Possessions
Throughout the latter part of the game, your apartment will become possessed and/or haunted. If you took the Shabby Doll that the mysterious man gave you inside of the Apartment World, Ghosts will slowly come into your apartment. No matter what, however, your apartment will become possessed from time to time. You must eliminate these possessions by lighting Holy Candles near the possessed item, or equipping a Saint Medallion once you go near it.
Moving Loading Screens
Whenever you enter a new room and get the loading screens with the weird symbols, move the left analog stick around and watch as they move across the screen.
Creepy Call
Whenever you walk around in Henry's apartment, go to his bedroom and look out of his window. If you notice, you will see a billboard that says "Bar Ashfield" on it and right below it as a phone number. Then go to his phone next to his bed and dial: 555 - 3750. It will play a little creepy call makes Henry feel disturbed.
Silent Hill 3 Cameo
Sometimes if you look out of Henry's windows, you may see a hot air baloon in the sky that has the Silent Hill 3 bunny rabbit from the amusement park as its design. You will also see the bunny as a stuffed animal if you look through the hole in the apartment where you can see Eileen's room.
Endings
There are four endings in Silent Hill 4: The Room: Escape (the good ending), Mother, Eileen's Death, and the 21 Sacraments (the bad ending). Ironically enough, the worst ending is the most interesting, and the best is the least interesting. To get Escape, you must take good care of Eileen and your room. For Mother, make sure Eileen is okay but disregard your room. For Eileen's Death, disregard Eileen's safety/sanity but take care of your room. For the 21 Sacraments, don't bother with either of them.
Fifth Alternate Ending
Successfully complete the game four times and earn the 4 different endings. Play the game again using the same save slot and select Eileen's nurse uniform. If you complete the game a fifth time, hold Triangle and Circle before the ending to see the special UFO fifth ending.
Submachine gun
Successfully complete the game with a rank of at least 9 big stars. Start a game in "Brand New Fear" mode and look in Room 202 in the Apartment World to find a submachine gun for Eileen.
Brand New Fear mode
Successfully complete the game under any difficulty. Save the game after the credits complete to unlock the "Brand New Fear" option .
One Weapon Mode
Get 10 big stars in hard mode.
Cynthia's Special Costume
Finish the game with all four endings on one slot. Start a new game and select Eileen's nurse uniform to have Cynthia wearing her special costume.
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