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The Awakening adds a whole new Act to the game, Act Four, which opens the Highgate Mine and all its evil within. This includes a face-off with something dubbed Nightmare, and what sounds like a jaunt inside the belly of the Beast.
In addition, the expansion bestows new skills, jewels, exotic items and challenge leagues. Plus, it rebalances the entirety of Path of Exile from the very beginning, and overhauls the game's user interface. There's a whole expansion mini-site with more detail.
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