diff --git a/pcsx2-qt/MainWindow.cpp b/pcsx2-qt/MainWindow.cpp
index 02a622a465..fd62dd8139 100644
--- a/pcsx2-qt/MainWindow.cpp
+++ b/pcsx2-qt/MainWindow.cpp
@@ -148,7 +148,7 @@ void MainWindow::initialize()
 	restoreStateFromConfig();
 	switchToGameListView();
 	updateWindowTitle();
-	updateSaveStateMenusEnableState(false);
+	updateGameDependentActions();
 
 #ifdef _WIN32
 	registerForDeviceNotifications();
@@ -389,6 +389,8 @@ void MainWindow::connectSignals()
 	connect(m_ui.actionShowAdvancedSettings, &QAction::toggled, this, &MainWindow::onShowAdvancedSettingsToggled);
 	connect(m_ui.actionSaveGSDump, &QAction::triggered, this, &MainWindow::onSaveGSDumpActionTriggered);
 	connect(m_ui.actionToolsVideoCapture, &QAction::toggled, this, &MainWindow::onToolsVideoCaptureToggled);
+	connect(m_ui.actionEditPatches, &QAction::triggered, this, [this]() { onToolsEditCheatsPatchesTriggered(false); });
+	connect(m_ui.actionEditCheats, &QAction::triggered, this, [this]() { onToolsEditCheatsPatchesTriggered(true); });
 
 	// Input Recording
 	connect(m_ui.actionInputRecNew, &QAction::triggered, this, &MainWindow::onInputRecNewActionTriggered);
@@ -1278,14 +1280,12 @@ void MainWindow::onChangeDiscMenuAboutToHide()
 void MainWindow::onLoadStateMenuAboutToShow()
 {
 	m_ui.menuLoadState->clear();
-	updateSaveStateMenusEnableState(!m_current_disc_serial.isEmpty());
 	populateLoadStateMenu(m_ui.menuLoadState, m_current_disc_path, m_current_disc_serial, m_current_disc_crc);
 }
 
 void MainWindow::onSaveStateMenuAboutToShow()
 {
 	m_ui.menuSaveState->clear();
-	updateSaveStateMenusEnableState(!m_current_disc_serial.isEmpty());
 	populateSaveStateMenu(m_ui.menuSaveState, m_current_disc_serial, m_current_disc_crc);
 }
 
@@ -1475,6 +1475,32 @@ void MainWindow::onToolsCoverDownloaderTriggered()
 	dlg.exec();
 }
 
+void MainWindow::onToolsEditCheatsPatchesTriggered(bool cheats)
+{
+	if (m_current_disc_serial.isEmpty() || m_current_running_crc == 0)
+		return;
+
+	const std::string path = Patch::GetPnachFilename(m_current_disc_serial.toStdString(), m_current_running_crc, cheats);
+	if (!FileSystem::FileExists(path.c_str()))
+	{
+		if (QMessageBox::question(this, tr("Confirm File Creation"),
+				tr("The pnach file '%1' does not currently exist. Do you want to create it?")
+					.arg(QtUtils::StringViewToQString(Path::GetFileName(path))),
+				QMessageBox::Yes, QMessageBox::No) != QMessageBox::Yes)
+		{
+			return;
+		}
+
+		if (!FileSystem::WriteStringToFile(path.c_str(), std::string_view()))
+		{
+			QMessageBox::critical(this, tr("Error"), tr("Failed to create '%1'.").arg(QString::fromStdString(path)));
+			return;
+		}
+	}
+
+	QtUtils::OpenURL(this, QUrl::fromLocalFile(QString::fromStdString(path)));
+}
+
 void MainWindow::updateTheme()
 {
 	QtHost::UpdateApplicationTheme();
@@ -1616,15 +1642,11 @@ void MainWindow::onInputRecOpenViewer()
 	}
 }
 
