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%%* [[LighterAndSofter A somewhat slight entry in the series,]] but it boasts the Cedar Grove Sanitarium and the Artaud Theatre, two of the creepiest environments of all the games.
%%* The opening in general.
* Travis enters the room where his father killed himself, and finds ''his hanged corpse'' still there. And then it begins to talk. And after he finishes speaking, his head begins to twitch as he mutates into a horrifying monster.
-->'''Memory of Richard Grady:''' "I'm not sleeping, son. You knew I wasn't sleeping. Why did you stand there for so long? It wasn't right. It wasn't healthy, son. Time you faced up to what happened. Your mother... and I... will see you in Heaven, son."
* Carrion. Slow moving skinless parodies of roadkill, dragging themselves across their ground with their hind limbs. They don't look like much, but running into more than one of them in the Otherworld with no warning [[EliteMooks and having half or ALL your health knocked out in a matter of seconds]] ups the NightmareFuel considerably, the fact they're near-impossible to fight in melee doesn't help.
* The Remnant, it may have a simple design but especially on the darker [=PS2=] Version, it's quite possible for you to stumble blind into one with your flashlight off as their simple design actually makes them hard to see with the flashlight off, meaning they can potentially catch you off guard if you try to be sneaky.
* Twoback. A perversion of the "lonely trucker" stereotype, it constantly twitch-spasms and either spits acid at you or attempts to strangle/crush poor Travis to death.
* When Travis has those weird... flashbacks. Everything suddenly shifts to black and white and muffled voices both familiar and foreign begin to speak. They come out of nowhere and break the silence, fading back to normal just as quickly.
* The Otherworld Library in the theater was definitely one of the creepiest locations in the series. It feels like something out of Lovecraft's Cthulhu stories, with all the oddly ancient books in the room (which are perhaps made of human flesh? Travis only notes that they definitely aren't made of paper) and the mention of unrecognizable languages.
* Nowhere. The streets of Silent Hill have shifted into the Otherworld, it's pitch black, [[OurMonstersAreDifferent and they're swarming with all the nastiest monsters in the game.]]
* The music for the [[https://www.youtube.com/watch?v=UpPCJcWFKPo Otherworld Hospital]] is the very definition of Nightmare Fuel.
%%* The Remnant. Those weird shadow creatures that are encountered in the Sanitarium.
%%* "PLEASE HELP ME"
* The Memories of Helen and Richard Grady. They're horrifyingly mutated versions of Travis' deceased parents.
* [[WorldOfSymbolism The entire backstory of the game]] falls into this when you really think about it. [[WouldHurtAChild Dahlia Gillespie]] sets her 7 year old daughter Alessa on fire, which would be an unfathomably heinous crime on its own, but considering that [[MoralEventHorizon she's doing it with the intention of causing her to suffer unimaginable agony so that she can incubate the cult's god,]] the situation is greatly worsened.
* The mutilated bodies in the motel rooms. They have their insides taken out and blood all over.
* [[https://www.youtube.com/watch?v=p62i_nqt2GA The E3 2006 Trailer]], '''holy shit'''. Very unnerving, creepy, surreal imagery all while playing a constant glitching version of "Hometown". And that's not ''even getting'' to the batshit insane scenes midway such as a wheelchair [[NothingIsScarier being pulled into the darkness without it being touched]] and then a silent scene of hanging chains and the Butcher being seen in the light.
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