Looted from the King of Leeches, located in the Eastern Sewers. The boss can be accessed via the Eastern Sewer entrance or, more directly, through a trapdoor in the Gardener's House.
After the King of Leeches has been defeated, the crown can be crafted at an Anvil of Zenithar using the following materials:
- 3 Leech Fang
- 5 Human Flesh
Leech Fangs can be acquired in large numbers from the Plague Leeches found throughout Coldharbor.