- Loot from most monsters in the Domain of Anguish. Each type of gemstone drops from a certain species, e.g. Margonite Gemstones drop from Margonites, etc.
- Chest loot from the chest that appears after completing each region of the Domain of Anguish. The number of gemstones rewarded is equal to the number of regions completed without leaving the Domain of Anguish (2 per region in Hard Mode); the type of gemstone depends on the region, e.g. Stygian Gemstones in the Stygian Veil.
- 1 of each type of gemstone is given as a quest reward for completing the Mallyx the Unyielding quest.
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