The 4th Division follows the traditional organization of a Gotei 13 Division.
The Division is further divided accordingly into Advanced Relief Teams, whether or not the relief squads are determined by Healing skill or area is unknown.
The 4th Division is the medical/supply division. They are responsible for both treating the injured and doing most of the manual labor, such as cleaning the Seireitei. The 4th Division is further divided into teams that have specific assigned jobs. Other division members use their spiritual power only for fighting. Members of the 4th Division possess spiritual powers that is used to tend to wounds and provide relief. They use these special powers and the benefits of their daily training to act with precision and speed to aid injured comrades. 4th Division administers emergency first aid to injured division members and transports them to the General Emergency Relief Station.
In addition, the nurses who work in the Sōgō Kyūgo Tsumesho (綜合救護詰所, the coordinated relief station) have special Shihakushō (死覇装, Garment of Dead Souls) that are pink in colour with hats that are reminicent of nurse uniforms of the Human World.