 Tom Kessenich in Examinations: An Unauthorized Look at Seasons 6-9 of the X-Files commented that the ending of "Sanguinarium" was similar to the ending of episode "Signs and Wonders", wherein the antagonist manages to get away. Frederick S. Clarke from Cinefantastique gave "Sanguinarium" a mixed review, writing that the episode "combines plastic surgery and black magic into an unsatisfying mix that fails to lampoon our obsession with beauty." Not all reviews were as negative. Writer Preston Nichols took a liking to the episode, having viewed it "eighteen times and counting". Michael Avalos and George Liedtke, writing for Knight Ridder, speculated that "Sanguinarium" provided viewers with "haunting memories". Mark Davis of The Daytona Beach News-Journal, in 1998, named the episode one of the "Best of The X-Files".
