This game, along with Silent Hill 3, takes place in the South Vale district of Silent Hill, while the first game (Harry Mason's story) takes place in the Old Silent Hill district, across the lake to the north.
Features two new endings that were not featured in the original game.
When James and Maria approach "Baldwin Manor", Maria is visibly very afraid. This is because she had recently been in this house before meeting James at the pier. She encountered various hauntings and a mysterious figure called Ernest who would only speak to her from the other side of a locked door.
After entering room 108 at Jacks Inn you can see Maria's original outfit in the wardrobe.
During the announcement of the game, it was revealed that Konami decided make this game after being informed by David Films that they were prepping for Retour à Silent Hill (2026).