Endings

As traditional in Silent Hill, Silent Hill 4 contains multiple endings. A total of four endings can be achieved, and for the first time all endings in the game are serious and normal endings. Therefore, there are no joke endings and so there is no UFO ending, unlike the past three games. This section discusses the four endings in the game and the requirements to get them.

How the Ending System Works
Similarly to the first Silent Hill, there are two factors that decide which ending you get, and between those two factors, one can be done and the other not done and vice versa, both can be done, or none can be done. With that, four endings can be achieved. These two factors only come into play past halfway through the game, and continue until the end of the game. The following looks into the two factors and their results.

The first factor is whether Eileen lives or dies in the final boss fight, and Eileen's condition plays into part here, which can be quite a nuisance. Once you meet up with Eileen in the Hospital World, you're responsible for taking care of her until the end of the game. Eileen does not have an actual health status, and she can never actually die, however, her condition is what matters. At the time when she leaves you at the end of Outside Room 302, her state of condition is what affects how fast she walks in the final boss fight with Walter. When she's on the walkway, she'll slowly walk into the pool of blood ahead of her, to her death, and the worse her condition is, the faster she'll walk. You can tell what her condition is at any time she's with you by looking at her back.

When you initially meet Eileen in the hospital, she's perfectly fine in terms of her status, although she limps and has numbers carved into her back. Her back is all clear except for the numbers and this is good. However, as she takes damage or if you leave her all by herself for a bit, her back will show blood flow and it increases to a very noticeable state. At her worst, Eileen's back will be dark red with extremely visible blood flow all over her body, which is best seen from the back. At this state, she is in very poor condition and is somewhat possessed – sometimes she'll partly turn into a Ghost Victim for a second and smack herself to stop it. If Eileen is in this state before she leaves you at the end of Outside Room 302, she'll walk really fast on the platform in the final fight and you probably won't be able to save her.

If you want to ensure Eileen's survival protect her well when fighting monsters, and don't leave her alone a room too often and for too long when you're off doing something else – make sure she's right behind you before you go through doors, or you may lose her and forget about her, increasing the bloodflow on her body and moving more towards her possessed state. There is a Holy Candle trick that recovers Eileen's condition (read more about this in the Extras section), but it only works temporarily and doesn't always end up working even if you perform it right before Eileen leaves you in the apartments. To save Eileen in the boss fight with Walter, it's important to work quickly with precision. When Eileen walks into the pool of blood and gets eaten up by the mechanism, you'll clearly hear her scream and that means she's dead. If Eileen dies, you'll receive one of the two endings where Eileen dies, and you'll receive one of the two endings where she lives if you save her. The factor that determines which of those two endings you'll receive is described below.

The second factor that determines which ending you get is the status of your apartment, meaning the presence of hauntings. Past halfway through the game, hauntings will start appearing in your apartment. Whether you leave your apartment alone or purify is the factor here. If you clear at least 80% of these hauntings before the end of the game, you'll receive one of the two purified apartment endings; if you don't clear them, you'll receive one of the possessed apartment endings. Instead of trying to clear 80%, just clear all of them whenever they appear to be safe.

Putting these two factors together, they work to determine one of the four endings. Each factor cancels out two endings individually, but when they work together they eliminate three endings to determine a final. If you save Eileen in the final boss fight, you'll receive one of the two Eileen survival endings (Escape, Mother). If you clear more than 80% of your apartment hauntings, you'll receive on of the two apartment clear endings (Escape, Eileen's Death). If you don't save Eileen in the final boss fight you'll receive one of the two Eileen death endings (Eileen's Death, 21 Sacraments). If you don't clear 80% of the hauntings in your apartment, you'll receive one of the two haunted apartment endings (Mother, 21 Sacraments). You should be able to determine which ending you'll get from doing what from this description, but you can read about each ending below and their individual requirements.

The Endings
The following are the four endings of Silent Hill and the requirements to get them. Unlike the past three games, each ending is available the first time through the game, thanks to no extra endings.

Note: If you have difficulty saving Eileen in the Final Sacraments battle and you want to save her to get a certain ending but you can't, you probably won't be able to save her, anyway. This may be because her status when she left you in the apartments was so terrible that she walks too quickly on the platform to save her. So if you can't save her, just let it go and try it another time, with more concern for Eileen when she's with you.

Escape

The happiest ending in the game, which is perhaps the hardest ending to achieve, although none are truly hard to get. To get the Escape ending, the player should be concerned about the health and safety of Eileen, and also be aware and take action against the hauntings in Room 302.

The player must clear at least 80% of the hauntings in Henry's apartment before the end of the game, and to make sure of this, it is important to clear each haunting as it appears. Don't pick up the Shabby Doll either, because that will just make things harder. As for Eileen, Henry must save Eileen in the Final Sacraments battle with Walter at the end of the game, by defeating Walter before Eileen steps into the pool of blood and dies. To ensure her survival, take good care of Eileen once you retrieve her from the Hospital World, and try not to let her engage in your fights, for her protection, and don't leave her alone often.

-Clear at least 80% of the hauntings in Room 302
-Save Eileen in the Final Sacraments battle

Mother

To achieve the Mother ending, the player should show compassion towards Eileen and her condition, but not be worried about the state of Room 302.

Eileen is the only worry here, and she must be saved in the final battle with Walter by defeating Walter before she walks into the machinery. Be sure to be on watch of her condition so she walks slow enough in the final battle, and don't leave her alone too often because you don't want her to become possessed and walk very fast. As for Room 302, the apartment room must not be cleared in order to get the ending, so don't clear any of the hauntings for assurance.

-Save Eileen in the Final Sacraments battle
-Do not clear 80% of the hauntings in Room 302

Eileen's Death

The result of this ending is quite obvious, as the name disallows anything to be hidden. With this ending, the player is not awfully concerned about Eileen's condition and her protection, but is concerned and responsive to the hauntings in Room 302. Quite ironic, actually, and selfish.

The hauntings in Room 302, at least 80% of them, must be cleared in order to get this endings, but there is no worry for Eileen. Feel free to let her fight alongside Henry for convenience when fighting monsters, and don't worry about ditching her whenever necessary – you'll still need to retrieve her to continue on to different worlds, though. To make things easier with the hauntings, don't pick up the Shabby Doll.

-Clear at least 80% of the hauntings in Room 302
-Do not save Eileen in the Final Sacraments battle

21 Sacraments

The player must show generally no true care whatsoever about anything, not worrying about the growing hauntings in Room 302 and not too concerned about Eileen's safety.

Henry is without a worry in this ending, not required to do anything at all. Working along that, however, your "requirements" are to not save Eileen in the final battle, so you can drag her along with you, ditch her, let monsters beat her up, and whatever – just remember to pick her up to continue on –, and also to not purify Henry's apartment. Be laid back without a care and just go along with everything. As a result, not only Eileen dies, but so does Henry; hence the "21 Sacraments".

-Do not clear 80% of the hauntings in Room 302
-Do not save Eileen in the Final Sacraments battle