diff --git a/CHANGELOG.md b/CHANGELOG.md
index 4b236b05..5a55613e 100644
--- a/CHANGELOG.md
+++ b/CHANGELOG.md
@@ -1,4 +1,5 @@
 ## [Unreleased](https://github.com/LostArtefacts/TR-Rando/compare/V1.9.1...master) - xxxx-xx-xx
+- fixed key item softlocks in TR1R New Game+ (#732)
 - fixed wireframe mode potentially exceeding texture limits and preventing levels from loading (#722)
 - fixed docile bird monsters causing multiple Laras to spawn in remastered levels (#723)
 - fixed the incomplete skidoo model in TR2R when it appears anywhere other than Tibetan Foothills (#721)
diff --git a/TRLevelControl/Helpers/TR1TypeUtilities.cs b/TRLevelControl/Helpers/TR1TypeUtilities.cs
index c8b6c8d5..a582ca0c 100644
--- a/TRLevelControl/Helpers/TR1TypeUtilities.cs
+++ b/TRLevelControl/Helpers/TR1TypeUtilities.cs
@@ -254,6 +254,11 @@ public static bool IsStandardPickupType(TR1Type type)
         return GetStandardPickupTypes().Contains(type);
     }
 
+    public static bool IsMediType(TR1Type type)
+    {
+        return type == TR1Type.SmallMed_S_P || type == TR1Type.LargeMed_S_P;
+    }
+
     public static bool IsWeaponPickup(TR1Type type)
     {
         return GetWeaponPickups().Contains(type);
diff --git a/TRRandomizerCore/Randomizers/TR1/Remastered/TR1RItemRandomizer.cs b/TRRandomizerCore/Randomizers/TR1/Remastered/TR1RItemRandomizer.cs
index b01ca56c..d6b3e010 100644
--- a/TRRandomizerCore/Randomizers/TR1/Remastered/TR1RItemRandomizer.cs
+++ b/TRRandomizerCore/Randomizers/TR1/Remastered/TR1RItemRandomizer.cs
@@ -3,6 +3,7 @@
 using TRLevelControl.Model;
 using TRRandomizerCore.Helpers;
 using TRRandomizerCore.Levels;
+using TRRandomizerCore.Utilities;
 
 namespace TRRandomizerCore.Randomizers;
 
@@ -51,6 +52,7 @@ public void FinalizeRandomization()
                 if (Settings.ItemMode == ItemMode.Shuffled)
                 {
                     _allocator.ApplyItemSwaps(_levelInstance.Name, _levelInstance.Data.Entities);
+                    AdjustNGPlusItems(_levelInstance);
                 }
                 else
                 {
@@ -77,4 +79,29 @@ private static void CheckTihocanPierre(TR1RCombinedLevel level)
 
         level.Data.Entities.AddRange(TR1ItemAllocator.TihocanEndItems);
     }
+
+    private void AdjustNGPlusItems(TR1RCombinedLevel level)
+    {
+        // If keys have ended up as OG medi-packs, NG+ will convert them to ammo and hence softlock-city.
+        // Duplicate the items so the game doesn't know their indices, and hide the originals.
+        List<TR1Entity> keyItems = level.Data.Entities.FindAll(e => TR1TypeUtilities.IsKeyItemType(e.TypeID));
+        TR1Level ogLevel = _levelControl.Read(Path.Combine(BackupPath, level.Name));
+        foreach (TR1Entity item in keyItems)
+        {
+            int currentIndex = level.Data.Entities.IndexOf(item);
+            if (currentIndex < ogLevel.Entities.Count
+                && TR1TypeUtilities.IsMediType(ogLevel.Entities[currentIndex].TypeID))
+            {
+                level.Data.Entities.Add((TR1Entity)item.Clone());
+                item.TypeID = TR1Type.CameraTarget_N;
+                ItemUtilities.HideEntity(item);
+
+                // Any triggers will need to match the new index
+                short newIndex = (short)(level.Data.Entities.Count - 1);
+                level.Data.FloorData.GetEntityTriggers(currentIndex)
+                    .SelectMany(t => t.Actions.Where(a => a.Action == FDTrigAction.Object && a.Parameter == currentIndex))
+                    .ToList().ForEach(a => a.Parameter = newIndex);
+            }
+        }
+    }
 }