* ContestedSequel: By far the most polarizing of the Team Silent entries. Even those who like it have trouble seeing it as a sequel; it's basically a slasher movie, while the previous games used a much more purgatorial theme.
* FoeYay: Walter persistently stalks Henry, addresses him as "the Receiver", and speaks in what many interpret to be a [[TermsOfEndangerment creepily affectionate manner]].
* GoodBadBugs: When you're at the EscortMission part of the game and have returned to Building World, there's a way to teleport Eileen to a part of the map normally inaccessible to her without solving a time-consuming puzzle. Very convenient for speedruns, as well as for those who just want the EscortMission phase of the game over with.
** There's also a random bug which fits the second half of this trope: for no apparent reason, however careful you might be with Eileen, at random points in the game, she might suddenly be fully haunted by Walter. At the very least, though, she can be (temporarily) treated with a Holy Candle, like a regular haunting. This second bug might occasionally coincide with the first, although it's relatively rare for this bug to happen.
* HilariousInHindsight: [[Film/TheRoom Does Tommy Wiseau appear in the game?]]
** Come to think of it, Adult Walter does look a bit like Tommy Wiseau. And not only did he [[spoiler:kill himself]], he did so with a spoon...
* NightmareFuel:
** Those double-headed baby ''things''. As if their appearances weren't already creepy enough, when you first seem them, they're pointing right at you! One of the scariest parts of the game, in fact, is having to face a grand total of ''six'' of them, all at once, in a long corridor! Thankfully, Eileen is with you at this point to help you take them on, but seeing them blocking your way and pointing at you from afar is truly the stuff of nightmares.
** A lot of the hauntings are creepy, but the shabby doll one probably takes the cake.
** Wow, this is a long hallway, why are there so many doors? Okay, let's open this one -- wait, what's that breathi... AAAAAGH, BIG GIANT HEAD!!!!!
*** And its accompaniment: [[http://www.youtube.com/watch?v=Qsm_-cvtv1A this sound]]. (Warning: NSFW audio. '''DO NOT''' play without headphones on, to avoid any awkward moments with anyone overhearing [[TheImmodestOrgasm this.]])
** And, of course, the titular Room itself.
* NightmareRetardant: The belching Patients. [[http://www.youtube.com/watch?v=TiDz69EqlFk Good luck figuring that one out]].
** And for some, the Victim Ghost version of Henry is UglyCute.
** Henry's [[DullSurprise non-reactions]] to the world around him can ruin the impact of some of the cutscenes too.
* ParanoiaFuel:
** The idea of suddenly being locked in your home, able to observe the outside world, but not contact it.
** Most of your time in Henry's apartment will be spent gawking at Eileen and your other neighbors through various peepholes.
** At the same time, things will move around in your apartment while you're off exploring other worlds. Two sections of the game are spent trawling through a tiny panopticon. Oh, and both the phone and the bunny are watching you.
** Ingame when you're in the second half, [[HellIsThatNoise cre]][[OhCrap eeak]]... [[ImplacableMan *bang bang bang* Hahahaha...]]
** There's also the [[spoiler:corpse of Walter stashed in a secret walled-off room in your apartment]]. Sweet dreams!
* TheScrappy: Henry is disliked for coming off as dull, unemotional and being [[FlatCharacter lacking in character development]] compared to silent hill protagonists before or since. Spouting many of the game's dumber lines certainly contributes.
* TheyChangedItNowItSucks: Some fans complain about how the gameplay is quite different from the previous ''Silent Hill'' games. You don't use a flashlight, you can only hold ten items at a time, and the game isn't as puzzle-oriented as its predecessors. And it is saddled with the (false) rumor that this is just a DolledUpInstallment. Though compared to the [[VideoGame/SilentHillHomecoming other]] [[VideoGame/SilentHillShatteredMemories Silent]] [[VideoGame/SilentHillDownpour Hill]] [[VideoGame/SilentHillBookOfMemories games]] released after 4, this one doesn't have that much hate as it used to have.