Blood Moon Breeches were one of the many unique items to get an overhaul in Diablo 4 Patch 1.5. 0, with the breeches now having an effect that gives minion attacks a chance to randomly inflict Iron Maiden or Decrepify. While they're great for Necromancers, they can be tricky to obtain.
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You have a chance to obtain Blood Moon Breeches as a random drop by defeating enemies, participating in Legion Events, and defeating World Bosses in World Tiers Three and Four. You can also obtain Blood Moon Breeches as a drop from the endgame bosses Duriel, the King of Maggots, and Andariel.
You can get these pants randomly by simply playing endgame content in Diablo 4. As you collect better gear in World Tier Four, you will have a higher chance of getting these pants by beating Elites, bosses, Events, and Nightmare Dungeons.
The only problem with this method is that you are not guaranteed to get them just for beating bosses and elites in World Tier Four. It is purely a chance drop.
