Silent Hill/Monsters

The following is a list of monsters in the video game series Silent Hill.

Common enemies

 * Air Screamer - Pterodactyl-like creatures that fly close to the ground surface and travel around in packs. They tend to linger around areas with garbage. The Air Screamers were inspired by memories of an illustration found in one of Alessa's favorite books, The Lost World.
 * Night Flutter - The creature that Air Screamers transform into when the world shifts to The Other side. They have the head and wings of a pterodactyl, although their faces are covered in masses of writhing worms; rather than pterodactyl bodies, though, they have the bodies of human men.
 * Grey Children - Knife-wielding, faceless children-like monsters. They were censored in the PAL version of the game due to their child-like appearance and were replaced by Mumblers. Near the end of the game, they can still be seen as a transparent silhouette similar to the Larval Stalkers (see below). They represent Alessa's fear/hatred of children who bullied her in school.
 * Mumbler - Humanoid creatures that loosely resembles a headless teddy bear with giant claws. The Mumblers are only present in the latter part of the US version, while completely replacing the Grey Children in the school area in the PAL version. They represent small menacing demons and animals from various fairy tales.
 * Larval Stalker - Partially visible ghost-like entities. Most are harmless. They cause the radio to emit white noise and laugh before disappearing. They cannot be killed, although they will stumble and vanish once the flashlight beam is directed at them. Their laughter provokes memories Alessa had of being teased during school.
 * Groaner - Demonic dogs with deteriorating flesh. Appearing commonly in outdoor locations, they are fast, nimble, and attack in packs. They are also sensitive to sound and will react to the source. This creature symbolically represents Alessa's fear of dogs.
 * Wormhead - The creature that Groaners transform into following a shift to the Otherside. Their bodies are more deteriorated and appear to be partially burnt, and their heads are covered in writhing masses of worms.
 * Puppet Nurse - Monstrous nurses wearing old-fashioned uniforms. Large, slug-like parasites grow out of their backs, causing the nurses to hunch forward when they walk. Their speed and strength differ depending on their hair and dress style.
 * Puppet Doctor - Monstrous doctors possessed by the same unspecified parasite in the Puppet Nurses, causing them to also have a hunchbacked appearance. The Doctors also attack using scalpels. To date, these are the only male medical staff to appear as enemies in the Silent Hill franchise; in games 2-5 and Origins, all hospital based enemies have been female, reflecting James' sexual frustration, Heather's buried memories, Walter's birth anxieties, Travis' sexual anxiety, and Alex's memories in the mental institution respectively.
 * Romper - Featureless, humanoid creatures that appear to be either skinless or burned. Their gorilla-like movements render them very fast, and they attack with a body blow by pouncing and tackling their prey to the ground. Rompers are more prevalent in the otherworld and around the Police Station. They are a manifestation of Alessa's fear of adults.
 * Creeper - Giant insect-like creatures that lurk inside the school, hospital, and sewers. They move very quickly and react highly to light. Creepers are a manifestation of Alessa's aversion to insects.
 * Hanged Scratcher - A humanoid praying mantis-like creature found exclusively in the sewers. Their name comes from the fact that they hang from the sewer pipes above Harry's head by their long claws and then drop down to scratch him. They are a manifestation of an image that is a mixture of various insect species.

Bosses

 * Split Head - The boss fought in the basement of the Otherworld Midwich Elementary school. A giant dragon-like lizard whose head is split vertically down the middle, it is manifested from a fairy tale Alessa heard/read as a child; Harry recalls reading the same story himself as a child. Another version of the Split-Head is shown in Silent Hill 3, but is dubbed "Split Worm".
 * Bloodsucker - A creature resembling three leeches fused together at the base, which writhes like octopus tentacles. Harry first encounters it in the Alchemilla Hospital. It lays docile on the floor, sucking up a puddle of blood, only becoming aggressive once Harry approaches it. A second Bloodsucker is encountered later in the game inside a fridge in the area called 'Nowhere'. Unlike the other boss monsters in the game, Harry cannot kill the Bloodsucker. The Bloodsucker is an incarnation of Alessa's aversion towards worms and snakes.
 * Twinfeeler - Boss fought in Silent Hill Central shopping mall. A giant larva, which resembles a centipede, that burrows into the earth and then emerges spitting some sort of poisonous gas/venom. After Harry deals enough damage to it, it flees from him and ventures into the city. It is a manifestation of the insect specimens in Alessa's room.
 * Floatstinger - Boss fought on the rooftops of Koontz Street. It is the adult form of the Twinfeeler, and appears as a giant, demonic moth. The baby versions of this moth can be seen in Silent Hill Origins. It attacks with a large stinger on its thorax and by spewing poisonous gas. Like the Twinfeeler before it, the Floatstinger is a manifestation of one of the insect specimens in Alessa's room.
 * Puppet Cybil Bennett - A demon-possessed police officer. For further information, see List of Silent Hill characters.
 * The God - The God worshiped by The Order. For further information, see Divine Creatures in Silent Hill. Depending on what ending the player gets, the God will take on a different form:
 * Incubator/Mother of God - The merging of the physical and spiritual Alessa. If Dahlia is allowed to perform the ritual without interruption, Alessa is replaced by a floating female figure that radiates with intense light. Manifestation of how Alessa believed the God would appear; fought in the "Bad" Endings.
 * Incubus/Samael - A hideous, shrieking demon that takes the place of the Incubator if the player rescued Kaufmann. The creature is the incarnation of the mental image Dahlia had for the God. Its image is based on Baphomet. Fought in the "Good" Endings.

