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Outside of these two events, you can run Nightmare Dungeons, kill World Bosses, and kill any enemy in the game for a chance at the item. You have the best chances of getting Ancestral Helmets by doing Helltide events and opening the Tortured Gift of Helmets or by doing the Tree of Whispers and choosing the Helmet cache. The Shako is extremely rare, as confirmed by Blizzard community manager Adam Fletcher on Twitter. The Harlequin Crest, also known as the Shako, is an Ancestral Unique item that can be obtained anywhere in World Tier 4.
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