==[[4.18 The Monster At The End Of This Book]]==
Lilith appears as an adult woman, possessing the body of a dental hygienist from Bloomingdale, Indiana. Sam and Dean have been warned of her arrival by the author and prophet [[Chuck Shirley]]. He also forsees a "night of fiery demonic passion" between Lilith and Sam. Dean wants them to avoid Lilith, but Sam is keen for a confrontation.
[[Image:Lilith in 4-22 Lucifer Rising.jpg|right|300px|thumb|Lilith about to be killed by Sam]]
Eventually, Lilith confronts Sam in his hotel room determined to make a deal; she will stop breaking the seals (that bind Lucifer in hell), in return for Sam and Dean's life’s. Sam is reluctant at first; he questions Lilith's motives as to why she has had a change of heart. Lilith tells Sam that apparently she dies before the apocalypse is set in motion - this is why she wants to make a deal. Sam reluctantly agrees to Lilith's terms; however Lilith tells Sam that the deal has to be consummated before they are bound to its terms.
As Sam embraces Lilith on the bed he grabs Ruby's knife in order to kill her; however she overpowers him and seizes the knife. Dean and Chuck abruptly enter the room, with Dean demanding that Lilith leave, before the Archangel who protects Chuck comes and kills her. As the room is slowly being engulfed by light, Lilith heeds Dean's words and departs from the body, leaving it motionless on the floor.
[[Image:Lilith in 4-22 Lucifer Rising.jpg|right|300px|thumb|Lilith about to be killed by Sam]]
Later Dean asks Sam whether he would've taken the deal, but Sam says no, because Lilith would've found some way to 'weasel out of it'. He does note that she's scared and that she was right about dying before the apocalypse because he'll make sure of it.