diff --git a/soh/soh/Enhancements/presets.h b/soh/soh/Enhancements/presets.h
index 390ddb1b4..de3b48b6a 100644
--- a/soh/soh/Enhancements/presets.h
+++ b/soh/soh/Enhancements/presets.h
@@ -584,7 +584,7 @@ const std::vector<PresetEntry> hellModePresetEntries = {
     PRESET_ENTRY_S32("gMMBunnyHood", 2),
     PRESET_ENTRY_S32("gRandomizeBigPoeTargetCount", 1),
     PRESET_ENTRY_S32("gRandomizeBlueFireArrows", 1),
-    PRESET_ENTRY_S32("gRandomizeBossKeysanity", 5),
+    PRESET_ENTRY_S32("gRandomizeBossKeysanity", RO_DUNGEON_ITEM_LOC_ANYWHERE),
     PRESET_ENTRY_S32("gRandomizeCompleteMaskQuest", 1),
     PRESET_ENTRY_S32("gRandomizeCuccosToReturn", 1),
     PRESET_ENTRY_S32("gRandomizeDoorOfTime", RO_DOOROFTIME_OPEN),
diff --git a/soh/soh/Enhancements/randomizer/randomizer.cpp b/soh/soh/Enhancements/randomizer/randomizer.cpp
index 0e5261780..7d5d4bcf5 100644
--- a/soh/soh/Enhancements/randomizer/randomizer.cpp
+++ b/soh/soh/Enhancements/randomizer/randomizer.cpp
@@ -1915,7 +1915,9 @@ GetItemID Randomizer::GetItemIdFromRandomizerGet(RandomizerGet randoGet, GetItem
         case RG_WATER_TEMPLE_BOSS_KEY:
         case RG_SPIRIT_TEMPLE_BOSS_KEY:
         case RG_SHADOW_TEMPLE_BOSS_KEY:
-            if (GetRandoSettingValue(RSK_BOSS_KEYSANITY) < 3) {
+            if (GetRandoSettingValue(RSK_BOSS_KEYSANITY) == RO_DUNGEON_ITEM_LOC_STARTWITH ||
+                GetRandoSettingValue(RSK_BOSS_KEYSANITY) == RO_DUNGEON_ITEM_LOC_VANILLA ||
+                GetRandoSettingValue(RSK_BOSS_KEYSANITY) == RO_DUNGEON_ITEM_LOC_OWN_DUNGEON) {
                 return GI_KEY_BOSS;
             } else {
                 return (GetItemID)randoGet;
@@ -2131,10 +2133,12 @@ bool Randomizer::IsItemVanilla(RandomizerGet randoGet) {
         case RG_WATER_TEMPLE_BOSS_KEY:
         case RG_SPIRIT_TEMPLE_BOSS_KEY:
         case RG_SHADOW_TEMPLE_BOSS_KEY:
-            if (GetRandoSettingValue(RSK_BOSS_KEYSANITY) > 2) {
-                return false;
+            if (GetRandoSettingValue(RSK_BOSS_KEYSANITY) == RO_DUNGEON_ITEM_LOC_STARTWITH ||
+                GetRandoSettingValue(RSK_BOSS_KEYSANITY) == RO_DUNGEON_ITEM_LOC_VANILLA ||
+                GetRandoSettingValue(RSK_BOSS_KEYSANITY) == RO_DUNGEON_ITEM_LOC_OWN_DUNGEON) {
+                return true;
             }
-            return true;
+            return false;
         case RG_GANONS_CASTLE_BOSS_KEY:
             if (GetRandoSettingValue(RSK_GANONS_BOSS_KEY) == RO_GANON_BOSS_KEY_VANILLA ||
                 GetRandoSettingValue(RSK_GANONS_BOSS_KEY) == RO_GANON_BOSS_KEY_OWN_DUNGEON ||
@@ -2629,7 +2633,7 @@ void GenerateRandomizerImgui() {
     cvarSettings[RSK_KEYRINGS_BOTTOM_OF_THE_WELL] = CVar_GetS32("gRandomizeShuffleKeyRingsBottomOfTheWell", 0);
     cvarSettings[RSK_KEYRINGS_GTG] = CVar_GetS32("gRandomizeShuffleKeyRingsGTG", 0);
     cvarSettings[RSK_KEYRINGS_GANONS_CASTLE] = CVar_GetS32("gRandomizeShuffleKeyRingsGanonsCastle", 0);
-    cvarSettings[RSK_BOSS_KEYSANITY] = CVar_GetS32("gRandomizeBossKeysanity", 2);
+    cvarSettings[RSK_BOSS_KEYSANITY] = CVar_GetS32("gRandomizeBossKeysanity", RO_DUNGEON_ITEM_LOC_OWN_DUNGEON);
     cvarSettings[RSK_GANONS_BOSS_KEY] = CVar_GetS32("gRandomizeShuffleGanonBossKey", RO_GANON_BOSS_KEY_VANILLA);
     cvarSettings[RSK_LACS_STONE_COUNT] = CVar_GetS32("gRandomizeLacsStoneCount", 3);
     cvarSettings[RSK_LACS_MEDALLION_COUNT] = CVar_GetS32("gRandomizeLacsMedallionCount", 6);
diff --git a/soh/soh/Enhancements/randomizer/randomizer_check_objects.cpp b/soh/soh/Enhancements/randomizer/randomizer_check_objects.cpp