Common enemies
Skulking, humanoid creatures trapped in what appears to be straitjackets made from their own flesh. They attack by spewing a spray of acidic mist from an opening in their chest. They are slow whilst standing upright, but when knocked down they stay in a lying position and move by skittering very quickly along the ground. The Lying Figure symbolizes a hospital and/or mental patient squirming in agony, and are also a manifestation of James Sunderland's internal suffering. The creature has been nicknamed Straight-Jacket prior to the release of The Book of Lost Memories which confirmed the official name. However, it should not be confused with the monster under the same name in Silent Hill: Origins which shares many similarities, but the latter has some significant changes. Headless, armless living sewing dummies which bear a resemblance to French artist Hans Bellmer's Dolls, directly modeled after the images from some of his work, depicting two sets of legs joined by their waists. These monsters consist of a feminine human torso and legs, upon which rest two more legs standing upright. The top pair of legs are used for striking while the bottom pair are used for walking. The creatures react highly to light and tend to stand still in plain sight. However, once the player approaches about three to five feet away they spring to life and start to attack. The Mannequin is a manifestation of James' natural urges and inclinations which, accordingly, the game features a sequence depicting a Pyramid Head raping two of them. Although they are not overly strong creatures, they have the advantage of stealth, as the radio will not emit any static to warn the player of their presence until the mannequin moves. They are commonly found in the apartment buildings and the Hotel. Well endowed, zombie-like nurses wearing low-cut outfits. Their heads are grotesquely swollen and face backwards, convulsing violently. The nurses are quicker on their feet than most of the other monsters and wield pipes that can deal heavy damage, as well as having a surprisingly long range. The Bubble Head Nurse is manifested from James' memories of Mary's hospitalization, and their attire and shapely bodies are yet another manifestation of James' sexual frustration. Apelike creatures with massive, tube-like arms. They swing from the underside of suspended metal catwalks, attacking James as he passes overhead. Their design is quite similar to the Closers found later in Silent Hill 3. The creature is a representation of feeling overwhelming, inexplicable anguish and, for this reason, the Mandarins are not allowed to stand above ground. Insect-like creatures that resemble large cockroaches. They attack by nipping at James' feet. Since they also appeared in the first Silent Hill, the player can assume that they are merely a manifestation of the town and not of James' mind. An unseen monster found within one of the cells in the prison. It has a deep, powerful voice and continuously pounds on the iron door of the prison cell, saying "ritual" (or possibly a reversed clip of the phrase "are you sure"). Despite the fact that it cannot be seen by the player, James can ready a weapon, attack, and even kill the creature using a firearm. It makes a very human grunt when hurt. Small but hulking creatures which take the form of a walking bed, on top of which are two writhing figures. The creature only manifests after James' fights a larger version of it (see "Abstract Daddy (Angela Papa)" below). These smaller versions of the Abstract Daddy manifest in the Hotel, due to Angela's presence. Some fans have interpreted the creature as a walking door dubbing it the Doorman prior to the publication of Lost Memories which confirmed the official name.
 * Lying Figure[[Image:LAB013-1-.jpg‎|thumb|110px|Lying Figure|right]]
 * Mannequin[[Image:SV051-1-.jpg|thumb|110px|Mannequin|right]]
 * Bubble Head Nurse[[Image:BH008-1-.jpg‎|thumb|110px|Two Bubble Head Nurses|right]]
 * Mandarin
 * Creeper
 * Prisoner
 * Abstract Daddy

Bosses
This lumbering, monstrous creature takes on the appearance of an executioner from the town's past, wielding an impossibly large blade known as the Great Knife and on other occasions a spear. It's depicted wearing a blood stained, triangular metal helmet. He relentlessly stalks both James and Maria and is the incarnation of the part from James' consciousness that believes he deserves punishment for murdering his wife and his repressed sexual urges. The creature is officially known as the Red Pyramid Thing according to the creator's commentary found in The Book of Lost Memories. However, the name can also be interpreted as 'Pyramid Head' which also was used in dialogue by the game's protagonist, James Sunderland. The latter name was widely used since the Silent Hill 2's release in 2001, two years prior to the publication of Lost Memories, and has since been confirmed as also another official title for the creature. For further information, please see the featured article. Lattice-based monster that is suspended from the ceiling within a metal frame (much like a cage) and attacks by strangling the player with its legs. James encountered these monsters when Laura locks him inside the room in Brookhaven Hospital. Also called "Lustful Lips" in production documents (indicating vaginal imagery), with the lattice representing a bed and the monsters themselves representing Mary. Two writhing, reclining figures on a walking bed-like form and a symbol of Angela's past. It has four legs which are used to approach a victim. The creature lifts its body and reveals a "mouth" that is used to attack. One of the only monsters in the game which does not originate in James' mind, it is a manifestation of Angela Orosco's sexually abusive father and the guilt she felt over falling prey to him. The original concept was the 'Ideal Father'. An overweight, mentally unstable young man who succumbs to the horrors of Silent Hill and tries to kill James. For a full character biography, see List of Silent Hill characters. The identity of the final boss is dependent on which ending the player has achieved by the end of the game, though the monster's actual appearance is identical in either scenario. Her design is quite similar to "Flesh Lips" in which both share the concept of a figure being encased by the same metal framework, but she is portrayed upside down (in the same way Maria was displayed to James during her execution by the two Pyramid Heads). She appears to also loosely resemble the Mannequin and Bubble-Head Nurse as well. While hanging in the air, her primary attack is a vine-like tentacle which emerges from the back of her head. She also unleashes a swarm of moths, which deal very little damage but delay James from moving temporarily. This being is the embodiment of James' conflicted emotions toward his wife Mary during her final days. For further information, see List of Silent Hill characters.
 * Red Pyramid (Pyramid Head)
 * Flesh Lips
 * Abstract Daddy
 * Eddie Dombrowski
 * Mary/Maria

Common Enemies

 * Numb Body - A relatively featureless, bipedal creature that appears in three sizes; small, medium and large. The small and medium versions make high-pitched moaning sounds similar to an infant's cries, especially after being struck down. The large ones make deeper roaring noises and are more ferocious. The creature was given its name due to its slow, awkward movements and its body appears pale as if frozen.
 * Double Head - Dogs that have their heads split vertically in half. They usually appear in groups and quickly attack Heather upon sight. The Double Heads are attracted to beef jerky, bloody carcasses found in some areas, and loud noises. They are "bandaged" in bloody strips of flesh. According to The Making of Silent Hill 3 DVD, their split skulls are meant to evoke Cerberus and to indicate the player is entering a nightmarish world. Their appearance is influenced by the image of Alessa after she was incapacitated by the fire.
 * Pendulum - A monster consisting of two conjoined torsos on each end and a metallic waist which allows it to spin. It has a blade attached to each of the heads and walks around on its stilt-like legs. They can also rotate in midair, without the use of wings, making a noisy screeching sound of grinding metal. The Pendulum was named based on its movements and attack methods while the upper half of its body rotates.
 * Insane Cancer - Enormous, obese humanoids with great strength. The name is derived from its outward appearance being suggestive of a cancerous mass. Although they usually move slowly, shifting their weight back and forth, they will sometimes run towards Heather and knock her down. They are usually found lying down or sleeping, and whilst doing this, they regenerate their health. They will "deflate" after dying.
 * Closer - Lumbering, extremely large-armed creature that attacks using concealed blades that extend out of each end of their arms. The lower portion of the body looks more like a female with a mini skirt, with what appears to be high heels for feet. In the second half of the game, the Closers become significantly more dangerous and if the player gets too close in an attempt to attack them, they will defend themselves by swinging their arms slowly, knocking Heather back. The sound they make is a synthesized rhinoceros roar. It has the appearance of a Mandarin from the previous installment that has risen above the ground and was named for its ability to block a passage using its body.
 * Slurper - Humanoid/anteater-like creatures that crawl along the ground with great speed. Their face is long and pointed, with teeth at the end of the snout. Loud noises tend to attract their attention. It often plays dead in an attempt to lure in the player and tries to pin down its prey. The Slurper was named after its habit of noisily consuming rust-colored blood and bits of flesh that stick to the floor with its bill.
 * Nurse - Unlike the previous entries, the nurse-type creatures in Silent Hill 3 have a more "human"-like appearance- their faces are smeared with makeup and blood, as opposed to being grossly deformed. As well as being equipped with the standard pipe which most use to attack with, some also carry revolver handguns. It appears as though they have either coughed up blood or have been feeding on a bloody carcass, as blood is visibly splattered all around their mouths. The exact bloodstain is in the shape of a rectangle, although it is unknown whether this is intentional or merely laziness on the game developer's part- the Nurses are hunched over most of the time, only showing brief flashes of their faces when they attack. They make heavy panting noises and when injured, they utter bloodcurdling screams. If the perfume is equipped while in the hospital, then they will attack in much greater numbers. The Nurses are only found within the hospital area and the creators have stated that the nurses roaming the halls may have changed into monsters, but they have indicated that the details remain unclear.
 * Scraper - A humanoid creature that wields two large, rusty blades. Its head looks like many layers of flesh stitched together and quivers rapidly. Scrapers are a minor variation of the Missionary boss, but moves with greater speed. It is named after its habit of endlessly scraping together the two sharped-edged weapons it holds.

