In the manga, Sanguinem is a large city beneath Kyoto. It is extravagant with buildings in 18th-century design, churches and cathedrals, and elaborate archways. There are also European-style houses. The ground often consists of either tile or stone. The city is set at one level, but many buildings have multiple stories. There are numerous large pipelines throughout the city.
Krul Tepes lives here in a large, elaborate mansion with a massive entrance hall. Her throne sits in the back center of the hall, and the hall is empty and without stairs. There are many elaborate arches on either side with detailed panels decorating them.
There are also books, which humans are free to read. One is Notes on Nightwalkers, which Yūichirō Hyakuya reads in chapter 1. Mikaela Hyakuya may sometimes be found sitting silently in the pews of one of the cathedrals all by himself.The homes of livestock are plain with tiled floors, blank walls, and no furniture.
- Anime: Sanguinem is an elaborate and large city composed of several bridges and waterways. There are many levels to the city. The buildings are designed in an 18th-century style, although some modern structures also exist. The churches and cathedrals are not shown, and the large pipes do not decorate the buildings. Krul's entrance hall has stairs and a long rug. The humans have furniture, and they wear shoes. Additionally, the house the Hyakuya orphans use is made of wood and has a loft. They have furniture, and there are many papers decorating the walls.
As the capital, Sanguinem is a center of politics in the vampire world. Important issues are discussed in the city, and it may serve as a meeting place for powerful nobles. It is not surprising that numerous vampires reside in this large city. Ferid Bathory lives in the city in his mansion, whilst Krul resides here as vampire Queen of Japan. Humans also live in the city, serving as livestock for the vampires. Most of these humans are children, and many were brought here during the Apocalypse in 2012 like the children from the Hyakuya Orphanage. Some of these children were sent by Kureto Hīragi to act as his spies and gather information from the nobles.
The vampires are not allowed to drink human blood directly from the livestock within the city. In the manga, the vampires remind the humans that they live at the mercy of the vampires, but they aren't violent toward them except during rare instances, such as when Ferid Bathory killed the Hyakuya orphans.
The livestock are raised to believe the world above ground has been destroyed, so they have no reason to escape. Unlike in the vampire cities above ground, the livestock cannot come and go freely as long as they do not know the locations of the exits.
- Anime: In the anime, the vampires are regularly violent toward the livestock, going so far as to even step on children drawing in the street and dangling Yūichirō Hyakuya off the edge of a bridge when he misbehaves.
- Ferid Bathory
- Krul Tepes
- Lacus Welt
- René Simm
- Yūichirō Hyakuya (Escaped)
- Mikaela Hyakuya (Former Resident)
- Akane Hyakuya (Deceased)
- Kōta Hyakuya (Deceased)
- Chihiro Hyakuya (Deceased)
- Ako Hyakuya (Deceased)
- Fumie Hyakuya (Deceased)
- Taichi Hyakuya (Deceased)
Yūichirō, Mikaela, Akane, and other children that survived the Apocalypse on Christmas of 2012 were deported to Sanguinem from Tokyo to become livestock for the vampires. Krul specifically collected the children from the Hyakuya Orphanage because she wanted the surviving seraphs.
Four years later, Mika stole a map and gun from Ferid Bathory, and he attempted to escape with his family of orphans. Ferid waited at the exit for them, slaughtered most of them, and dismembered Mika. Only Yu escaped into the outside world after he was able to shoot Ferid in the head. In order to save Mika's life, Krul then turned him into a vampire.
In 2016, the vampires in Sanguinem discussed the growing threat of the Japanese Imperial Demon Army. Krul declared war on the JIDA for the crimes of killing their kin, stealing their territory, and dabbling with taboo magic.
Three months after Nagoya, Kureto and Guren lead their army into Sanguinem and wreck the place. Mirai appears with them in her Seraph form.
However, due to Krul Tepes and Ferid Bathory's failure to repel Kureto and Guren's attack, Second Progenitor Urd Geales and Third Progenitor Lest Karr had personally traveled to Japan together with a large contingent of vampire nobility to retake the fallen stronghold. After punishing both Krul and Ferid, and learning of former Second Progenitor Rigr Stafford's presence in the country, Urd and Lest proceeded to lead the attack to retake the city and successfully root out and remove the JIDA forces there and reclaim the stronghold for the vampires once more.
After Ky Luc had returned with former Queen Krul Tepes after retreating from the combined forces of the Rogue JIDA soldiers and former seventh and thirteenth Progenitors Ferid Bathory and Crowley Eusford, Ky proceeded to escort her to one of the Cities prison cells to be interrogated by Lest and Urd,where he then amusingly watched the interrogation and proceed to learn of Krul's true motivation for her actions together with his superiors.
- "Sanguinem" means "Blood" in Latin.