After coming to, Harry stood up from the wreckage and took a look around. It was the spot of their vacation destination, only something was seriously wrong. There were no pedestrians or cars around; he was seemingly alone and his daughter was missing. It was snowing – something seemingly impossible during the summer months and the air was filled with a thick, dense fog.

Much like the Resident Evil series, Silent Hill is played from a third-person perspective in a world emphasizing on elements of horror and fear. It focuses on realistic character controls – Harry runs and acts like an average person; he'll get tired after constantly running around and begin to breathe heavily. Because most people lack the knowledge of operating firearms, Harry has an inaccurate aim meaning he often misses his target.

Unlike other survival horror games (circa 1999), Silent Hill takes place in a seemingly real town – road signs and park benches are strewn about on each sidewalk and the buildings are modeled with names and window dressings. Instead of rummaging around through biochemical laboratories and big mansions, Harry will search for his daughter through an elementary school, a hospital and the town's many streets.

While walking down the various roadways, caution must be practiced – horrific creatures are lurking about; hellhounds are ready to pounce on you, flying and seemingly skinned pterodactyls hover around, and little mummified babies with knives are prepared to end Harry's life. Fortunately, he has been supplied with a pocket radio that emits noise and static when an enemy is approaching – will you run or will you face the unknown terror?