Bosses

 * Split Worm - Boss fought beneath the shopping mall. A gigantic, vile worm that is covered with a protective outer layer. The outer skin splits vertically to reveal a fleshy head without any visible eyes or nostrils. The creature's design was based on the Split Head that appeared in the first Silent Hill.
 * Glutton - Boss "fought" in the abandoned office building. An enormous monster that is suspended from a cylindrical frame and is invulnerable to any weapons used against it. Although the "monster" appears in a picture booklet during the game, its form was manifested by the otherworld's power. Unlike the game's other bosses, he is defeated simply by finding and reciting an incantation
 * Missionary - Boss fought on the roof of Heather's apartment. A member of The Order, sent by Claudia Wolf to kill Harry Mason. A giant, hulking, humanoid monster wearing the Order's ceremonial robes (such as those seen on Pyramid Head). Carries a pair of bent spears with which he attacks Heather.
 * Leonard Wolf - Boss fought in the Brookhaven Hospital septic system. The father of Claudia Wolf. Like the missionary, he is not a human, appears as a giant, scale-covered, amphibious monster, representing either Claudia's hatred or Heather's fear. For further information, please see List of Silent Hill characters.
 * Memory of Alessa -Boss fought at the Lakeside Amusement Park. Manifestation of the burnt-up Alessa Gillespie. It attempts to kill the player by using a large variety of weaponry, such as the sub-machine gun and knife. The creature is Alessa's "other mind" that was separated seventeen years ago during the events of the first installment; a memory that still clings to Silent Hill. She is seen another time in the game. In Brookhaven hospital during The Otherword session, the player can enter a storeroom with a large mirror and a table. If the player stays in for too long, the door locks, Heather's reflection slowly transforms into Alessa and stops moving, at which point the door will unlock and the player can leave before the room drains Heather's health.
 * The God - Boss fought at The Order's Church. A deity that's capable of manipulating fire. The lower portion of the its body is in an immature state due to its recent birth. As a result from being born from Claudia's womb, it takes on the form of Alessa, her vision of the God she believed in.
 * Valtiel - A creature that appears in numerous locations, but never makes any attempt to harm Heather. Its name was derived from "valet" and, as the God's servant, Valtiel must observe Heather to ensure the birth of God. He is also a symbol for the otherworld and is a creature intended by artist Masahiro Ito to connect with the two previous releases. If Heather should die during the course of the game, Valtiel must take measures to resurrect the Mother of God. He is often depicted as turning a valve which represents the cycle of rebirth. It is stated in The Book of Lost Memories that the clothed covered, body-like figures common in Silent Hill are actually bodies wearing a ceremonial robe modeled from the appearance of an angel for the town's occult religion, particularly Valtiel. In relation to Silent Hill 2, if the helmet of Pyramid Head were to be removed the designs between the two are surprisingly similar as the executioner's attire was also modeled after Valtiel. For further information please see Divine Creatures in Silent Hill and the featured article.

Common enemies

 * Sniffer Dogs - Dog-type creatures that have long, prehensile tongues that they use to drain the blood of their prey. They have dirty, leathery yellow skin which appears to be decaying and, strangely, make snarling sounds which resemble that of a large feline rather than a canine. The male Sniffer Dogs attack by charging up and lunging towards Henry Townshend's torso. Female Sniffer Dogs, which have a slight purple-pink tinge to their skin, are more intelligent and tend to detect Henry's presence more quickly. The females are capable of grabbing onto the leg and pinning the player down while others of its companions attack him. The Sniffer Dogs often appear in groups and are usually witnessed feeding on other deceased monster carcasses. Their canine form is a reference to young Walter's fear of dogs after he visited a pet shop during his childhood and was nearly bitten by one.
 * Twin Victims (Victim 07 + 08) - Walter Sullivan's seventh and eight victims were twins Billy and Miriam Locane. They are the only two of Walter's victims that have been reincarnated into the form of a monster instead of ghosts. It is speculated this was partly due to the fact that they were children and may be related to Walter feeling guilty for murdering two innocent children. The creature looks like a giant bust walking on a pair of rotted arms; the twins' bodies have been fused together, giving the bust two heads, which resemble the faces of a pair of sleeping infants. They only attack Henry if he gets close; otherwise they merely stand stationary, pointing at him and whispering "receiver" over and over.Twin victims are absolutely brutal at mid-range, they are also particularly fast for such large bodies.
 * Bottom - A rotting, upside down human torso which walks on its hands. It moves around and behaves much like the Twin Victims, but more dangerous. They will detect or "hop" up very quickly compared to the other enemies and also appear in groups on various occasions.
 * Greedy Worm - An enormous, fleshy worm-like creature seen burrowing infinitely throughout Walter's various otherworlds, symbolically linking them together like an umbilical cord. Though the creature is not hostile, it cannot be killed. Its appearance could be influenced from Walter's hatred for being separated by the "magical cord" from this mother, although it holds great importance in his mind for representing his mental connection with his "mother", Room 302.
 * Gum Head - A grotesque, decaying ape-like creature that appear in two variations known separately as "Old Type" and "New Type". The 'Old Type' tends to wait for Henry to make a move before reacting. When approached too close, they fall onto all fours and leap at the player. The 'New Type' doesn't follow any exact attack method and will aggressively confront Henry at any opportune moment, but they do attempt to try and catch him off guard. Some can be found wielding golf clubs as weapons. It is interesting to note that the 'New Type' Gum Heads will sometimes steal melee weapons from the player when successfully hit. They represent Walter's view of men.
 * Hummer - A small, odd creature that appears to be a bat with a humming bird's head. It flies through the air making a loud buzzing sound and attacks by hovering over Henry's head before jabbing him with a sharp, needle-like beak. Hummers heavily rely on attacking in packs and will inflict great damage if left together. Later on during the second half of the game, Walter will attack these creatures for reasons unknown.
 * Toadstool / Whitestool - Disfigured, "vegetable"-like fungi that grows together in tight groups. They come in two varieties: Toadstools, which are reddish-brown and bulge at the top, and Whitestools, which are appropriately white and consist of a single stalk. Both types are immobile, and can only damage Henry if he walks into them. Whitestools are found in damp places, and can be seen to slowly grow if left alone. Toadstools are slightly more damaging, and can be found growing in corpses: if the player kills a monster and returns to the body some time later, a Toadstool may be growing from it.
 * Tremer - Leech-like creature that comes in various sizes and two colors; blue and red with the red ones being the slightly more damaging of the two. They crawl slowly along filthy floors, walls and roofs, and generally make no effort to attack Henry. However, if he walks on one or one falls from the ceiling above onto him, he will take damage. Curiously, he will take no damage if he intentionally stomps on one. Instead, they will burst upon impact from the attack or from being trod or stomped upon. As a child in the Water Prison, Walter was forced, by Andrew DeSalvo, to drink water with leeches in it. This is because Andrew overheard a conversation between members of the cult talking about the re-birth of God and this was his way of trying to help, thinking that the leeches would act as a 'fetus'.
 * Wall Man - Humanoid monsters attached to the wall at the waist; they sink into the wall and are perfectly camouflaged until they attack. They do so by swinging their powerful arms at their prey. A related monster, the One Truth, is one of the game's few boss fights.
 * Wheelchair - An ordinary wheelchair that has a will of its own and, much like the Victims, cannot be killed. Henry also suffers a severe headache whenever he is near one, suggesting that the wheelchairs are possessed. In one room found within the Hospital World, the shadow of a figure sitting in what should be an empty wheelchair can be seen on the ground. However, once the player leaves and re-enters the area, the shadow suddenly disappears.
 * Patient - Abnormally tall, feminine creatures in hospital garb, resembling maternity patients or nurses. They are first encountered in the Hospital World and usually carry powerful close-range weapons which can deal heavy damage using a basic combo technique. Walter excessively disfigured their faces and removed their wombs and lungs. The Patients tend to appear together in groups, but some are alone on various occasions. They make odd belching sounds when they are hit or when pushed down a flight of stairs. They represent Walter's birth disturbances.

