In January 2020, Christophe Gans, who directed the original Silent Hill (2006), revealed to French magazine Allocine that he was writing new screenplays for both the Silent Hill and Fatal Frame series with producer Victor Hadida. He clarified that the new film wouldn’t be a direct sequel to the earlier series and described it as an anthology, akin to The Twilight Zone, allowing for diverse stories to be told within the same universe. He aimed to explore a more psychoanalytic side of the town.

The film, written by Gans, Sandra Vo-Anh, and Will Schneider, adapts the video game Silent Hill 2. By September 2022, Gans had completed the storyboards and indicated that the film drew inspiration from P.T., the playable teaser for the cancelled game Silent Hills. In October 2022, the film was officially green-lit under the title Return to Silent Hill. Gans collaborated with Konami to create a fresh aesthetic for the monsters, including the iconic Pyramid Head from his previous film.