index ada9ca474..f08d25be7 100644
--- a/soh/soh/Enhancements/randomizer/randomizer_check_objects.cpp
+++ b/soh/soh/Enhancements/randomizer/randomizer_check_objects.cpp
@@ -916,7 +916,7 @@ void RandomizerCheckObjects::UpdateImGuiVisibility() {
             ((locationIt.rcType != RCTYPE_MAP_COMPASS) || CVar_GetS32("gRandomizeStartingMapsCompasses", RO_DUNGEON_ITEM_LOC_STARTWITH) != RO_DUNGEON_ITEM_LOC_VANILLA) &&
             ((locationIt.rcType != RCTYPE_SMALL_KEY) || CVar_GetS32("gRandomizeKeysanity", RO_DUNGEON_ITEM_LOC_OWN_DUNGEON) != RO_DUNGEON_ITEM_LOC_VANILLA) &&
             ((locationIt.rcType != RCTYPE_GF_KEY) || CVar_GetS32("gRandomizeGerudoKeys", RO_GERUDO_KEYS_VANILLA) != RO_GERUDO_KEYS_VANILLA) &&
-            ((locationIt.rcType != RCTYPE_BOSS_KEY) || CVar_GetS32("gRandomizeBossKeysanity", 0) != 1) && // 1 is the value for "vanilla" boss keys
+            ((locationIt.rcType != RCTYPE_BOSS_KEY) || CVar_GetS32("gRandomizeBossKeysanity", RO_DUNGEON_ITEM_LOC_STARTWITH) != RO_DUNGEON_ITEM_LOC_VANILLA) &&
             ((locationIt.rcType != RCTYPE_GANON_BOSS_KEY) || CVar_GetS32("gRandomizeShuffleGanonBossKey", RO_GANON_BOSS_KEY_VANILLA) != RO_GANON_BOSS_KEY_VANILLA)
         );
     }
diff --git a/soh/soh/GameMenuBar.cpp b/soh/soh/GameMenuBar.cpp
index 8226e13cb..d41e96723 100644
--- a/soh/soh/GameMenuBar.cpp
+++ b/soh/soh/GameMenuBar.cpp
@@ -1194,7 +1194,9 @@ namespace GameMenuBar {
                     OTRGlobals::Instance->gRandomizer->GetRandoSettingValue(RSK_KEYSANITY) == RO_DUNGEON_ITEM_LOC_OVERWORLD ||
                     OTRGlobals::Instance->gRandomizer->GetRandoSettingValue(RSK_KEYSANITY) == RO_DUNGEON_ITEM_LOC_ANYWHERE ||
                     OTRGlobals::Instance->gRandomizer->GetRandoSettingValue(RSK_GERUDO_KEYS) != RO_GERUDO_KEYS_VANILLA ||
-                    OTRGlobals::Instance->gRandomizer->GetRandoSettingValue(RSK_BOSS_KEYSANITY) > 2 ||
+                    OTRGlobals::Instance->gRandomizer->GetRandoSettingValue(RSK_BOSS_KEYSANITY) == RO_DUNGEON_ITEM_LOC_ANY_DUNGEON ||
+                    OTRGlobals::Instance->gRandomizer->GetRandoSettingValue(RSK_BOSS_KEYSANITY) == RO_DUNGEON_ITEM_LOC_OVERWORLD ||
+                    OTRGlobals::Instance->gRandomizer->GetRandoSettingValue(RSK_BOSS_KEYSANITY) == RO_DUNGEON_ITEM_LOC_ANYWHERE ||
                     (OTRGlobals::Instance->gRandomizer->GetRandoSettingValue(RSK_GANONS_BOSS_KEY) != RO_GANON_BOSS_KEY_VANILLA &&
                      OTRGlobals::Instance->gRandomizer->GetRandoSettingValue(RSK_GANONS_BOSS_KEY) != RO_GANON_BOSS_KEY_OWN_DUNGEON &&
                      OTRGlobals::Instance->gRandomizer->GetRandoSettingValue(RSK_GANONS_BOSS_KEY) != RO_GANON_BOSS_KEY_STARTWITH) || 
diff --git a/soh/src/code/z_sram.c b/soh/src/code/z_sram.c
index a483687dc..1b3c0ff18 100644
--- a/soh/src/code/z_sram.c
+++ b/soh/src/code/z_sram.c
@@ -490,8 +490,7 @@ void Sram_InitSave(FileChooseContext* fileChooseCtx) {
             gSaveContext.sohStats.dungeonKeys[SCENE_GANONTIKA]     = GANONS_CASTLE_SMALL_KEY_MAX; // Ganon
         }
 
-        // "Start with" == 0 for Boss Kesanity
-        if(Randomizer_GetSettingValue(RSK_BOSS_KEYSANITY) == 0) {
+        if(Randomizer_GetSettingValue(RSK_BOSS_KEYSANITY) == RO_DUNGEON_ITEM_LOC_STARTWITH) {
             gSaveContext.inventory.dungeonItems[SCENE_BMORI1] |= 1; // Forest
             gSaveContext.inventory.dungeonItems[SCENE_HIDAN] |= 1; // Fire
             gSaveContext.inventory.dungeonItems[SCENE_MIZUSIN] |= 1; // Water