The Saint Medallion is an item obtainable in Silent Hill 4: The Room. It's a magical stone whose aura is strong against 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.
- "I've found two mysterious and powerful artifacts that seem to be very effective for evading the ghost-victims: the Holy Candle and the Saint Medallion. Not only are they effective against the ghost-victims in the Other World, they also seem to prevent them from invading my room. Just light the candle near where they're coming in and its holy power is activated. The Saint Medallion seems to repel unholy energy when it's worn (equipped). I'm starting to gain some hope."
- If looked upon closely, the medallion depicts an image of a mother and child: "Saint Alessa." The exact picture is featured in a chapel found in Silent Hill 3.