Here's a couple things you should know before reading this guide.

How it works
The three main endings go off a point system, there's nothing you can actually do to lock them in. something such as examining Angela's knife will give you a point that'll go into the "in water" ending or examining Mary's photo/letter will give points to the "Leave" ending. Some things will give more points than others so keep that in mind. It's also not required to do everything listed but increases your odds on getting the ending you're looking for.

For the people on their first play-through
If you're new to the series or have been around for some time, personally I wouldn't stress too much about the ending. I think the best way to go into this game is going in blind just as any silent hill game. Please just try and enjoy the game, you can always come back and get the ending you desired.

Misc.
- For the three main endings everything is ordered by things you should do in general and then the things you will first come across.
- It's possible to achieve multiple endings in one playthrough (bonus and main endings)
- NG+ is required for all bonus endings
- For the bonus endings its very important you don't miss an item.
- Six of the achievements are locked behind endings
- The two new endings don't have achievements tied to them

Requirements:

• Heal to full whenever Injured (the blood on James's coat will be an indicator of this and can be hard to miss as it appears very light sometimes)
  
• Killing less than 150 enemies
  
• Checking Mary's photo/letter (3 or more times gives a point to this ending)
  
• When the coin puzzle in the apartment asks who's the one to carry the blame the snake
  
• Don't engage in combat on the first pyramid head fight - There is a timer on this fight. Once the timer is finished pyramid head will leave. (Phase 1 timer: 60 Seconds, Phase 2 timer: 120 Seconds)
  
• Choose a innocent prisoner for the gallows puzzle.
  
• Choosing the rotten apple for the mirror puzzle, Can be found on the right side of the garden in Lake View Hotel (you can only use one apple for the puzzle)
  
• Choose the rusted colored egg to open the door after pyramid head fight (it's required you place both of them but important which one you walk through).
  
• Listen to Mary's full Dialog in the hallway at the end of the game
  
  IMPORTANT: Make sure to avoid requirements to the other main endings while going for this.
  
  The "Leave" ending is 1/3 of the main endings, it unlocks the "Making Peace" achievement. This is the most common ending to unlock through normal gameplay and is considered the good ending.

Requirements:

• Not healing immediately and keeping health moderately low
  
• Killing more than 350 enemies
  
• Stomp dead enemies more than 30 times.
  
• When the coin puzzle asks who's the one to carry the blame the man
  
• Inspecting Angela's Knife (more than 2 times gives a point to this ending)
  
• Engage in combat on the first pyramid head fight. The timer on this fight is - (Phase 1 timer: 60 Seconds, Phase 2 timer: 120 Seconds)
  
• Reading the writing on the wall just above the jukebox in Neely's Bar once you've returned after the hospital
  
• Choose a innocent prisoner for the gallows puzzle
  
• Choosing the rotten apple for the mirror puzzle, Can be found on the right side of the garden in Lake View Hotel
  
• Killing all defenseless enemies before the double pyramid head boss fight
  
• Choosing the rusted colored egg to open the door after pyramid head fight
  
• Staying in the hallway for Mary's dialog

IMPORTANT: Make sure to avoid requirements to the other main endings while going for this.

The "In water" ending is 2/3 of the main endings, it unlocks the "Only Way Out" achievement. It's considered the bad ending.

Requirements:

• Avoid inspecting Mary's photo
  
• When the coin puzzle asks who's the one to carry the blame the woman
  
• Minimize the damage Maria takes.
  
• Getting more than 7 redirection comments from Maria will subtract points from the 2 other main endings
  
• Maria Interactions, make sure you interact with her - When you try to enter the Silent Hill Historical Society, just outside of Baldwin Mansion and inside the hospital once she first goes into the bed.
  
• Inspect the following, inside Heaven's Night: 3 pictures (found to the right of Maria when she's waiting), 1 poster (to the right of the save point) , and the bottle of whisky (behind the bar). After you've inspected all these, Maria will say "Any port in a storm" when you're leaving Heaven's Night
  
• Frequently visit her in the hospital, she has 2 cut-scenes. You can trigger the 1st by getting your first bracelet and the second by obtaining the key to the roof. It's important to know that once you've done the rooftop scene you cannot visit her again.
  
