Based on the 2001 game Silent Hill 2 by Konami.
Announced during Konami's "Silent Hill Transmission" presentation in October 2022 alongside four other Silent Hill games, including a remake of Silent Hill 2, which serves as the basis for this film.
Director and screenplay writer Christophe Gans has said that Silent Hill P.T was the inspiration for this film.
Christophe Gans has confirmed that the monsters will be played by dancers and acrobats in prosthetic makeup like in the first Silent Hill (2006).
The design of Pyramid Head / Red Pyramid is redesigned from Silent Hill (2006) and Silent Hill: Revelation (2012). This iteration has his upper body clothed with naked arms (as opposed to bare chested) and a flat surface on the front side making his appearance much closer to the game counterpart in Silent Hill 2 (2001).