- The three types of ammo have birds on them (penguin, crow and owl).
- There is a poster of Maria in the bathrooms at the beginning of the game.
- When James runs to Silent Hill, extra footsteps can be heard almost as if someone is chasing him from behind. There are also dog-like sounds.
- In Neely's Bar, there are two messages that appear on the walls inside the room:
- The first message is "There was a HOLE here. It's gone now." when James Sunderland first arrives in Silent Hill.
- The second message is "If you really want to SEE Mary, you should just DIE. But you might be heading to a different place than Mary, James." after leaving Brookhaven Hospital. Reading this message will increase the chances of obtaining the In Water ending.
- Most corpses in the game are in James's clothing (green jacket, blue jeans, black dress shoes). They are signs of what may happen to James throughout his quest. Some notable corpses include:
- In the area where James fights the first Lying Figure.
- In front of Neely's Bar.
- The corpse at the north end of Martin Street, which is holding the Apartment Gate Key.
- In room 208 of the Wood Side Apartments, which also contains the Clock Puzzle.
- At the north end of Neely Street across from the Pet Center with a number of papers strewn around.
- There is a establishment called "Phoinix body" or "Phoenix Body" on Lindsey Street. This might be a reference to reincarnation, like a phoenix does, and a nod to Alessa Gillespie/Cheryl Mason/Heather Mason from the previous game, or Mary and Maria, as there is a theme of rebirth in Silent Hill 2.
- A "Magical Envelopes" signboard attached to the building on Sanders street might be an allusion to Mary's letter that disappears with its envelope at the end of the game.
- In the room where James obtains his flashlight, the mannequin is wearing Mary Shepherd-Sunderland's clothes.
- Heavy breathing can be heard on the third floor of Wood Side Apartments, as if the building is alive.
- In Room 307 of Wood Side Apartments, James hides in a closet from Pyramid Head. This appears to be a reference to the film Blue Velvet. In the same room, a painting of a mountain scene hangs on one of the walls. If viewed closely, skulls can be seen hidden in the picture.
|The whisper heard in Room 209.|
- In Room 209 of the Blue Creek Apartments, a whisper may be heard that says something along the lines of "See my dead wife, come home to do some laundry..." This whisper is random, and there is about 50/50 chance that the whisper will occur.
- The red cross texture in the PC version for low health is the image of the graffiti-covered wall where Laura sits reading the letter.
- Heaven's Night appears to be directly modeled after the bar in the film Blue Velvet.
- "Brookhaven Hospital" is misspelled as "Blookhaven Hospital" in-game, but this error was corrected in Silent Hill 3. This could be because in Japanese grammar, "L" and "R" are interchangeable.
- In Brookhaven Hospital, heavy breathing can be heard when James discovers Maria isn't in her room.
- In Brookhaven Hospital, if James inspects the open refrigerator after obtaining the lead ring from it, he will comment that there is a rotting smell coming from it, implying that a body may have been stored in it at some point.
- In the Otherworld Brookhaven Hospital at the very bottom of the stairwell, there is a fenced-off area right next to the basement storeroom. Each time James passes by it, a disturbing noise in the distance that sounds like a cross between a squealing pig and a wailing infant can be heard. There are also sounds of glass shattering in Room C2.
- According to the Book of Lost Memories, one of the pictures in the Silent Hill Historical Society is of the game's development team. It is likely a reference to this one.
- In Toluca Prison, in the cafeteria where Eddie Dombrowski explains the dead body slumped over a table, there is a portrait of the cafeteria hanging on the back wall near a health drink. If viewed closely, the picture shows that the corpse is in James's clothing, insinuating that the corpse is a sign of punishment.
- In Toluca Prison, in the women's bathroom, if James knocks on a stall door and walks away, he may hear a sudden scream of a woman falling down, followed by a crash. This is considered to be one of the few "shock" or "jump scare" moments of the game.
- In Toluca Prison, in the gallows where James inserts the three plates, a sound similar to horses galloping in the distance can be heard, running back and forth. Afterwards, James coincidentally finds a horseshoe. Another interpretation is that the sounds are the ghosts of the prisoners murdered at the prison, who may have done jogging exercise drills. 
