickly, consider buying POE2 Items to optimize your build before farming.

How to Use the Sacrificial Heart in Path of Exile 2

1. Once you've obtained the Sacrificial Heart, your next step is to use it to complete the secret quest Blood Sacrifice. 

2. The altar you're looking for is located in Aggorat, the same region where you can also find Doryani's Laboratory.

Tips: The specific location is known as the Trial of Sacrifice, an eerie area filled with Vaal followers performing dark rituals.

3. If you're unfamiliar with Aggorat's layout, focus your exploration on the right-hand side of the map. 

Tips: The altar room is distinct-it looks like a morgue or ceremonial chamber with blood markings and ritual symbols. You'll also find a checkpoint nearby, which helps in case you discover Doryani's lab before locating the altar.

4. When you arrive at the Trial of Sacrifice, you'll encounter a group of Vaal cultists already in the middle of a ritual. Defeat them, and one of the corpses will drop a Sacrificial Dagger, which you'll need to complete the offering.

After clearing the area:

Interact with the altar and place the Sacrificial Heart on it.
Use the Sacrificial Dagger to stab the heart and initiate the ritual.
A short cutscene or visual effect will play, signaling that the Blood Sacrifice quest has been completed.

Once done, you'll automatically receive two passive skill points and a bonus weapon set slot as your rewards. These rewards will appear in buy POE2 Currency your character menu and can be used immediately.