The Saint Medallions are items obtainable in Silent Hill 4: The Room. Its aura repels all supernatural phenomena including ghosts, wheelchairs, and the hauntings that occur in Room 302. When held in the presence of a ghost, its movement will become slower; however, they are still capable of dealing damage. After being held for a period of time, it will break and lose its power permanently. They can be found in various locations but are not as abundant as the Holy Candle.
Henry Townshend discovers the existence of the medallions, along with the Holy Candle, when he is given a red letter from Joseph Schreiber under Room 302's front door. Joseph comments that it seems to repel unholy energy when it's worn.
- Water Prison World, interior spiral staircase
- Hospital World, 2F, the room with the light coming from a window
- Subway World second time, B3, Lynch Street subway car
- Forest World second time, the room where Nakheehona (the mother of stones) are located
- Water Prison World second time, B1, on a bench on the dining hall
- Building World second time, B12, base of the tower
- Apartment World second time, 3F, outside Room 302
- Apartment World second time, 3F, Room 301
- Apartment World Second Time, Second Floor, room 201
- If examined closely, the medallion depicts an image of a mother and child: "Saint Alessa" and Heather Mason as a baby. The exact picture is featured in a chapel found in Silent Hill 3.