Depressing. Silent Hill reached its peak with its second outing, known widely amongst gamers for its iconic Pyramid Head character. Yet the phallic symbol with the giant butcher's knife was merely part of the disturbing storyline presented here; James' intimate journey to find his wife was perhaps the most effective personal story told in video games at the time. Conveying a sense of maturity "Mature" games could only dream to achieve, this simple exposition of a man trying to understand himself and his feelings could not have been executed more successfully. A new landmark for "survival horror" -- and for games that wish to envelop the player in a believable, consistent universe.
- The original European Playstation 2 edition also includes a second disc: a "Making-of" DVD video featuring trailers, an artwork gallery and a documentary on the title's development.
- The Xbox port was released late in the same year as the PS2 version, on December 20, and the PC version in December of the following year. Each region had a different subtitle; the Xbox port was subtitled Saigo no Uta (最期の詩 or "Poem of the Last Moment") in Japan, Restless Dreams in North America, and Inner Fears in Europe. The ports also contained additional material. James' scenario was given a sixth ending and an additional sub-scenario titled "Born from a Wish" was included. This mini-game is shown from the perspective of Maria, which explains her background before she met James in the main game.1
- James' outfit in the game is based on that of Jacob Singer in the film Jacob's Ladder. In fact, it could be said that James' entire character is based on that of Singer, in that his mannerisms and responses to certain stimuli are strikingly similar.