The band appeared on major tours to support the album, including The Unholy Alliance with Slayer, Mastodon, Children of Bodom, and Thine Eyes Bleed, Gigantour, supporting Megadeth; main stage at Ozzfest; an appearance at the Download Festival, and an exclusive co-headlining tour with Killswitch Engage, Soilwork, and DevilDriver, where Killswitch Engage and Lamb of God shared headlining spots alternately each show.
В поддержку "Sacrament" группа дала аншлаговый концерт в лондонской «Астории», после чего выступила в нескольких больших турне, включая "The Unholy Alliance" со Slayer, Mastodon, Children of Bodom, Thine Eyes Bleed, а также Gigantour, с Megadeth и на главных сценах «Оззфеста» и Download Festival.