• Choose a innocent prisoner for the gallows puzzle
  
• Visit her in the labyrinth (she has no cut-scenes).
  
• Choose the Ripe apple for the mirror puzzle in Lake View. It can be found in the back of the mannequin room.
  
• Choosing the Scarlet egg to open the door after pyramid head fight
  
• Don't stay for Mary's Dialog in the final hallway

IMPORTANT: Make sure to avoid requirements to the other main endings while going for this.

The "Maria" ending is 3/3 of the main endings, it unlocks the "Vicious Circle" achievement. This ending can be interpreted as however you wish.

Requirements:

NG+ Required.

Step 1 - Obtaining "Crimson Ceremony", you can find it inside the graveyard after you first encounter Angela, It's located near the water in front of a grave.



Step 2 - Obtaining "White Chrism" which can be found on porch of Baldwin mansion across the street from jacks in.



Step 3 - Obtaining "Obsidian Goblet" can be found inside the Silent hill Historical Society, adjacent to where the pyramid head painting is. There will be a secret compartment where a painting once was.


Step 4 - Obtaining "Book of Lost Memories" can be found inside the Lake View Hotel and is found inside the lost in found which can be accessed from breaking a wall inside Cafe Toluca.



Step 5 - Finish the game like normal and it'll unlock the "Rebirth ending"

IMPORTANT: Grabbing the final item it should be noted that this ending will lock you out of all the endings that require you to defeat the final boss.

The "Rebirth" ending unlocks the "Defy Even Death" achievement.

Requirements:

NG+ Required.

Step 1 - Head North of Big Jay's, Just past the pet store. You'll find a jewelry store in the left window you'll see a blue gem sitting in a box, break the window and collect the gem



Step 2 - After you've collected the gem make your way on top of Saul Apartments where you'll find a some strange noises, once you've heard the noises you can inspect the gem and if you hear more weird noises you're safe to move on


Step 3 - For the second location you'll want to head north to Rosewater Park on the water front and repeat what you did before


Step 4 - For the third spot go to the Lake View hotel pier/dock and inspect the gem


Step 5 - Lastly go to room 312 in Lake View hotel and inspect the gem to unlock the ending.


The "UFO" ending is 1/2 joke endings and unlocks the "Tinfoil Hat" achievement.

Requirements:

NG+ Required

Step 1 - Obtaining the first broken dog key part, found inside a pet-store just north of big jays, once you enter the pet store it can be found inside the room in the back


(screenshot of the map is taken inside the store)

Step 2 - Obtaining the second broken dog key part found on Katz St. The first house's backyard which can be accessed by a gate on the side, you'll find a dog house with the second part of the key once you've collected it you can fully craft the key


Step 3 - The final part of this is opening up the Observation room instead of Room 312.

The dog ending is 2/2 joke endings. It unlocks the "The Goodest Boi" achievement.

Requirements:

NG+ Required, Having the "In Water" Ending Required

Step 1 - Obtaining the "Key of Sorrow" which can be found inside the green car on the right rear window, found right before entering the town. Once you've acquired this key there isn't much you can do with it until the end of the game.



Step 2 - Once you've reached the otherworld of Lake View Hotel keep progressing until you've reached Angela's scene. after that go up the stairs and find your way into the mangers office, there's going to be a safe, you must put the Key of Sorrow inside and use the code R3 L1 R4.


Step 3 - Finish the game like normal and you'll have unlocked the "Stillness" ending

IMPORTANT: Grabbing the final item it should be noted that this ending will lock you out of all the endings that require you to defeat the final boss.

Stillness is 1/2 of the new endings and is very similar to the "In water" ending.

Requirements:

NG+ is required

Step 1 - Obtain a Rusted Key which can be found in a safe at Pete's Bowl-O-Rama, the code to the safe is 1887

Step 2 - The next item we need is located in small chest that we will be opening up with the Rusted Key. The chest located inside the gazebo at Brookhaven Hospital Garden.
After this we can hold onto the White Claudia until room 312.


Step 3 - Once you've reached room 312 you can drink the White Claudia, use the video tape and you will have obtained the "Bliss Ending"

"Bliss" is 2/2 of the new endings.
It should be known that the two new endings don't have achievements linked to them.