Extra options:
In the Options screen, press L1, L2, R1, or R2.

Hyper blaster:
If you have Konami's old game gun plug it in to controler port 2 before you start the game. Load up the game, in your inventory you will now have the hyperblaster. NOTE: To use it it's almost better to have two players one to control the gun and one to control Harry

Hospital doors:
In the third floor of hospital area are two doors with three panels of push buttons over each one. Read the two pictures at the far end of the room. Use the "Camera" that you already should have found on each of the pictures. This will reveal the necessary pattern(s) that need to be re-drawn on the push-button panels. This opens the respective door and allows the game to proceed.

Hyper Blaster:
The Hyper Blaster is obtained by unlocking the UFO ending, detailed below. Note: Channeling stone shows up on the Game Ending screen, not this weapon. The channeling stone is another possible item (in the convenience store in Next Fear mode if the game is completed with a Good+ rating). To get the UFO ending with it (and subsequently the Hyper Blaster immediately in the Next Fear mode), use the item at these locations:

Old Silent Hill: On the roof of the Alternate School
Alternate Central Silent Hill: Right outside the hospital before fighting the Moth/Adul Grub.

Resort Area: Norman's Motel, in front of the apartments
Alternate Resort Area: On the bridge of the boat.
Alternate Resort Area: Roof of lighthouse.

Zodiac Room:
In the room with the Zodiac Signs, click the digit according to the amount of limbs in the picture (from left to right; Sagitarrius:6, Taurus:4, Gemini:8).

True ending
Successfully complete the game with the best ending to get the Channeling Stone. You have to use this item in five different locations to get the true secret ending:

1. On the roof of the "Alternate School".
2. In the hotel parking lot.
3. The cabin of the boat.
4. Outside the entrance of the "Alternate Hospital".
5. On top of the lighthouse.

Unlocking the Grim Reaper's door:
To unlock the Grim Reapers door in "nowhere", type ALERT on the panel next to the door.

Saving Cybil Bennet on the carousel:
Walk up to Cybil at the very start of the fight, while your energy is full. She should slap you. Immediately after she slaps you, splash her with the "red liquid" to save her, saving valuable time. Note: The red liquid is found in the "normal" hospital, on the floor next to the administrator's desk.

Getting the katana:
Complete the game with the good ending to receive the katana. Save, then begin the game again. Play through until reaching the first house that was entered in old Silent Hill. Go to the door that was previously locked in the hallway to find the katana. Completing the game with the good ending will also allow access to the channeling stone.

Bathroom teleporters in school:
Enter and exit the girl's bathroom in the second part of the school (through the clock tower). The game will transport your character to the second floor bathroom, which is closed off (along with the men's second floor bathroom) from the rest of the second floor hallway. There are two boxes of handgun ammunition and one box of shotgun shells in the second floor men's bathroom. After collecting them, enter and exit the girl's bathroom on that floor to return to the first floor.

Telling Dr. Kaufmann about drugs:
When you are doing the things that Kaufmann left in the pool hall, go to the Indian Runner Store, enter the combination (0473). and go inside. Move around the counter, stand in front of the white drawer, and press X. Answer "Yes" to open it. Go all the way back behind the counter. Use the "Safe Key" on the safe that is down by your feet. It will open, and reveal three bags of drugs. You can not take them. Talk to Kaufmann to mention them to him.

Nurse Center puzzle
You must solve a puzzle to open a door. The door itself has four open slots and four full slots.

[1] - [white] - [2]
[black] - [orange-red]
[3] - [purple] - [4]

Clues to solve the puzzle can be found in the poem:

clouds flowing over a hill
sky on a sunny day
tangerines that are bitter
lucky four-leaf-clover
violets in the garden
dandelions along a path
unavoidable sleep time
liquid flowing from a slashed wrist

The red block goes in slot one, the blue block goes in slot two, the yellow block goes in slot three, and the green block goes in slot four.