Among the influences on Silent Hill 3 are the film Jacob's Ladder and the works of horror novelist Stephen King.

Silent Hill 3 sold over 300,000 copies by November 2003 and was well-received by critics, garnering praise for its presentation, including the environments, graphics and audio, as well as the overall horror elements and themes that are continued from past installments; although there was minor criticism of the game's short length, camera, and gameplay mechanics.

Silent Hill 3 is a survival horror video game in which the player takes control of Heather, a teenager who awakens from a nightmare in a shopping mall and tries to return home to her father, while navigating environments that oscillate between reality and the Otherworld, a bloodier, supernatural version of it.

[2] To aid in exploration, Heather obtains a flashlight and radio early on, the latter of which crackles when monsters are in proximity.

She then encounters Claudia (Donna Burke), a mysterious woman who hints that Heather will be instrumental in bringing about paradise on earth.

[9] Intent on killing Claudia, Heather resolves to go to Silent Hill and accepts Douglas' offer to drive her there.

[10] Arriving in the seemingly abandoned and fog-shrouded town, Heather sets out to find a man named Leonard in a local hospital, being told by a member of the cult named Vincent that Leonard was in possession of a powerful magical sigil, the Seal of Metatron.

[13] Heather reaches the church and learns that Claudia, who was Alessa's childhood friend, intends to bring about the god's birth to remake the world into a paradise.

Heather confronts her and vomits out the fetal deity, which was nourished by her hatred, using a supernatural substance given to her by Harry before his death to expel the god.

Claudia promptly swallows the fetus to Heather's horror in an attempt to complete the birthing process of the god.

Claudia is snatched away by an archangel of the cult to the chapel below, where she is found to have given birth and disappeared (with Heather presuming her dead).

[23] A smaller group of Konami Computer Entertainment Tokyo staff later developed a port for Windows.

According to Masahiro Ito, this decision wasted considerable development time and part of the game's budget.

[26] Eventually, the creators decided to model her on Julianne Moore, and then remove her eyebrows, so that the appearance was slightly skewed.

[26] Early designs were based on actor Ethan Hawke and focused on capturing a look of "derangement and moodiness.

"[26] A remastered high-definition version was released as part of the Silent Hill HD Collection, for the PlayStation 3[27] and the Xbox 360[28] on March 20, 2012.

[41] Positive reactions were given to the general horror and atmosphere of the game,[2][4] including "truly horrifying sections",[42] it "packs some genuine scares"[41] and "the feeling of eeriness and doom is almost overwhelming".