Primordial Items are a powerful type of equipment, with a restriction of only being able to wield one at a time.

There are two types of Primordial items, Exalted and Unique. Primordial exalted affixes are tier 8, and are primarily created by using a Rune of Evolution on an item with at least one tier 7 affix on it. Primordial uniques are similar to other unique items in that they can also be crafted to Legendary items, but usually come with some more extraordinary effects. Most Primordial Unique items are created by Skarven Bloodhorn by giving him Rift Beasts body parts.