The substitution of canonical nucleobases by thiated analogues in natural DNA has been exploited in pharmacology, photochemotherapy, and structural biology. Thionucleobases react with adjacent thymines leading to 6-4 pyrimidine-pyrimidone photoproducts (6-4PPs), which are a major source of DNA photodamage, in particular intrastrand cross-linked photolesions. Here, we study the mechanism responsible for the formation of 6-4PPs in thionucleobases by employing quantum-mechanical calculations. We use multiconfiguration pair-density functional theory, complete active space second-order perturbation theory, and Kohn-Sham density functional theory. Scrutinizing the photochemistry of thionucleobases can elucidate the reaction mechanism of these prodrugs and identify the role that triplet excited states play in the generation of photolesions in the natural biopolymer. Three different possible mechanisms to generate the 6-4PPs are presented, and we conclude that the use of multireference approaches is indispensable to capture important features of the potential energy surface.