Silent Hill 4: The Room is the fourth installment in the Silent Hill survival horror series. The game is similar to the past entries in terms of atmosphere, never letting the player know what's behind the next corner or down the street. Aside from the traditional third-person-view, there is now a first-person mode which is used to control the main character when he is in his apartment. Objects that can be interacted with are highlighted by eyeball icons. The previous games in the series have mostly been about exploring the town and solving puzzles, but this installment has much more combat involved. There are more enemies in a given area, spread in cramped spaces. The main character mostly uses a standard Silent Hill arsenal of weapons, such as the steel pipe, pistol and a golf club.

Henry Townshend is living in South Ashfield, a city that's half a day's drive away from Silent Hill. He is content with his life, living in the South Ashfield Heights apartments. However, one day he finds himself mysteriously locked in his own apartment, Room 302. Along with experiencing strange and nightmarish dreams, he cannot escape through either the windows or his front door, which has been chained shut from the inside. No one, not even people standing directly outside of it, can hear him when he pounds on the door and cries for help. Henry explores his apartment, trying to figure out what is happening, when he spots a giant hole in the wall of his bathroom. Henry goes through the hole, only to find a portal which leads him to alternate dimensions.