The 211cm man mountain also took four contested marks, gathered 20 possessions and booted a goal in a performance that helped pilot Fremantle to its first win over the Saints since 2007.
Sandilands has now amassed an incredible 152 hit-outs in his past three matches, after posting career-high totals of 54 against both the Sydney Swans in round two and Brisbane Lions in round three.
Friday night was the 10th time in his 173-game career that the 29-year-old has had 44 or more hit-outs.
But despite Sandilands' commanding display, Fremantle was thrashed 43-30 at clearances.
St Kilda champion Lenny Hayes took the ball from a stoppage a game-high nine times, with Clinton Jones collecting six clearances and Jack Steven and Nick Dal Santo five each.
Michael Barlow was Fremantle's leading in-and-under player, his 30 disposals including seven clearances.
Fremantle coach Ross Lyon said his team would work on capitalising on Sandilands' dominance during the week, ahead of its clash with Carlton's star-studded midfield on Friday night.
"They [St Kilda] have got some great midfielders…so it was no surprise what they did tonight," he said. "We need to learn from it. "We'll analyse it and…put it into the program more, train it, and aim to deliver against a great clearance team next week. "Carlton are taking everyone to the cleaners, so we'll want to pick it up a little bit."
Aaron Sandilands is a $472,400 ruckman in Toyota AFL Dream Team. Register your team here.
