What the achievement asks
Hold maximum stacks of Rampaging for 30 consecutive seconds, while the Blessing Rampage is running. Ten points.
This is the easiest of the four, and the one most likely to be missed entirely, because Rampage is a Blessing rather than a Torment.
The rotation is the real obstacle
Blessings and Torments are fixed per wing and reroll when the daily quests do. You cannot pick the one you want: you check what is up, and if it is not there, you come back tomorrow.
They are not the same across the six wings on a given day, so check all of them before giving up. People find the torment they need sitting in a wing they never usually run.
Layers matter too. A run carries more torments the higher the layer, so if the one you want sits late in the list you have to go deep enough for it to be active at all. Roughly: layer 8 for one, layer 10 for two, layer 12 for three, and the last slots only appear at 15 and 16.
How to do it
Kill things. Each kill adds a stack, up to ten, and the buff lasts sixteen seconds on its own. Stagger your kills so it never lapses, and you only need one or two refreshes to cover thirty seconds.
Anything counts. Mawrats, skeletal remains, whatever is lying around. If you are worried about survival, find a pen of the weakest enemies on the floor and work through them slowly rather than picking a fight.
You do not need a high layer. A low layer with the Blessing up is enough.
The achievement does not fire while you are holding the buff. It comes through when the buff finally drops, or when you finish the floor. People assume they have failed and start again, several times, because nothing happens at the thirty-second mark.
If you never see Blessings at all, you have not bought Blessing of the Ancients in the Box of Many Things. Without it a run has torments and nothing else, and this achievement can never come up.
It works again
Rampage stopped awarding in patch 10.2.7 and stayed broken for three months, which is longer than its sibling Avenge Me! and long enough that Blizzard published a support article about it. The fix landed in 11.0.2, in mid-August 2024, and it has been reliable since.
Where it fits
This is one of the four under Master of Torment, which is one fifth of Tower Ranger and the Shadowlands meta.