-
 void MainWindow::onVMStarting()
 {
 	s_vm_valid = true;
 	updateEmulationActions(true, false, false);
 	updateWindowTitle();
-
-	// prevent loading state until we're fully initialized
-	updateSaveStateMenusEnableState(false);
 }
 
 void MainWindow::onVMStarted()
@@ -1632,6 +1654,7 @@ void MainWindow::onVMStarted()
 	s_vm_valid = true;
 	m_was_disc_change_request = false;
 	updateEmulationActions(true, true, false);
+	updateGameDependentActions();
 	updateWindowTitle();
 	updateStatusBarWidgetVisibility();
 	updateInputRecordingActions(true);
@@ -1689,6 +1712,7 @@ void MainWindow::onVMStopped()
 	s_vm_paused = false;
 	m_last_fps_status = QString();
 	updateEmulationActions(false, false, false);
+	updateGameDependentActions();
 	updateWindowTitle();
 	updateWindowState();
 	updateStatusBarWidgetVisibility();
@@ -1722,7 +1746,7 @@ void MainWindow::onGameChanged(const QString& title, const QString& elf_override
 	m_current_disc_crc = disc_crc;
 	m_current_running_crc = crc;
 	updateWindowTitle();
-	updateSaveStateMenusEnableState(!serial.isEmpty());
+	updateGameDependentActions();
 }
 
 void MainWindow::showEvent(QShowEvent* event)
@@ -2544,14 +2568,18 @@ void MainWindow::populateSaveStateMenu(QMenu* menu, const QString& serial, quint
 	}
 }
 
-void MainWindow::updateSaveStateMenusEnableState(bool enable)
+void MainWindow::updateGameDependentActions()
 {
-	const bool load_enabled = enable;
-	const bool save_enabled = enable && s_vm_valid;
-	m_ui.menuLoadState->setEnabled(load_enabled);
-	m_ui.actionToolbarLoadState->setEnabled(load_enabled);
-	m_ui.menuSaveState->setEnabled(save_enabled);
-	m_ui.actionToolbarSaveState->setEnabled(save_enabled);
+	const bool valid_serial_and_crc = (s_vm_valid && !m_current_disc_serial.isEmpty() && m_current_disc_crc != 0);
+	m_ui.menuLoadState->setEnabled(valid_serial_and_crc);
+	m_ui.actionToolbarLoadState->setEnabled(valid_serial_and_crc);
+	m_ui.menuSaveState->setEnabled(valid_serial_and_crc);
+	m_ui.actionToolbarSaveState->setEnabled(valid_serial_and_crc);
+
+	const bool can_use_pnach = (s_vm_valid && !m_current_disc_serial.isEmpty() && m_current_running_crc != 0);
+	m_ui.actionEditCheats->setEnabled(can_use_pnach);
+	m_ui.actionEditPatches->setEnabled(can_use_pnach);
+	m_ui.actionReloadPatches->setEnabled(s_vm_valid);
 }
 
 void MainWindow::doStartFile(std::optional<CDVD_SourceType> source, const QString& path)
diff --git a/pcsx2-qt/MainWindow.h b/pcsx2-qt/MainWindow.h
index 4b0cda7ba5..eef59740a0 100644
--- a/pcsx2-qt/MainWindow.h
+++ b/pcsx2-qt/MainWindow.h
@@ -165,6 +165,7 @@ private Q_SLOTS:
 	void onAboutActionTriggered();
 	void onToolsOpenDataDirectoryTriggered();
 	void onToolsCoverDownloaderTriggered();
+	void onToolsEditCheatsPatchesTriggered(bool cheats);
 	void updateTheme();
 	void updateLanguage();
 	void onScreenshotActionTriggered();
@@ -222,6 +223,7 @@ private:
 
 	void updateEmulationActions(bool starting, bool running, bool stopping);
 	void updateDisplayRelatedActions(bool has_surface, bool render_to_main, bool fullscreen);
+	void updateGameDependentActions();
 	void updateStatusBarWidgetVisibility();
 	void updateWindowTitle();
 	void updateWindowState(bool force_visible = false);
@@ -267,7 +269,6 @@ private:
 	void loadSaveStateFile(const QString& filename, const QString& state_filename);
 	void populateLoadStateMenu(QMenu* menu, const QString& filename, const QString& serial, quint32 crc);
 	void populateSaveStateMenu(QMenu* menu, const QString& serial, quint32 crc);
-	void updateSaveStateMenusEnableState(bool enable);
 	void doStartFile(std::optional<CDVD_SourceType> source, const QString& path);
 	void doDiscChange(CDVD_SourceType source, const QString& path);
 
