Later editions of the game include a second storyline titled " Born From A Wish" which follows a character named Maria. How many children wake up screaming because they had a dream where they beat up a zombie with a baseball bat? Com, Christophe Gans (director of the 2006 Silent Hill movie) confirmed that he had completed a script for a third Silent Hill film, and is aiming for a 2023 release for the project.

In 2009, Wired News listed it as the 11th most influential game of the decade for its emphasis on psychological horror and exploration of taboo topics such as incest and domestic abuse, rather than gore.Voice actress Mary Elizabeth McGlynn provided vocals for four musical pieces included in the game and co-directed Shattered Memories ' voice acting, and musician Joe Romersa wrote lyrics for three of the pieces. Much of the gameplay consists of navigating the town and finding keys or other items to bypass doors or other obstructions, with less focus on killing enemies. Silent Hill: Shattered Memories is a 2009 survival horror game developed by Climax Studios and published by Konami Digital Entertainment. Konami has announced Silent Hill-themed pachinko machines, one in 2015 and another titled Silent Hill: Escape in 2019.

In a retrospective feature, NintendoWorldReport 's Jonathan Metts generally agreed with GameSpot, stating that the installment "is a noble and arguably successful attempt to revive and reform the survival horror genre. The default control for Silent Hill 2 has James moving in the direction that he is facing when the player tilts the analogue stick upwards.

Silent Hill 2 features both the main scenario and the Born from a Wish sub-scenario seen in later re-releases, such as the Director's Cut. The chase sequences were designed to evoke a brief sense of tension and fright for the player, although the developers did not want to prolong the tension with the constant presence of monsters, and were concerned that this would become overwhelming and spoil the player's immersion in the game and interest in the story. Pyramid Head also wields a large blade titled the "Great Knife" that it heaves across the floor in almost all player encounters.