- In the morgue at Toluca Prison, if James inspects one of the corpses on a gurney, he will comment, "Did that just move or was it my imagination?" Also, if he tries to access one of the jammed doors, he will mention that there is a rotting smell coming from within. If he looks into one of the chutes, he may say that one of the bodies inside is terribly dismembered or that he regrets looking into them.
- In the Lakeview Hotel, James may hear a man sobbing when he walks past Room 208. Room 208 is the room in the Wood Side Apartments where he sees the body of a man in front of a TV. Room 208 is also written on the door where James discovers Maria is dead in her prison cell.
- In the Lakeview Hotel, in the basement elevator where James finds the thinner, heavy breathing can be heard upon entering.
- In the Lakeview Hotel, if James enters the lounge (with his flashlight on) and examines the heater, he will find a note on the back of it that says: "I'm Johnny, one hot guy." This implies that the boiler directly caught a curtain on fire, which caused the hotel fire. Another suggestion is that this may be a reference to Stephen King's The Shining, where the main character Jack Torrance forgets to control the pressure on the old boiler room of the Overlook Hotel, causing it to catch on fire and explode. In the original novel, he purposefully overheats the boiler to destroy the hotel. In the film version, while possessed, Jack famously says "Here's Johnny!" during an attack on his family--specifically, his wife. A poster for The Shining can also be seen on a wall before James arrives in town.
- The framing of the scene when James enters the hotel resembles the one from the original Pet Sematary finale.
- The Little Mermaid music box is located near a water fountain (the sea), the Snow White music box in the pantry next to canned apples (poisoned apples) and the Cinderella music box in a briefcase with stickers from many cities (Cinderella's shoe was brought to many people before finding its rightful owner, and it needed just the right fit/combination. Or, being locked in the suitcase could represent how Cinderella was cruelly treated by her sisters/shunned from society).
- The photos on the hotel bed by the briefcase in room 202 are of the game characters and enemies.
- The suitcase in room 202 of the Lakeview Hotel can begin with the combination reading "KIRA". As "killer", when written in Japanese katakana, reads "kiraa", this may be a manifestation of the act which drew him to Silent Hill creeping back into memory. Also "kira" in Japanese literally translates to "shiny"; this would hint to Cinderella's slipper on the music box inside.
- On the first try to get up to the third floor of the Lakeview Hotel, it's locked. When James turns around, Mary may be heard calling to him.
- The scene where Angela ascends the hotel staircase might have been inspired by the last scene in Jacob's Ladder where the protagonist goes up the stairs following his son and, at the same time, dies in the real world.
- After defeating the two Pyramid Heads in the Otherworld Lakeview Hotel, James uses two eggs, one rust-colored and the other scarlet, to enter another corridor. In this corridor, there is a stain on a door that looks very much like a man's face imprinted on the wall.
- If the player saves after receiving the Dog ending, the icon on the memory card will be the dog house where the key was found.
- In the PC version, it is sometimes possible to continue playing the game after the ending. If the game results are loaded from the game's pause menu, James will appear where the previous game was finished.
An alternative joke ending. It was not included in the initial PlayStation 2 release of the game. It was added in the Xbox version, the PlayStation 2 Greatest Hits version and the Director's Cut PC version.
An ending where James attempts to revive his dead wife.
In order to receive the Rebirth Ending, the player must beat the game at least once. Start a new game and there will be four extra items that James must obtain:
To get this ending, the player must receive the three normal endings, Leave, In Water, and Maria, or just receive the Rebirth Ending in a replay game. Once these endings are on the same save file, load it and start a new game. When exiting Rosewater Park for the first time, head straight and enter an open yard just west of Jacks Inn. Inside is a doghouse with a key inside. Get the key and use it to enter the Observation Room on 3F of the Nightmare Lakeview Hotel, after viewing the video tape in Room 312. Once this ending is achieved and saved, the low poly model representing the game's save data on PS2 versions changes from the radio to a bouncing doghouse.
Extra Riddle mode
The hardest possible Riddle difficulty that can be selected. To unlock this, you must complete the game on each Riddle level at least once. The order of difficulties does not matter, nor does Action difficulty, as long as you have completed the game once on each Riddle setting.
After beating the game on each Riddle difficulty at least once, you will then unlock the option to choose Extra Riddle difficulty. To do this, you must start a new game and select hard for both Action and Riddle difficulty. Your new game will begin in Extra Riddle mode.
