Silent Hill: Downpour
The building serves as both a place of worship and an overnight school for young children, complete with a theater for children to perform plays. In memos throughout the journey in the monastery, it is revealed that many of the children were neurotypical and autistic, and the hospital was meant to "cure" them of these conditions. These treatments were often harmful and abusive, ending in injury or death. It also has a medical ward which includes a morgue and an operating room. Murphy meets the nun, a little boy, and a little girl, before he is transferred to the Otherworld, where he is briefly chased by the Void before he battles the Bogeyman. This is also the location where Murphy finally reveals that he had a son: Charlie Pendleton, who was killed by Patrick Napier.
In the Otherworld version of St. Maria's Monastery, Murphy is chased by the Void through cavernous hallways, where he must avoid being attacked by Wall Corpses. After the chase sequence, he finds himself in a set of strange stairways where he must choose the correct floor, denoted by paintings, in order to advance. Afterwards, Murphy must descend into a strange theater where behind the curtains is a mock-up of a prison made out of cardboard.
The monastery is notable for the usage of short Otherworld sections while exploring the place in the Fog World. These include a non-existent hallway, a bathroom behind a bookshelf, a section with large X-ray photos, and a "shadow" play that comes to life.
- A tire swing in the eastern courtyard will change into a prisoner's corpse hanging from a noose every time Murphy turns his back, and stares again to the place where the tire swing was placed. If the player looks somewhere else, then again to the swing, it will be back to the tire swing.
- The layout of the monastery is similar to Cedar Grove Sanitarium.
- Every memo found within St. Maria's bears a small caption that reads, "Agnus Dei, qui tollis peccata mundi." This translates to "Lamb of God, who takes away the sins of the world."
- The comic-book prison stage in the Otherworld theater could be inspired by the 2003 game Max Payne 2's "A Linear Sequence of Scares" chapter, where the protagonist goes through an abandoned funhouse full of cardboard enemies.