* ContestedSequel: By far the most polarizing of the Team Silent entries.
* DesignatedProtagonistSyndrome: Henry suffers from this probably more than any other main character in the series. Mainly due to coming off as, at best, [[DullSurprise boring and unemotional]], and at worst, unbelievably dense.
* GoodBadBugs: When you're at the EscortMission part of the game, specifically returning 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. Convenient for speedruns, but not recommended for those aiming for better endings, as the downside to this exploit is Eileen getting instantly possessed by Walter. Thankfully, she can be (temporarily) treated with a Holy Candle like any other haunting.
** Actually, that shouldn't 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...
** 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!!!!!
* 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.
** 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!
* 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. Rumor has it that it [[DolledUpInstallment wasn't supposed to be a Silent Hill game]].