Ghosts/bosses

 * Walter's Victims (Ghosts) - Victims of Walter Sullivan. Being ghosts, they are immortal and impossible for Henry to destroy. While the total number of possible Victims is 21, only 10 are fought by Henry Townshend through the game (excluding the Twin Victims, Walter Sullivan, Joseph Schreiber, and the Victim version of Henry as a part of the room 302's hauntings). Simply being near a Victim gives Henry a severe headache which gradually damages him. While conventional weapons will briefly disable a Victim, only the five Swords of Obedience are capable of permanently neutralizing them: a ghost pinned to the ground by a Sword loses its headache-inducing aura and is rendered immobile as long as the sword remains. Henry comes across six "standard" victims and four "super" Victims (see below) that are noticeably more powerful and have unique abilities. For further information on SH4s Victims, see the article on Walter Sullivan.

Normal victims
Victims with no special powers or abilities; with the exception of Victim 4, who uses a small spade as a weapon, they attack Henry by reaching into his chest and squeezing his heart. These are the victims encountered in-game:
 * Victim 1 - The ghost of Jimmy Stone, Walter's first victim. A member of The Order, he founded a sect dedicated to the worship of Valtiel. Walter killed him by shooting him in the back of the head.
 * Victim 4- The ghost of Steve Garland, a pet shop owner; may have a connection to Lisa Garland; as a child, Walter was almost bitten by a dog in his store. Walter shot him to death with a submachine gun. The animals in Steve Garland's shop were also brutally slaughtered with a submachine gun, Also his shop was in terrible condition after Walter demolished it.
 * Victim 10 - The ghost of Eric Walsh, a bartender whose establishment was located near Steve Garland's pet shop. The day that Steve Garland was murdered was Eric Walsh's birthday, and when he heard that the murderer had not yet been apprehended, he decided to go home and enjoy the rest of the day with his family. He arrived home to discover a birthday cake, and Walter, who shot him in the face.
 * Victim 12- The ghost of Peter Walls, a stoner who bought drugs from one of the priests of The Order. Walter beat him to death at South Ashfield Apartments.
 * Victim 13- The ghost of Sharon Blake, a housewife whose family joined The Order. When she went to go rescue them, she discovered that they had all been killed; she was then ambushed by Walter, who drowned her in the woods outside of Wish House Orphanage.
 * Victim 14 - The ghost of Toby Archbolt, a member of The Order and priest of the Holy Mother sect. A known pedophile, he operated the Wish House Orphanage, funding it with money made by selling marijuana to teenagers, including Peter Walls. Walter threw him off of a cliff in Mexico.

Super victims

 * Victim 16 (Cynthia Velázquez) - The ghost of Cynthia Velázquez, whom Henry first encounters in the Subway World. Walter stabs her to death. Her ghost form depicts her with long jet-black hair, which hides her entire face, and deathly pale skin. She has the ability to immobilize Henry by catching him in her hair. When she is knocked down, she emits a loud, piercing shriek and occasionally slithers away from the screen. Arguably the most persistent ghost in the entire game.
 * Victim 17 (Jasper Gein) - The ghost of Jasper Gein, whom Henry encounters in the Forest World. His body is severely charred and still burning from his death by immolation. He wields a bladed ceremonial chalice and has a very powerful ghost aura (compared to most other Victims). Jasper is also capable of quickly passing through walls.
 * Victim 18 (Andrew DeSalvo) - The ghost of Andrew DeSalvo, found in the Water Prison. His corpse is severely bloated from his death by drowning. The numbers 18/21 are carved into his stomach. Like Victim 17, he too has a powerful ghost aura which is coupled with ramming and barrel roll attacks. He is the only Victim who is capable of a semblance of speech and he can be heard singing and talking to himself in a heavily distorted voice. He tends to hover where Henry cannot reach him. Victim 18 is the only ghost who must be pinned with a Sword of Obedience in order to complete the game.
 * Victim 19 (Richard Braintree) - The ghost of Henry's deceased neighbor. Walter electrocutes him in an old-fashioned electric chair. Richard wields a pipe weapon. He attacks with tremendous speed and has the ability to teleport in flashes behind Henry. He is the only ghost that is found to walk rather than float. Richard is also charred and is "steaming" due to his death by electrocution.

Bosses

 * The One Truth - A larger, more powerful version of the Wall Man. Its attacks cause a great deal of damage.  It has the ability to scale up and down walls. Instead of appearing from the walls, The One Truth appears to be suspended inside of a metal square, with its flesh stretched out and attached to each corner.  The boss is fought along with several dummies of itself.  In order for the player to win, Henry must find and defeat The One Truth, or the real creature, amongst the dummy Wall Men.
 * Sacrificed Walter - Walter Sullivan's reanimated corpse, transforming as room 302 begins to become his "mother." It appears as a giant, decayed, hairless corpse dangling from a series of hooks. Henry must collect the spears located in the room and stab them into the giant corpse, along with Walter's umbilical cord, in order to defeat it.
 * Walter Sullivan - A sadistic serial killer come back to life as a ghost. He pursues Henry in the other worlds during the second half of the game. He is found, armed with a pistol (single or dual), a chainsaw, and a pipe. During the final battle, Walter's ghost teleports around the room, rendering him invulnerable to any attacks until Henry destroys his reanimated corpse (see above). For further information, see List of Silent Hill characters.

