The staff has a built-in magic spell that can be used regardless of the spellbook the player is using, although it cannot be used to autocast any other combat spells. The spell gives no base experience and grants the player 2 Magic experience per damage dealt.
In order to use the staff's magic spell, it must be charged with blood runes, holding up to 20,000 charges when fully charged. Each cast requires 3 blood runes, costing 993 coins per cast, and 19,860,000 coins to fully charge it with 60,000 blood runes.
Compared to the trident of the swamp, the built-in spell hits one damage higher with a maximum base damage of 34 compared to the trident of the swamp's 33. The trident possesses the ability to envenom, while the staff possesses the healing passive effect.
Thus, the staff is most optimal in situations where venom or poison has no benefit, and where healing is required. However, if the player's target is not immune to venom, players could initially use the trident of the swamp against the target until the target has been envenomed, then switch to the Sanguinesti staff. Notable encounters where the staff's healing capability proves very useful include the Kraken, the Chambers of Xeric and Dagannoth Rex.
Requires 240 Telekinetic, 240 Alchemist, 2400 Enchantment and 240 Graveyard points, and a teacher wand equipped or in the player's inventory, to purchase from the Mage Training Arena. Thus it does not cost much besides the time and runes spent in the Mage Training Arena.
Has a special attack that halves all melee damage the player takes for one minute, which stacks with the PvP damage reduction effect of the Protect from Melee prayer. This consumes 100% of the player's special attack.
When a combat spell is cast with the staff, there is a 1/8 (12.5%) chance that the staff will negate the rune cost for that spell.
Currently the strongest staff when used as a melee weapon, surpassing the Ancient staff and Iban's staff, and provides +17 magic defence.