Do note, however, that there is not a separate option to select Extra riddle difficulty. The steps listed above are the only way to access Extra Riddle difficulty. Once you complete the game on the Extra Riddle difficulty, starting a new game with both hard Action and Riddle difficulty will not enable Extra Riddle again. To replay Extra Riddle once completing it, you must beat the game once more on hard Action and Riddle difficulty, and then start yet another game with both difficulties set to hard.
To verify that Extra Riddle is able to be selected, start a new game with Action and Riddle set to hard as usual. Then, make your way to the first save point and save your game. Then, simply view the newly created save file, and Extra Riddle will be listed as the difficulty, if eligible.
Note: Despite rumors that the text can be unlocked in-game, this is not possible. It can only be read by hacking into the game files to display it.
Remains of Blood Swamp
The x meters of land surrounding this monument was originally swamp, but was later filled in.
From long ago, the swamp was nicknamed Blood Swamp because the executioners poured the water used to wash the execution tools in here.
Perhaps it's for that reason many people seem to have seen ghosts in the area.
Jennifer Carroll's monument, Rosewater Park
Victim of persecution by the Christians. Jennifer Carroll lived with pride and honor. What happened here shall never be forgotten.
The body of a man later identified as Thomas Orosco (Lumberjack, age 39) was discovered in the middle of his room lying face up.
The probable cause of death was multiple stab wounds to the front of the neck and the left side of the torso by a sharp edged weapon. The estimated time of death was somewhere between 11:00 p.m. and 12:30 midnight.
Due to signs of struggle in the room and the lack of a murder weapon, police are considering this a homicide and have opened a murder investigation.
Furthermore, given the fact that the cash in the room was untouched and Mr. Orosco had a history of drunkenness and violence, the police suspect that the motive was not robbery but some sort of crime of passion.
- Main article: Great Knife
Before James acquires the Great Knife, Pyramid Head wields this enormous weapon. The Great Knife is an incredibly large and heavy blade with a razor-sharp edge. The Great Knife will indeed kill, or at least knock down, almost anything in one hit, but it is very awkward to handle and use. James can only drag the knife across the floor, which slows him down immensely, due to its large size and extreme weight. James can find the Great Knife in the center room of Pyramid Head's "lair" in the labyrinth.
- Main article: Chainsaw
The chainsaw can be obtained during a second playthrough, or while playing on Easy mode. After talking to Angela Orosco, a buzzing sound is heard, and when leaving the cemetery, the sound will get louder. The chainsaw is jammed into a log on the path after leaving the cemetery. It is powerful and has different attacks, but is slow to recover, and has a brief waiting period while it warms up. If James is left idle for a moment after downing a monster (not stomping), he lets out a battle cry.
- Main article: Hyper Spray
The Hyper Spray can be unlocked by doing one of three possible things: completed the game on Hard mode, completed the game twice (at least once on Normal), or complete it three times, regardless of difficulty level. It is found inside the motorhome on Saul Street. The good part about the Hyper Spray is that no ammo is required, and depending on which version of the Hyper Spray is used, it can be quite effective, particularly if James is in a tight spot and needs to escape. The bad part about it is that the range is limited, and pressing it too long will lower the effect until James shakes the can. Also, while playing on Normal or Hard difficulties, James will get injured if he uses it too much. There are four different kinds of hyper spray in the game.
Deleted, unused and inaccessible content
- Silent Hill 2 originally featured a mini-map.
- In the game, Mary's video tape plays without sound. There is an unused sound file that corresponds to the video, however. The audio itself is profoundly disturbing, consisting of Mary's muffled screams.
- At the top of the hotel stairs, Angela can be seen bending and twisting. 
- Though they don't appear in the game, the floating naked bodies from the concept art  can be found on the disc. The bodies can also be seen during the ending credits.
- The Church of the Rebirth can be seen briefly in the Rebirth ending, but it is possible to get James to the island by hacking the game. The area consists of a church sprite, many trees, and a dock.
- The corpse in front of the TV is James's model.
- Another tombstone for James can be found in the first cemetery in the game.
- There is a plate for Cornwell Street that can be found in game's files.
- It is possible to use hacks to get James into the reddish hallway from the cutscene in Brookhaven Hospital, located on the east side of the hospital garden.
- The text on Mary's letter to Laura is actually Bon Jovi's "Blaze of Glory".