Common Enemies

 * Nurse - A faceless nurse creature that is first encountered by Travis in the Alchemilla Hospital. Their appearance is quite similar to those previously seen in the second and third installments, but they act more feminine-like, wield syringes, and look as though surgical masks have been melted to their faces. The nurses are fairly slow, but can be overwhelming if not taken seriously. They are capable of using a grappling attack in which the nurses will attempt to stab Travis with either a syringe or scalpel. It is notable that in the Sanitarium the nurses are colored green, but that is the only difference.


 * Straitjacket - A shambling creature that appears as if it is wrapped from head to waist in a straitjacket made of its own flesh. It closely resembles the Lying Figures in Silent Hill 2. They often appear in "packs" and will charge Travis, encircling him and spewing gelatinous balls of some corrosive substance. If they get close to Travis, they will leap up and wrap their legs around his waist, trying to suffocate him; if Travis doesn't shake them off quickly enough, they will either kill him, or spew a ball of acid in his face. The Straight-Jackets in the Otherworld Theatre are covered in blood for reasons unknown.


 * Carrion - Large creature that appears to be a skinned cow or bull, dragging its head and two front limbs along the ground. Although the creatures are quite slow and can be easily outrun, if given the opportunity they will launch at Travis with considerable strength and knock him off his feet with their head. Unlike the straight-jacket and the nurse, they do not use grappling moves. After leaving Artaud Theatre, their sizes vary, sometimes being much larger than the player. It seems to symbolize all of the roadkill that the animal-loving Travis has seen over his time as a trucker-- upon finding a series of taxidermied animal heads late in the game, Travis states that "this kind of thing makes me feel bad."


 * Remnant - A floating object that resembles a rusted harness used to restrain the mentally insane and tend to make rattling, stomping sounds while walking. Though it looks like no one is inside it, it has the shadow of a human-like figure, bleeds when attacked, and will scream in a female voice- if killed, the harness will fall to the floor and a human-shaped bloodstain will appear. The creature is found only in the Cedar Grove Sanitarium and is attracted to light. When the player confronts the Remnant, they will attack persistently until Travis leaves the area or it is killed. They can be very difficult to notice, but is easier to detect with the radio turned on. It appears to represent the sub-humane treatment in the sanitarium, hinted at in the game.


 * Ariel - A theatre mannequin of a child that represents the character from William Shakespeare play The Tempest, Ariel hangs upside-down from the ceiling or walks along the ground on its hands. They are distinguished by the rattling sound they produce, and can easily be avoided by turning your flashlight off. However, they tend to appear in pairs or groups and are able to use a grappling maneuver that will result in an instant Game Over if the player fails in getting loose. When hanging from the ceiling, Ariel will attempt to pick up Travis by his head and break his neck.


 * Twoback - A fleshy monster that has the appearance of two bodies engaged in sexual intercourse ("the beast with two backs" is a Shakespearean euphemism for 2 people copulating) fused together by a large layer of skin. They are found predominantly in the Riverside Motel, but also in the "Otherworld". The Twoback attacks by spitting acid at Travis from far away, and is extremely aggressive. Although the occurrence is rare, they are also capable of using a grappling move in which they will pin the player to the ground and deliver a powerful bite.


 * Caliban - The largest monster in the game, Caliban is a twisted memory Alessa has of the theatre's production of the classic William Shakespeare play The Tempest, in which the director used a Native American theme for all of the characters; the actor playing Caliban was dressed as a half-human, half-buffalo. It is very slow, but its stomping is very powerful. Like Carrion, it will launch itself at you if close enough and can catch up to Travis if he tries to run away- however, it mostly keeps to itself and will not attack unless Travis gets very close to it. The Caliban first appears as a boss at the end of the Artuad Theatre, but later becomes one of the common enemies. It resembles an extremely tall, faceless man covered in buffalo hair, with its legs folded backwards and over its head, arms and legs wrapped in bandages. This creature also looks distinctly alike the "Janitor" from the Silent hill movie due to both of their legs are folded backwards over its head.

Bosses

 * Momma - A manifestation of Travis' feelings towards his mother, who died in an insane asylum. She was placed there after she developed schizophrenia and tried to murder Travis under the belief that men living in her mirror wanted him dead. The creature looks like an emaciated woman with bulging eyes and a gaping mouth, wrapped from neck to feet in bandages; she is suspended in a gibbet, which moves around the ceiling on a crane. She spits poisonous gas, and causes impossibly large knives to burst forth from the gibbet.


 * The Butcher - A large creature resembling a giant, muscular man with a deformed face; he wears a strange metal helmet that only covers half of his head and face, and drags along a weapon called The Great Cleaver, slaughtering monsters and people alike throughout the town. Travis first encounters it in the Silent Hill butcher shop, mutilating a Nurse demon; he later discovers documents around town written by a Silent Hill resident that indicates at least one other person, in the real world, has seen the creature at the motel. Travis later finds The Butcher in the motel's kitchen, mutilating a Doubleback creature; he fights and kills it, and then mutilates its corpse with the Great Cleaver. Its behavior and appearance is reminiscent of Pyramid Head from Silent Hill 2 and shares a similar significance which is expanded upon in the 'Bad' ending of the game.


 * Sad Daddy - Travis confronts a demonic beast symbolizing his father, who hung himself in the "Otherworld" variation of the Riverside Motel. The creature is split into three parts and attacks with tentacles that will attempt to strangle Travis. The distorted centermost "head" vomits out geysers of blood.


 * Flauros - A large winged demon resembling traditional depictions of the devil. Alessa uses Travis to assemble the multiple pieces of an ancient artifact (also called Flauros) which releases the demonic demon of demonicnous, thus interrupting the Order's attempts to complete the "birthing of god" ritual. Travis must fight it and re-imprison it in order to escape the town. It is very possible that the demon is a creature of the "God", or the Order, because when it summons it's "rain of fire", the Halo of the Sun appeares on the ground where ever it is standing.

Common Enemies

 * Feral - A zombie dog that resembles the Groaners from Silent Hill 1. They have no skin or noticable features, and seem to attack alone. They also seem to be quite intelligent, as they will circle around Alex and use a variety of attacks. They have the ability to knock and pin Alex down, then bite him repeatedly. They are a possible reference to the Shepherd family dog, and thus Alex's lost childhood.


 * Lurker - A humanoid monster that has its legs fused together, vaguely resembling a mermaid. It appears to move using its hands, which are metal hooks. Its mouth is vertical and takes up most of its face. Any level with water promises the presence of a Lurker, as they tend to hide beneath the surface and pop up to attack with no warning. They likely represent Josh's drowning.


 * Needler - Needler is a monster that resembles a mix between a human and a spider. Its head, which has no discernible features other than two black eyes and a mouth resembling a furless hamster, appears to be between its bottom legs where its genitals should be, while on its shoulders there is nothing.  It's hands and feet have been replaced by blades which it uses to walk on and which make a distinct noise when it moves.  The blades are also what it uses to slash and attack its enemy, but it can attack by biting as well. They also have the ability to crawl along vertical walls and even on roofs. It is a startlingly fast and persistent enemy, and is tricky to kill as it can easily block attacks. Besides the sexual imagery they portray, they are likely influenced by Josh's apparent love of spiders.