diff --git a/pcsx2-qt/MainWindow.ui b/pcsx2-qt/MainWindow.ui
index 3aad1321a5..d846d185e7 100644
--- a/pcsx2-qt/MainWindow.ui
+++ b/pcsx2-qt/MainWindow.ui
@@ -186,7 +186,7 @@
      </property>
      <property name="icon">
       <iconset theme="keyboard-line">
-      <normaloff>.</normaloff>.</iconset>
+       <normaloff>.</normaloff>.</iconset>
      </property>
      <addaction name="actionInputRecNew"/>
      <addaction name="actionInputRecPlay"/>
@@ -201,8 +201,11 @@
     <addaction name="actionOpenDataDirectory"/>
     <addaction name="actionCoverDownloader"/>
     <addaction name="separator"/>
-    <addaction name="actionToggleSoftwareRendering"/>
+    <addaction name="actionEditCheats"/>
+    <addaction name="actionEditPatches"/>
     <addaction name="actionReloadPatches"/>
+    <addaction name="separator"/>
+    <addaction name="actionToggleSoftwareRendering"/>
     <addaction name="menuInput_Recording"/>
     <addaction name="actionToolsVideoCapture"/>
     <addaction name="separator"/>
@@ -864,13 +867,13 @@
    </property>
   </action>
   <action name="actionToggleSoftwareRendering">
-   <property name="text">
-    <string>Toggle Software Rendering</string>
-   </property>
    <property name="icon">
     <iconset theme="brush-line">
      <normaloff>.</normaloff>.</iconset>
    </property>
+   <property name="text">
+    <string>Toggle Software Rendering</string>
+   </property>
   </action>
   <action name="actionDebugger">
    <property name="icon">
@@ -882,13 +885,13 @@
    </property>
   </action>
   <action name="actionReloadPatches">
-   <property name="text">
-    <string>Reload Cheats/Patches</string>
-   </property>
    <property name="icon">
     <iconset theme="refresh-line">
      <normaloff>.</normaloff>.</iconset>
    </property>
+   <property name="text">
+    <string>Reload Cheats/Patches</string>
+   </property>
   </action>
   <action name="actionEnableSystemConsole">
    <property name="checkable">
@@ -923,13 +926,13 @@
    </property>
   </action>
   <action name="actionSaveGSDump">
-   <property name="text">
-    <string>Save Single Frame GS Dump</string>
-   </property>
    <property name="icon">
     <iconset theme="save-3-line">
      <normaloff>.</normaloff>.</iconset>
    </property>
+   <property name="text">
+    <string>Save Single Frame GS Dump</string>
+   </property>
   </action>
   <action name="actionInputRecNew">
    <property name="enabled">
@@ -1064,6 +1067,16 @@
     <string>Video Capture</string>
    </property>
   </action>
+  <action name="actionEditCheats">
+   <property name="text">
+    <string>Edit Cheats...</string>
+   </property>
+  </action>
+  <action name="actionEditPatches">
+   <property name="text">
+    <string>Edit Patches...</string>
+   </property>
+  </action>
  </widget>
  <resources>
   <include location="resources/resources.qrc"/>
diff --git a/pcsx2/Patch.cpp b/pcsx2/Patch.cpp
index 66f7b397dd..70a7369db5 100644
--- a/pcsx2/Patch.cpp
+++ b/pcsx2/Patch.cpp
@@ -471,6 +471,11 @@ Patch::PatchInfoList Patch::GetPatchInfo(const std::string_view& serial, u32 crc
 	return ret;
 }
 
+std::string Patch::GetPnachFilename(const std::string_view& serial, u32 crc, bool cheats)
+{
+	return Path::Combine(cheats ? EmuFolders::Cheats : EmuFolders::Patches, GetPnachTemplate(serial, crc, true, false, false));
+}
+
 void Patch::ReloadEnabledLists()
 {
 	if (EmuConfig.EnableCheats && !Achievements::ChallengeModeActive())
diff --git a/pcsx2/Patch.h b/pcsx2/Patch.h
index a4512f1015..6fb035bc54 100644
--- a/pcsx2/Patch.h
+++ b/pcsx2/Patch.h
@@ -95,6 +95,9 @@ namespace Patch
 
 	extern PatchInfoList GetPatchInfo(const std::string_view& serial, u32 crc, bool cheats, u32* num_unlabelled_patches);
 
+	/// Returns the path to a new cheat/patch pnach for the specified serial and CRC.
+	extern std::string GetPnachFilename(const std::string_view& serial, u32 crc, bool cheats);
+
 	/// Reloads cheats/patches. If verbose is set, the number of patches loaded will be shown in the OSD.
 	extern void ReloadPatches(const std::string& serial, u32 crc, bool reload_files, bool reload_enabled_list, bool verbose, bool verbose_if_changed);