The blood talisman was an unobtainable item that would allow players to enter the blood altar. As the blood altar did not exist at the time of its release, it was not made available.
With the release of the blood altar in Arceuus on 7 January 2016, which does not require a blood talisman, it was removed from the game. However, since the Sins of the Father quest was released, the true blood altar now exists in-game albeit impossible to enter since the talisman is unobtainable.
- The blood talisman is referenced by the dwarf Thorgel in the Mourning's End Part II quest. Players take a list of items to him in exchange for a death talisman, but if you ask why he wants the items, if one of them is a jail key, he will say "Pretty please with a blood talisman on top?" at which point the player exclaims "A Blood Talisman!?" and he replies "Oops! I meant Death Talisman!" with a shifty look on his face.