 * Nurse - The classic Silent Hill nurse returns in the fifth installment wielding long, sharp knives. They have unrecognizable faces and seem to be heavily inspired by those from the Silent Hill film. They are attracted to light and sound, and can be heard approaching from a distance by the disjointed clacking on their heels. They move slowly until approached by Alex, and pick up speed as they prepare to attack. Their appearance can likely be linked to Alex's time served in the military, hinted at in his journal that he believes the military intentionally provides its nurses with sexual clothing, this concept later coming into play in the game.


 * Schism - Like the first boss of Silent Hill 1, its elongated head is split down the middle (making it look like male genetlia) with a hammer shaped, sharpened bulge at the end, but the rest of its body resembles a human. They scuffle on two feet and move quickly. They attack mostly by swiping at Alex with the sharpened tip of its head, but a special attack from this creature - rearing back and catching Alex in a death grip between its split halves - can prove to be tremendously fatal on even moderately low health.


 * Siam - A creature that combines two mutilated bodies, one of a man and the other a woman. On the back of Siam is the female side while the male side serves as the front. The two are bound together by a green bondage suit with the heads being fused as one whole. Both faces lack eyes and are wrapped in leather strips. The female's arms dangle in front of the male's face, but his are largely swollen in a similar fashion to the Closer's from Silent Hill 3 and the Mandarins from Silent Hill 2. They are quick and highly destructive. Siams can be considered a common enemy, but they don't show up quite as frequently as most of the other monsters in the game do. Their posture and movements are similar to the Missionary of Silent Hill 3. Like the Needlers, they have a spiderlike appearance, and for the same potential reasons. The Xbox achievments hint that they are a reference to James Sunderland from Silent Hill 2.


 * Smog - A deformed, humanoid creature that has been described as a variation of the Lying Figure from Silent Hill 2. It can be heard from a good distance away - scuffling and choking on its own smog. The Smog is somewhat hard to kill, even with a shotgun, unless the player waits for it to expose its weak point - the lungs. Its rib cage parts opens, revealing the inflating lungs, and it attempts to poison its victim by spewing forth its toxic gas. It appears to be scorched and the lumps on its skin depict charred flesh and burning ash. This incarnation resembles the burning children from the Silent Hill movie.


 * Swarm - Huge insects the size of footballs, these creatures hint to the giant insects in most other Silent Hill games. These ones are different however, in the fact that they can fly short distances given their new, more beetle like form. They attack in swarms, and will crawl all over Alex, biting him. You must shake them off in a similar manner to the Feral's. They accompany Pyramid Head in a simmilar way to in the movie and the arcade game, but to a much lesser degree, as only a small group scuttle around him.


 * The Order Members - Human enemies who closely resemble the members of the cult in the Silent Hill film, hidden in thick coal miners suits and gas masks. They first appear in the Hell House stage.

Bosses
Curtis - Although this is not technically a "Boss Fight", Alex kills the junk yard manager during the final part of the game in order to save Elle.


 * Bogeyman - Returning from Silent Hill 2, "Bogeyman" or "Pyramid Head" as he is more popularly known as imbodies his movie incarnation more than his previous game forms. His great knife is given the appearance of a huge combat knife, a hinter to Alex's wartime past. In the 'Judgment' ending, Alex is turned into a Bogeyman by two others, and he then roars. His new name is revealed in the Silent Hill Homecoming walkthrough by Brady Games, and is also implied in a series of drawings found in the game. It's worth noting that, despite the creature's return, Alex does not face this monster in combat.


 * Sepulcher - One of the first bosses you face in Silent Hill: Homecoming, this monster appears to be a giant deformed man with very long arms who is supported by, for lack of a better word, meat-sacks. The man's torso appears to be heavily deformed and ripped in half.  It is missing its legs while its long and thin arms are still in-tact.  Its face lacks any eyes, although its teeth are visible and its jaws are always open with black tentacle-like things jutting from them.  At the second half of the boss battle, it drops to the floor where it supports its weight with its two front arms while alternately trying to swipe and smash at Alex with one at a time. It is heavily implied by the dialogue (and somewhat confirmed during the cut-scene where Alex kills Judge Holloway,) that it is meant to be a representation of, or physical embodiment of Joey, the mayor's missing son. It is that implied that Joey was buried alive by his father, Mayor Bartlett as a sacrifice to their God.


 * Scarlet - Appearing similar to a porcelain doll, she is extremely tall and thin, with an almost dinosaur lope to her walk. Her mouth is filled with razor-like teeth. Hacking away at her legs and avoiding her swiping attacks will eventually cause her to fall to her knees, where Alex may attack her back. After she is weakened, she becomes a faster, harder enemy to defeat. She skitters desperately around the room on all fours like a spider, climbing up across the ceiling, and dropping down to attack unexpectedly. Like the other bosses, Scarlet represents one of the sacrificed children, in this case Scarlet Fitch. Dr. Fitch dismembered her, the removal of limbs resembling a doll's joints. According to Dr. Fitch and as seen from her room, Scarlet loved dolls.


 * Asphyxia - Asphyixa was first revealed by an artwork leak at the end of 2007. It appears to be almost centipede-like with many legs. However, all of its limbs and flesh is that of a human female's, with great emphasis on sexuality and also suffocation: hands cover up its breasts and genitals, but also appear to be gripping the throats of some of its heads while others cover up the main head's mouth. Represents the death of Nora Holloway, Elle's little sister, and the betrayal between mother and daughter that occurred with Nora's murder.


 * Amnion- The final boss in the game. A giant spider-like monster with metal limbs. Four of its limbs are used for walking while two others located in front of the creature are used for attacking. The two attack limbs are tipped with an assortment of bladed weapons. At the center of the legs there is a human body hanging down from the spiders steel structure by hooked wires which pull at its flesh. It has a bloated stomach which the player discovers after defeating the creature contains Alex's brother, Josh. Most disturbing of all the creatures head is a face stuck to an accordion-like device that allows the face to move forward and backward a distance of two feet or so. The face also has a similar appearance to Alex's and Joshua's mother. A picture that Alex finds at the playground adjacent his house showing a giant toy spider towering over a toy man and car serves as a prelude to this boss. It likely represents birth and Joshua's drowning, as well as yet another stab at spiders.

Divine Creatures in Silent Hill

 * God/Samael - The female solar deity worshiped by the Silent Hill cult. According to their dogma, God was born from two humans, who offered their prayers to the sun, and brought an end to the suffering of ancient man by taking away eternal life from humankind. She created many gods (including Xuchilbara and Lobsel Vith) and angels to help lead people to her. Then, she set out to create "Paradise" for people, but her strength ran out and eventually it caused her death. However, she promised to return again one day.

