Madmen will very rarely drop music boxes, and The Collector miniboss will sometimes drop powerful head-based trinkets (though these can also be found in Secret Rooms). Some unique trinkets can only be found by killing specific enemies.

These can still be bought from the Nomad Wagon. Some trinkets can be found as a quest reward for only a specific region. Boss-slaying expeditions always have a Very Rare trinket as a reward regardless of difficulty. A trinket is given as a reward for completing each expedition, starting at Common for short Apprentice dungeons and increasing one level of rarity for each additional difficulty or length (up to Ancestral for long Champion dungeons). Trinkets have different rarities, which are denoted in game by color and description. The trinkets confer stat bonuses and penalties when worn, and it is up to the player to use them to their full effect. Fleeing a battle will not give such an opportunity. If a hero dies, their trinkets can be scavenged if the player perseveres and wins the battle.

Each hero is able to carry up to two different trinkets at a time.

Certain trinkets are earned by defeating specific enemies.

Trinkets are equippable items that are commonly obtained while adventuring in the dungeons, earned as rewards from quests, or bought at the Nomad Wagon.

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