** The ghost in the subway and the Happy Birthday phone call in the hospital.
---> '''Unknown caller:''' Happy birthday, dear... I'm sorry. I forgot your name.\\
'''Heather:''' Who are you?\\
'''Unknown caller:''' Oh... okay. Happy birthday dear "Hooaryou"...
** On subsequent playthroughs, in the sewers you have the option to drop the steel pipe into the water. This spawns a fairy who presents two pipes, one made of silver and another made of gold. If you refuse both you get to keep both and you get your steel pipe back. There are no future references to it other than Heather thinking about pawning the gold pipe. It only happens in NewGamePlus, so it's really just a shout out to an [[HonestAxe old legend]] that's been referenced by [[OlderThanTheyThink pretty much everything ever.]]
*** The HD Collection gives a trophy for this event, called "[[LampshadeHanging What the Hill just happened]]"
* DemonicSpiders: The Slurper enemies, which are fond of repeatedly knocking Heather to the ground and crawling on top of her for damage.
* EnsembleDarkhorse: Considering he doesn't actually appear, there is a surprisingly large number of Stanley Coleman fanfics on the net.
** Vincent. A lot of fans found him to be one of the most interesting psychos in the series.
* ''FreudWasRight: The Video Game''. Sometimes, a giant worm monster going in and out of holes repeatedly is just a giant worm monster... but not in this game. And that's just the ''first'' boss...
** It's possible to force the Missionary Boss into a corner, making him much easier to fight.
** Nurses can sometimes get stuck near corners making it hard for them to hit you but easy for you to hit them.
* HellIsThatNoise: The sound the pendulum enemies make. Imagine the sound of a red tailed hawk screaming ''[[MostAnnoyingSound constantly]]'', mixed with rusty metallic scraping sounds.
** The soundtrack in the FinalBoss fight. It's hard enough to dodge advancing swaths of flame and the boss's humongous arm trying to smack you, but trying to concentrate on the fight with all the blaring sounds makes the battle so much more annoying.
* HilariousInHindsight: Having Heather run around the hellish landscape of Silent Hill in her MagicalGirl costume is pretty amusing since the popularity of ''Anime/PuellaMagiMadokaMagica''.
* ItWasHisSled: Good luck finding ''anyone'' who doesn't know that Heather and her father are [[spoiler:Cheryl and Harry Mason from the [[VideoGame/SilentHill1 first game]].]]
* MoralEventHorizon: Claudia crosses this when she [[spoiler: murders Harry]].
** Alternatively, [[spoiler:messing with Heather in the chapel in order to get her to birth God. The Vincent-stabbing was justified, though, what with the whole backstabbing and all.]]
* NarmCharm: "SHUT YOUR STINKING MOUTH, BITCH!" Stupid as that line may be, it's delivered so passionately it crosses over into awesome.
* ParanoiaFuel: "They looked like monsters to you?" ...Oh no.
** Valtiel. He never attacks you, and is always just out of reach, and just... watches. He's a thoroughly disturbing reinforcement of the stalker theme that Stanley represents.
* PlayerPunch: [[spoiler:Harry's death. Doubly so for those who played the first game]].
** The infamous WhamLine of the game. Almost makes you think twice about the enemies you've faced.
* ToughActToFollow: It was itself subjected to this a bit after the magnificent ''VideoGame/SilentHill2'', which is commonly regarded as one of the finest works of horror in the medium. It's also an example itself, as after this game, the series never really hit the same level of success again.
* TheWoobie: Heather for a good chunk of the game. Her character design was made to make it seem like she was constantly slightly teary-eyed, which fits for the first portion of the game where all she wants is to get home and get away from the hellish surroundings. [[FromBadToWorse It gets worse]] when she finds out [[spoiler:her father has been murdered]].
** [[JerkAssWoobie Claudia is this as well]]. He father used to beat her so badly that memory of it was burned into ''Vincent's'' brain somehow. Then her best friend when she was a little kid disappeared, as did the woman who rescued her from her father.