In Silent Hill 1, Dahlia offers her own daughter, Alessa, as a sacrifice to impregnate her with God. The God is forced out prematurely by Kaufmann and takes on a hideous demonic form. Harry slays the malevolent deity soon thereafter. Claudia Wolf tried to get Heather to remember her "true self" in order to birth God in Silent Hill 3. Claudia's idea was to have God born and usher in Paradise. The role of Mother of God was shifted when Heather exorcised the deity by vomiting the fetus up, which Claudia then swallowed, resulting in her demise. Because Claudia gave birth to the God it takes a similar appearance to that of Alessa, the form of God that she believed in. Due to its state of birth the lower half of its body remains immature. It has been further explained that the appearance of the God changes depending on the person who summons it and can be considered equal to the other monsters. Likewise the cause may be attributed to the town's power to manifest delusions.

The name Samael was first used by Dahlia in Silent Hill 1, calling the Seal of Metatron the Mark of Samael. Because of this, most fans believed that the symbol Alessa spread through the city was evil; but at the end of the game we discover that Dahlia was lying about the true nature of the Seal, and that Alessa was placing it all around the city to stop Samael (it seems that Metatron is Samael's nemesis).


 * Lobsel Vith - The yellow god, referred to in the paintings in The Chapel in Silent Hill 3 and one of the beings said to be made to lead people in obedience to God. The nature, appearance, and purpose of Lobsel Vith is unknown, as nothing is explicitly stated about it in any of the games.


 * Xuchilbara (Xuchilpaba) The red god of Silent Hill and one of the beings mentioned in a painting in Silent Hill 3 created to lead people in obedience to God. A god of judgement, Xuchilbara presides over rebirth and has been known to be used in a ceremony to resurrect the dead, called the "Crimson Ceremony". It should be noted that the etymology of Xuchilbara's name is Nahuatl for flower and Japanese "bara" means rose. This character is also mentioned by name briefly near the end of the Silent Hill2 sub story 'Born from a Wish'


 * Metatron (Metratron) - Metatron is another archangel mentioned in the series, known to be a messenger for God (YHWH in Judaism) in Abrahamic religions, and is consider to be second only to 'Yaweh' himself in Judaism. Metatron is only explicitly mentioned in the series through The Talisman Of Metatron or Seal of Metatron (also known as the Virun VII Crest.) in Silent Hill 1 and Silent Hill 3. . The seal was said only to be given the name Metatron because of its difficulty to control. In Silent Hill 1, Alessa uses the seal in order to prevent the birth of God by spreading it in various locations in Silent Hill. Heather in Silent Hill 3 attempts to use the Seal Of Metatron against Claudia Wolf, but it does nothing. It is also important to note that both Metatron and Valtiel were described by Hiroyuki Owaku (Silent Hill scenario writer) as "agents of God" in the Book of Lost Memories.


 * Hagith, Phaleg, Ophiel, Aratron and Bethor - These five beings, known as the Olympic Spirits, are involved to help get past the last area in Silent Hill 1. Their significance is trivial but they represent planets in Greek mythology, and along with two other powerful spirits, Och and Phul, they form a group of relative significance to the kabbalah known as the Arbatel.

Common Enemies

 * Gumhead - A common enemy that first debuted in Silent Hill 4: The Room. Their design has been simplified considerably, and these Gumheads are gray with darker splotches that resemble vascular birthmarks. In later areas of the game, their faces become distorted, their arms bloody, and they seem to be wearing leather trousers. They also have the disturbing ability to literally give birth to Creepers when they die. In their final appearance, they are greenish, and resemble their first incarnation more than their second.


 * Creeper - These creatures look like large cockroaches and leap up onto the screen to bite your character. They are initially summoned by Pyramid Head in his boss fight sequence, but then appear several more times without him. This enemy first appeared in the original Silent Hill.


 * Nurse - A staple of the series, making appearances of one sort or another in almost all of the Silent Hill titles. The obscured head (and especially face) that has been a part of this creature since Silent Hill 2 returns again in a slightly different form, as their faces are bandaged up completely but they now have well-groomed shoulder-length hair. They seem to carry either an iron pipe or a pistol, and they move in odd, bounding strides, as if in some parody of a thief sneaking silently through the night.


 * Scraper - A common enemy from Silent Hill 3. They fight with dual rotating blades and may be tinged either red or blue. The only other difference in their appearance from Silent Hill 3 is that their faces are covered not by folds of skin but by what looks like some type of rough veil.


 * Toadstool - Identical to previous game version, but this version is much larger and attacks by spraying acid or ramming the player. They are often found around the corpses of insane cancers.


 * Robbie the Rabbit - The mascot of the Lakeside Amusement Park. There have been occasional hints before that Robbie the Rabbit might have a more sinister nature (one example is an extra costume Heather can equip, which features one Robbie standing over another with a bloody weapon, and the words "Red Robbie Wins"), but this is still the first time it has actually appeared as an enemy creature. Like all of the other monsters, Robbie's appearance has been changed slightly, and it no longer has a bloody stain on its mouth. They can be found using an axe (which can be thrown), metal pipe, knife, hunting rifle, pistol or chain saw.


 * Groaner (unofficial name) - Similar in design to the Split Head enemies from Silent Hill 3, medium-sized dogs covered in bandages of peeled flesh. These creatures also have similar attack patterns to previous dog-type enemies in the series.


 * Numb Body- Yet another enemy from Silent Hill 3, these Numb Bodies are white in color rather than pink and have long tails now in place of the more familiar spikes on their backs. Also different from their previous iteration is the fact that there are no small Numb Bodies in this game, only large ones. They can also lean back and spit balls of acid, hinting that the black mark on their "head" isn't an eye, but is actually a mouth.


 * Hummer (unofficial name) - Small, raven-like creatures with small heads and long pointed beaks. They may hover motionlessly for long periods before attacking, and move in swarms. Later in the game, they take on a more demonic appearance, their wings turning fleshy and developing spikes.


 * Tremer (unofficial name) - Similar to their console counterparts (Silent Hill 4: The Room), but flesh-colored and smaller now. They attack in the same way that the Creepers do, however some explode into green goo rather than leaping onto you.


 * Insane Cancer - Both taller and wider than the similar enemy in Silent Hill 3, this version is also much weaker. No longer covered in blood or greenish pus, they now have a long slit down their bellies, and more distinct heads. Near the end of the game, however, this monster does get its grubby, Silent Hill 3 appearance back.

Bosses

 * Red Pyramid (Pyramid Head) -Pyramid Head: Originally introduced in Silent Hill 2, this boss monster bears a stronger resemblance to his incarnation in the Silent Hill movie. Accompanied by a copious amount of Creepers (this is also truer to the movie than any of the games, although large insects like these have made appearances as enemies in the original Silent Hill as well as Silent Hill 2), he wields his signature weapon, the Great Knife, and first confronts Eric and Tina in the Brookhaven Hospital, curiously accompanied by the sound of a boat whistle, which seems to also signify shifts between the real world and the Otherworld, an event that's been signaled in the past by the sound of sirens. He is fought a second time later in the game between the Marionette and Phantom bosses. His appearance is still similar to Silent Hill 2, although he's noticeably much bigger and muscular.


