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The Pickaxe of Despair is a melee weapon that can be obtained by Henry Townshend in Silent Hill 4: The Room. It is an ordinary pickaxe with the word "DESPAIR" written on its handle. Henry can find it during his second journey into the Forest World. It is the heaviest and most powerful of Henry's melee weapons, outclassing some firearms in sheer damage potential. However, its weight also makes it difficult to swing. Unlike most weapons, Henry can only perform single swings, and the charge attack is extremely slow.

The Pickaxe of Despair is best used against slow or easily predictable enemies, supposing that the timing is correct. Though it can be difficult to use, with practice and timing it can be used effectively even against faster or more dangerous enemies. Its strength lies in its ability to put enemies down with just a few hits. Against small or weak enemies like Hummers, however, the Pickaxe is a waste, or at the very least more trouble than it's worth.

Later in the game, Henry finds another pickaxe, the Pickaxe of Hope, which he uses to find a secret area in his apartment. However, unlike Despair, Hope cannot be used as a weapon, obviously symbolic of the words written down on their handles.

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