<?xml version="1.0"?>
<ownershipDocument>

    <schemaVersion>X0609</schemaVersion>

    <documentType>4</documentType>

    <periodOfReport>2026-08-20</periodOfReport>

    <issuer>
        <issuerCik>0001134115</issuerCik>
        <issuerName>INTERNATIONAL TOWER HILL MINES LTD</issuerName>
        <issuerTradingSymbol>THM</issuerTradingSymbol>
        <issuerForeignTradingSymbol></issuerForeignTradingSymbol>
    </issuer>

    <reportingOwner>
        <reportingOwnerId>
            <rptOwnerCik>0001642445</rptOwnerCik>
            <rptOwnerName>Cross David Allen</rptOwnerName>
        </reportingOwnerId>
        <reportingOwnerAddress>
            <rptOwnerNonUSAddressFlag>true</rptOwnerNonUSAddressFlag>
            <rptOwnerStreet1>C/O INTERNATIONAL TOWER HILL MINES LTD.</rptOwnerStreet1>
            <rptOwnerStreet2>200 BURRARD ST., SUITE 1570</rptOwnerStreet2>
            <rptOwnerCity>VANCOUVER</rptOwnerCity>
            <rptOwnerNonUSStateTerritory></rptOwnerNonUSStateTerritory>
            <rptOwnerCountry>Z4</rptOwnerCountry>
            <rptOwnerZipCode>V6C 3L6</rptOwnerZipCode>
            <rptOwnerStateDescription>CANADA (FEDERAL LEVEL)</rptOwnerStateDescription>
        </reportingOwnerAddress>
        <reportingOwnerRelationship>
            <isDirector>0</isDirector>
            <isOfficer>1</isOfficer>
            <isTenPercentOwner>0</isTenPercentOwner>
            <isOther>0</isOther>
            <officerTitle>Chief Financial Officer</officerTitle>
        </reportingOwnerRelationship>
    </reportingOwner>

    <aff10b5One>0</aff10b5One>

    <nonDerivativeTable>
        <nonDerivativeTransaction>
            <securityTitle>
                <value>Common Stock</value>
            </securityTitle>
            <transactionDate>
                <value>2026-08-20</value>
            </transactionDate>
            <transactionCoding>
                <transactionFormType>4</transactionFormType>
                <transactionCode>M</transactionCode>
                <equitySwapInvolved>0</equitySwapInvolved>
            </transactionCoding>
            <transactionAmounts>
                <transactionShares>
                    <value>30000</value>
                </transactionShares>
                <transactionPricePerShare>
                    <value>0.67</value>
                    <footnoteId id="F1"/>
                </transactionPricePerShare>
                <transactionAcquiredDisposedCode>
                    <value>A</value>
                </transactionAcquiredDisposedCode>
            </transactionAmounts>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>30000</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </nonDerivativeTransaction>
    </nonDerivativeTable>

    <derivativeTable>
        <derivativeTransaction>
            <securityTitle>
                <value>Stock Options (right to buy)</value>
            </securityTitle>
            <conversionOrExercisePrice>
                <value>0.67</value>
                <footnoteId id="F1"/>
            </conversionOrExercisePrice>
            <transactionDate>
                <value>2026-08-20</value>
            </transactionDate>
            <transactionCoding>
                <transactionFormType>4</transactionFormType>
                <transactionCode>M</transactionCode>
                <equitySwapInvolved>0</equitySwapInvolved>
            </transactionCoding>
            <transactionAmounts>
                <transactionShares>
                    <value>30000</value>
                </transactionShares>
                <transactionPricePerShare>
                    <value>0</value>
                </transactionPricePerShare>
                <transactionAcquiredDisposedCode>
                    <value>D</value>
                </transactionAcquiredDisposedCode>
            </transactionAmounts>
            <exerciseDate>
                <footnoteId id="F2"/>
            </exerciseDate>
            <expirationDate>
                <value>2026-08-28</value>
                <footnoteId id="F3"/>
            </expirationDate>
            <underlyingSecurity>
                <underlyingSecurityTitle>
                    <value>Common Stock</value>
                </underlyingSecurityTitle>
                <underlyingSecurityShares>
                    <value>30000</value>
                </underlyingSecurityShares>
            </underlyingSecurity>
            <postTransactionAmounts>
                <sharesOwnedFollowingTransaction>
                    <value>0</value>
                </sharesOwnedFollowingTransaction>
            </postTransactionAmounts>
            <ownershipNature>
                <directOrIndirectOwnership>
                    <value>D</value>
                </directOrIndirectOwnership>
            </ownershipNature>
        </derivativeTransaction>
    </derivativeTable>

    <footnotes>
        <footnote id="F1">The exercise price was converted from CAD 0.92 to USD 0.67, based on the August 19, 2026 exchange rate as quoted by the Bank of Canada.  The exercise price is the actual Canadian dollar amount regardless of the exchange rate on the date of exercise.</footnote>
        <footnote id="F2">Options were granted on March 27, 2020 and vested as follows: one-third on the grant date, one-third on March 27, 2021, and one-third on March 27, 2022.</footnote>
        <footnote id="F3">Pursuant to the International Tower Hill Mines Ltd. (the &quot;Company&quot;) 2006 Incentive Stock Option Plan, if the expiry date of an option would fall during a trading blackout period imposed on the holder of the option by the Company, the expiry date of such option shall be extended to the close of business on the tenth business day after the end of such trading blackout period. The Company's most recent trading blackout period commenced on February 26, 2026 and ended on August 14, 2026, with the result that the expiry date for the option was August 28, 2026.</footnote>
    </footnotes>

    <ownerSignature>
        <signatureName>/s/ Debbie Evans by Power of Attorney</signatureName>
        <signatureDate>2026-08-25</signatureDate>
    </ownerSignature>
</ownershipDocument>