 * Guardian (unofficial name)- This creature has the appearance of a huge Gumhead crossed with a Numb Body and a dragon. The massive humanoid creature twitches and thrashes around constantly, as if it were in pain. One of its hands is a huge axe blade which it strikes you with and another claw hand. It has wing-like skin flaps under its arms, but even though they are tiny, the creature has the ability to fly. However, it never flaps its "wings" which means the it may not actually use the flaps to fly, and uses some other method, such as telepathy, and only uses the flaps to "steer." Its face is elongated with a mouth full of huge fangs and the skin around its head is torn, revealing many black eyes and muscular tissue underneath. It also has a fleshy bulge on its chest which is seen as its "weak point." The creature knows this however, and sometimes shields it with its hand or axe. The creature is found guarding Emily, but is later revealed not to be holding her hostage, but keeping her safe from the other creatures, but it couldn't differ between them and you.


 * Greedy Worm - A minor boss fought before the Split Worm. Unlike in Silent Hill 4, this creature becomes hostile and tries to consume you, however it still can't be killed, only repelled slightly. After it is fought for some time, it disappears around a corner and is never fought again.


 * Split Worm - Unlike the previous boss fight in a series of tunnels, this creature is fought in a pool of brown liquid. It also has the ability to spit "Tremers." Otherwise, it attacks in the same way as its previous game counterpart.


 * Marionette - This creature resembles a giant female creature made of mannequin parts. It has long arms and legs, a human face and distorted mouth, which can spit Creepers.


 * Phantom - The final boss of the game, this creature is in fact Emily but who is possessed by Hanna and her evil mother. It resembles a huge deformed severed head with long tentacles rather than hair. It can generate a huge hand from its mouth and can create multiple smaller ones from the floor. Killing the smaller ones isn't necessary, but changes the game's ending.

Film adaptation
Several creatures from the first four installments made a big screen appearance in the Silent Hill film adaptation. All of the creatures, with the exception of one, are present in the previous games. There are many possible explanations for why the creatures are present in the film but Director Christophe Gans stated that the simplest explanation is that the creatures are victims of Alessa's vengeance. However, Gans first specified that every interpretation was possible and further listed that the monsters could also be hallucinations from the psyche of the protagonists.


 * Grey Child [Silent Hill 1] - They do not wield knives like their video game counterpart, but instead use their clawed hands to grab and drag their victim. Their appearance has been altered to look blackened and smoldering. The Grey Children emit a high-pitched shriek and are seen swarming Rose Da Silva when she chases an image of Sharon, quite similar to what Harry Mason experienced during the first game. They represent Alessa’s pain when she was being incinerated by the cult.


 * Creeper [Silent Hill 1 & 2] - Thousands of these creatures crawl around Red Pyramid in Midwich Elementary School where Rose first encounters him. They are later seen swarming members of the religious cult and finally crawling through the hole made by Red Pyramid to attack Cybil Bennett and Rose. When Cybil stares down at one of the upturned insects, she discovers to her horror that it bears a small, screaming, human-like face.


 * Dark Nurse [Silent Hill 1, 2, 3, Homecoming and Origins] - The movie representation of the nurses closely resembles the Bubble Head Nurse, including voluptuous figures, monstrous and disfigured faces, and suggestive clothing. They react strongly to light and, while most of them wield scalpels, one is seen holding a pipe in the film. The Dark Nurses move and attack in groups and, when attempting to attack Rose as she sneaks through them, they ultimately end up stabbing and cutting each other. They also make soft, feminine moans and whispers and seem to "creak" when they make sudden movements. These nurses had been adapted into the new Silent Hill: Homecoming game, completely unaltered and entirely based on the movie version of the Dark Nurses. The idea behind the "Dark Nurse" is realized when Alessa is hospitalized. A nurse, curious as to what’s in the container, peeks in to see the horribly burnt Alessa. Enraged, Alessa uses her powers to take away the nurse's eyes. In the movie you will notice the nurses have bandages wrapped around where their eyes used to be. The nurse’s natural attraction to the light is symbolic of the blond haired nurse’s attraction to the container.


 * Lying Figure [Silent Hill 2 and Origins] - A humanoid demon that resembles a badly burnt patient wrapped in a straight jacket. This humanoid demon is seen attacking Cybil by spraying her with an acidic, tar-like substance after she arrested Rose. Although Rose gets away during the confrontation, Cybil kills the creature and notices that there are many others wandering in the edge of sight. This is notably the only creature that appears in the foggy world. The creature's look is less bloody than it was in its game incarnation. This creature is listed as "Armless Man" in the film's ending credits. The lying figure represents Alessa's mental breakdown while in the hospital.


 * Red Pyramid (Pyramid Head) [Silent Hill 2] - A lumbering, monstrous figure that is depicted wearing a black, four-sided Tetrahedron instead of the five-sided one from the original game. His apron is extended from the waist down and appears to be composed of human flesh that has been stitched together. In his first appearance he is accompanied by Creepers and he is seen wielding the "Great Knife" weapon just like in the second game. Red Pyramid displays his characteristic strength and brutality when trying to kill Rose and her companion. He later catches Anna, holding her in the air with only one arm, tears off her dress, and then grabs her chest and tears off all of her skin in a single movement. Red Pyramid is described by the producers during the making-of features as being punished by having to wear the trademark helmet. Director Gans also stated that his appearance was based from the female perspective of the characters..


 * The Janitor - A monster that was created by director Christophe Gans and Paul Jones' SPFX team specifically for the movie. Rose discovers him while searching for her daughter at the Midwich Elementary School. While fleeing a trio of cult members, she stumbles into the school's washroom where she encounters the Janitor. He resembles a man bound by barbed wire, and is wearing a ripped janitor's uniform with a name tag reading "Colin". Located behind him on the wall written in blood are the words "Dare you, dare you, double-dare you" with an arrow pointing into his mouth where a key chain from a hotel is found. After the shift to the otherworld, he escapes from his confines in the cubicle and crawls toward Rose with his feet still bound to the back of his head. When he touches the wall, it decays and holes appear that spawn Creepers. Gans stated that series' composer Akira Yamaoka approved of the creature during post production and even asked if he could use it for a future Silent Hill game. The creature design bears a striking resemblance in style and action to the Victims (Ghosts) from Silent Hill 4: The Room as both are capable of decaying the wall surfaces and corrupting the environment around them. The origin of the creature comes from when the school janitor, Colin, molested Alessa in the washroom shortly before her near-death by burning. She finally got her revenge upon the man after gaining her powers, by manipulating a mass of barbed wire to permanently contort and bind his body. He appears as a lifeless corpse in the foggy world.
 * Alessa Gillespie [Silent Hill 1,3 & Origins] - The physical body of Alessa makes an intimidating appearance inside the church in the movie's finale. Being unable to move, the hospital bed upon which she has lain for 30 years has become part of her monstrous guise. She controls hundreds of tentacle-like barbed wire strands that sprout from the bed and uses them to massacre all of the cult followers. There is a striking resemblance between Alessa's film incarnation and the Mary/Maria boss that protagonist James Sunderland was forced to attack in Silent Hill 2. However, Gans stated that the ending was inspired by the erotic anime Legend of the Overfiend after budget constraints forced him to create a new finale with this design for Alessa.