The Sin Lieutenants helped Azmodan gain dominance over the Burning Hells. During the End of Days, the lieutenants were present when Azmodan confronted Leah in a vision, staring menacingly at her. Some of them participated in the Army of Sin's siege on Bastion's Keep but were soon defeated by Tyrael and the Nephalem.
- The aforementioned Lieutenants appear to correspond to the Cardinal sins in Church doctrine.
- The enthroned horned skeletons seen in Leah's vision of Azmodan may be representations of the Sin Lieutenants. The central throne is empty however, suggesting that there are either only six Lieutenants, or that they actually represent the Great Evils.