Some time ago, we extended our monogenity investigations and calculations of generators of power integral bases to the relative case, cf. [5, 11, 10]. Up to now, we considered (usually totally real) extensions of complex quartic fields. In the present paper, we consider power integral bases in relative extensions of totally real fields. Totally complex quartic extensions of totally real number fields seem the most simple that we discuss in detail. As we shall see, even in this case, we have to overcome several unexpected difficulties, which we can, however, solve by properly (but not trivially) adjusting standard methods. We demonstrate our general algorithm on an explicit example. We describe how the general methods for solving relative index form equations in quartic relative extensions are modified in this case. As a byproduct, we show that relative Thue equations in totally complex extensions of totally real fields can only have small solutions, and we construct a special method for the enumeration of small solutions of special unit equations. These statements can be applied to other Diophantine problems, as well.