Not being limited to simple character introductions, the opening depicts events that take place prior to the start of the game. After the "Good+" ending, the image in one section of the opening is altered.

01. A photograph of Alessa is projected following the words, "The fear of blood tends to create fear for the flesh.".
02. Harry stands with his wife holding a baby in his arms. Although it doesn't appear in the main part of the game, this image is probably from the moment when Cheryl was found.

03. Cheryl stands amidst the fog. Harry comes to wander about the town of Silent Hill in his attempt to find her.
04. Harry awakens on the sofa in the cafe. He was dreaming that he was pursuing Cheryl and had lost his way in the otherworld.

05. The nurse Lisa crawls out from under the desk where she was hiding. This image is from the scene in which she runs into Harry for the first time in the hospital.
06. Dahlia turns around as she becomes aware that Harry has entered the church. Behind her is an image of Christ on the cross.

07. Only for an instant, a vision of Alessa appears in the boiler room in the basement of the elementary school. She looks older than she does in the photograph in 01.
08. Imploring him to help her, Lisa clings to Harry. She appears before him whenever the world is transfigured into the otherworld.

09. Having killed a creature with his gun, Kaufmann feebly sits in a chair. This image is from the scene in which he encounters Harry for the first time in the hospital's examination room.
10. Cybil walks up with a mysterious smile. When she encounters Harry in the cafe, she is not yet aware of the seriousness of the situation.

11. A single car drives up a deserted county road. Riding in the car are Harry and Cheryl, who are going to Silent Hill for their vacation.
12. Nodding off in the passenger seat, Cheryl holds the sketchbook that Harry gave to her. Later, this sketchbook is found in the otherside alleyway.

13. A woman whose skin is inflamed as a result of burns and is wrapped in bandages which cover her whole body. This is the only image seen of Alessa suffering in her sickbed.
14. After getting confirmation over her wireless, Cybil leaves the room in a haste. This is a depiction of the sequence of events prior to her arrival in Silent Hill.

15. Drawing near to Kaufmann, Lisa quarrels in a vehement tone. The fact that the matter of Alessa's nursing is at hand indicates the subject of their dispute.
16. Lisa laughs as if possessed by something. Could this be the state induced by the drug administered to her by Kaufmann?

17. Driving alongside Harry's car, Cybil uses her fingers to signal something to him. She passes Harry and continues to drive on head.
18. Immediately afterwards, for unknown reasons Cybil's bike is rolled over on its side. His attention attracted by the bike, Harry is unaware of the imminent danger he is in.

19. A close-up of Dahlia looking back in bewilderment as she becomes aware of someone's presence. This is yet another image that doesn't appear in the main part of the game.
20. A single house surrounded by disused telephone poles and a pool of water. Could this be Dahlia's house where Alessa was burned in the fire?

21. Harry hurriedly turns the wheel as he realizes that someone has appeared suddenly in front of the car.
22. In front of the car is a young girl with the same appearance as in 07. Could the female figure that Harry saw really have been Alessa?

23. Upon attaining the "Good+" ending, the image in 02 is altered. Cybil replaces Harry's wife.

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