There are a total of 12 Sacred tears to find in Elden Ring. The Sacred Tears are used to upgrade the flask of crimson tears and the flask of cerulean tears. Upgrading the flask makes it so you get more HP or FP back when you use it.
They are all found in the open world, inside churches. Once you have a Sacred Tear, bring it to a Site of Grace and then go to the “Flasks” section, and then “Increase Amount Replenished by Flasks”. This will then use up the Sacred Tear and add a +1 next to the flasks. There is no trophy / achievement for getting them all, but the flask upgrades are very much needed to help against the bosses.
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