- Found in Depth 3 and 4 Chalice Dungeons.
- Can drop from Kidnappers in Depth 3/5 Chalice Dungeons.
- Can be dropped by all variants of Merciless Watcher in Depth 3/5 Chalice Dungeons.
- Can drop from Labyrinth Ritekeepers in Depth 3/5 Chalice Dungeons.
- Can be dropped by all variants of Shadows of Yharnam. (Only Shadows of Yharnam encountered in the chalice dungeons can drop Ritual Blood (4).)
- Purchased from the Bath Messengers in the Hunter's Dream for 24,000 Blood Echoes after defeating Yharnam, Pthumerian Queen.
- An good farming spot for Ritual Blood (4) is on layer 2 of Lower Pthumerian Labyrinth. After unlocking the gate that leads to the boss, go into the right side door in the hallway. Go forward and take the ladder up by the scorpion, To your left is a stairway with a Snatcher, and another one at the top of those stairs. They both have a good chance of dropping Ritual Blood (4).
Ritual Blood (4) is a basic material used in Chalice Rituals, in order to create Chalice Dungeons.