Silent Hill: Book of Memories is a Silent Hill role-playing spin-off game exclusively for the PlayStation Vita. The primary focus of the gameplay is on dungeon-crawling and cooperative multiplayer action, rather than the survival horror elements that the series is known for. Players can work together as they explore several different Otherworlds, solving puzzles and defeating creatures to advance through the Nightmares and uncover the truth behind the Book of Memories. Scare rooms, limited resources, and dark atmosphere all return but in a gameplay package specifically designed to take advantage of the PlayStation Vita handheld entertainment system.

The protagonist receives a strange book on his birthday from an unknown sender in Silent Hill. All of his memories are written there, and by altering the book, he finds that he can alter past events in his life. Before the changes take effect though, the character falls asleep and must survive a nightmare, explore the Otherworld and battle creatures from previous Silent Hill games on the way.