The ritual knife is used by the swampfolk in rituals. It can be repaired with knives as well as the slasher knife and Ant's Sting. This weapon, along with the atomic pulverizer, has a high rate of attack and the second lowest AP cost in the game — the lowest is the toy knife, but that weapon is less useful than the ritual knife due to its very low item HP, its lower damage and its lower critical hit multiplier.
Toy knife - Using even less AP than the ritual knife (10 instead of 12) the toy knife uses the lowest amount of AP for any weapon in Fallout 3. However, it does very little damage, much less than the regular knife.
Playstation 3 The ritual knife will sometimes fall inside the sacrificing table making it difficult to obtain. It is possible to dislodge it with explosives and/or third person view to pick it up.[verified]