Cookies help us deliver our Services. By using our Services, you agree to our use of cookies. Learn More.

The Ending Of The Medium Explained

The story in The Medium is all about twists and turns. It raises a lot of questions early on, and throughout your journey of trying to get those questions answered, it doesn't hesitate to ask a bunch of new ones, too. The game stars Marianne, a woman who's struggled her whole life with the fact that she has psychic powers. Marianne is a medium — a being capable of communicating with and freeing the spirts trapped between life and death.


As Marianne recounts in her own narration of her tale, "It all starts with a dead girl." From there, The Medium begins to pull back some of its layers while also growing some new ones in the process. By the time you finish playing the game, you may feel slightly lost about what all has happened and where all the central characters stand. Below, you'll find the ending of The Medium explained — a guide to what you should take away from this Xbox-exclusive horror title.

Thomas is also a medium

Toward the very beginning of The Medium, Marianne gets a call to visit the Niwa worker's resort. The person on the other end of the telephone is a rather desperate and panicked-sounding man by the name of Thomas. Thomas tells her he knows what she is, and claims Marianne is the only one who can help him. Marianne — wanting to figure out who this man is and what's going on — goes to Niwa, and spends most of the game searching both for Thomas and for Answers.


As events unfold at Niwa, Marianne is presented with visions of Thomas that help fill in some of his backstory. He, too, is a medium. He has the power to send a spirit version of himself into someone else's mind if they make skin-to-skin contact with him. The spirit version of Thomas became trapped in another man's mind, thus leading Thomas to try and devise some way to rescue him. Marianne later frees the spirit version of Thomas, but after the game's credits, it is implied the real Thomas is somewhere in the spirit realm.

Sadness is Lily, Thomas's daughter

When she first arrives at Niwa, Marianne meets the spirit of a young girl who calls herself Sadness. The girl goes by that name because she can't remember who she is, and sadness is all she has any recollection of. Sadness serves as a helpful companion for Marianne, showing her the path forward toward completing various objectives. Sadness also leads Marianne to discover something truly terrible that happened in the little girl's past.


Through visions, Marianne learns that Sadness's real name is Lily, and that Lily is the daughter of Thomas. Marianne also sees what happened to Lily as a child — her father's best friend, Richard, abused her. After that incident took place, Thomas extracted revenge on Richard by entering his mind and destroying it, leaving him in a vegetative state. The damage was done, however — the abuse stirred something dark inside Lily that later manifested into something deadly.

Marianne is Thomas's daughter and Lily's sister

While exploring the forest near Niwa, Marianne happens upon Sadness as she plays on a swing. Marianne helps Sadness remember who she is — Lily — and who her parents are, too. Marianne offers to send Lily away; to free her from the spirit world so her soul can move on. Lily refuses this help, however, and tells Marianne she needs to remember her own story.


Marianne moves forward to discover a house in the woods. After interacting with objects outside of it, she is shown another vision of Thomas as he was interrogated by a man in the garage. The man was a government spy who set fire to Thomas's home in order to extract information about his powers. The interrogation revealed that Thomas actually had two daughters. Thomas later overwhelmed the spy, killed him, and then attempted to rescue his girls.

After seeing the vision, Marianne comes to and finds a partially burned photo on the ground. What it offers is irrefutable proof: she is Thomas's other daughter, which makes Lily her sister.

The Maw is Lily's inner demon

Throughout The Medium, Marianne is stalked by a giant creature known as The Maw. This beast exists in both the real world and the spirit world, and uses the skin of its dead prey to keep itself alive. It hunts Marianne because it needs her skin to replenish itself — it has sapped the life from everything around and has no options left. While it is known this monster is dangerous, players don't find out how The Maw came to be until the very end of the game.


Because they are Thomas's daughters, both Marianne and Lily are mediums. Marianne was graced with a fairly normal childhood, as Thomas gave her up in hopes of protecting her. Lily, however, stayed with Thomas and suffered abuse at the hands of his best friend. Lily's hurt and anger grew inside her and became a deadly and demonic spirit: The Maw. When the two girls were very young and fire was set to their house, Lily released The Maw from her mind and into the real and spirit worlds. In exchange, both her and Marianne were rescued from the blaze.

The Medium ends on a cliffhanger

At the conclusion of The Medium, Marianne discovers that Lily is still alive. Marianne finds her by a pier — the same one that appears in Marianne's recurring nightmares. In those nightmares, Marianne is placed into the shoes of a little girl running through the woods, presumably being chased by someone. Once the girl reaches the end of the pier with nowhere else to go, a man emerges with a gun and kills her.


Lily explains to Marianne that this nightmare isn't a vision of the past, but one of the future. Lily then hands her sister a gun and asks Marianne to shoot her. As long as The Maw's host is alive, she says, the creature will keep trying to kill and devour others. The Maw then appears, but Marianne points the gun at herself. She believes taking her own life will starve The Maw while also allowing Lily to live.

Marianne wrestles with the decision before her, while also feeling herself being torn between the real world and the spirit world. Suddenly, she finds a sense of calm. The screen goes black and a gunshot is heard.

The recipient of the bullet is never revealed.