On the wall of Ashley's bedroom, you can find a poster of the previous game's Japanese box art, released under the title "Clock Tower 2", and featuring Jennifer. When examined, Alyssa remarks "This isn't a game!" in reference to it being localized outside Japan as the first Clock Tower game despite it being a sequel, since the actual first Clock Tower game was never released outside Japan.

Despite having a number in its Western release the game is actually a spin-off. Released originally in Japan as Clock Tower: Ghost Head the game bears little to no connection to the series' two previous titles. It was given a number in the title due to the original Clock Tower never getting a Western release and the second game losing its numbering outside of Japan.