
In the Australian and German versions of the game the cutscene where Spoiler:Pyramid Head kills Alex's father is censored by removing the body.
The song, "Wintery Mist", sounds almost identical to "Winter Tundra" from Spyro 2: Ripto's Rage.

Originally Alex Sheperd was meant to have a blonde look with a more militaristic appearance, however he was later re-designed to look younger and more "average". His original "blonde" look was left in some of the game's loading screens as a mistake.

Travis Grady, the main character of Silent Hill Origins, makes a cameo appearance at the beginning of the game, being the truck driver who gave Alex Shepherd a ride to Shepherd's Glen.
The opening of Homecoming is a homage to the film Jacob's Ladder.