Revision 5

SILENT HILL: Townfall is rated for sale by boards across thirteen territories, and Konami has published a content warning of its own separate from any of them. This page collects both, plus what is still unpublished.

Ratings by Board

The ratings shown on each storefront follow the region the storefront is serving, so the same product page shows an ESRB mark in North America, a PEGI mark in Europe and a CERO mark in Japan.

The German Steam storefront carries a separate 18 rating of its own, with descriptors covering drastic violence, alcohol, tobacco and coarse language.

Three of these entries independently list alcohol, tobacco or licit drugs among the game's content, in Brazil, Germany and Indonesia. No marketing copy or store description mentions either, so the descriptor lists are the only published indication that the game contains them.

Storefront Content Notes

The Steam listing carries its own note alongside the rating: frequent violence and general mature content. The PlayStation Store lists Blood, Strong Language and Violence in North America and Horror, Language and Violence in Europe, matching the board descriptors for each region.

The Official Content Warning

Konami published Video and Screenshot Posting Guidelines for the game on September 8, 2026. They carry the only content warning the publisher has issued: "The Game contains depictions of medical procedures and body horror, serious illness, overwhelming healthcare situations, and scenarios involving widespread injury, grief, and loss of life."

That warning is consistent with what the game has shown. A clinical room with a draped bed, vital-signs monitors and an IV pole has appeared in official footage, Zoe is a clinic nurse, Simon wakes wearing a medical wristband with an IV bag, and the town appears to have suffered some kind of medical outbreak.

Posting Guidelines

The same document sets out what players may do with footage. Individual players can post gameplay video and screenshots on a listed set of platforms without asking permission first. Companies and other organisations are not covered by that permission. Commercial use is prohibited, as is isolating parts of the game such as its music or character images, and so is posting content taken from modified or datamined builds. Konami recommends that anyone posting footage display the appropriate age rating and content warnings alongside it.

Accessibility

Accessibility information reached the storefronts in the week before launch. On September 15, 2026 the PlayStation Store's accessibility field was present but empty for this title and the Steam listing declared no accessibility feature at all. By September 21 both had changed: the PlayStation Store lists twenty-two accessibility features in its North American, British and Japanese storefronts, and the Steam listing declares five. Neither Konami nor Screen Burn published an options list of its own before release, so the two storefront checklists were the whole of the pre-release record.

Steam

The Steam listing declares Adjustable Difficulty, Subtitle Options, Camera Comfort, Custom Volume Controls and Stereo Sound. Its remaining accessibility flags are still unset, which records that nothing has been declared for them rather than that the options are absent.

PlayStation Store

Three of those entries say something about the game that no other published material does. Simplified Quick Time Events implies timed on-screen prompts exist somewhere in the game; Manual Saving implies saves are not limited to the automatic kind; and the playable-without entries confirm that the motion controls, vibration and adaptive trigger effects described on PS5 Features can each be switched off. Konami's own September 16 post says the same of the motion controls, calling them customizable in the menu options.

One entry on the PlayStation list should not be read literally. The store also tags the game as playable without subtitles, and the platform's canned wording for that tag says the game does not include spoken dialogue. That contradicts the announced English and Japanese voice casts on Cast and the neighbouring tag stating that spoken dialogue is fully subtitled, so it is a checklist template artefact rather than a description of the game.

Two settings that are not accessibility features but do change difficulty were first reported from a press build and are confirmed in reviews of the released game: a difficulty tier of Story, Normal or Nightmare, and a separate puzzle setting of Hinted or Normal. Both are on Combat and Stealth and Puzzles.

The game has no published photosensitivity warning of its own. The South African board's descriptor list is the only rating entry that mentions photo and pattern sensitivity.

The lists above are storefront declarations made by the publisher rather than a full options list. Reviews of the released game add what the options menu offers: subtitles and closed captions that can be switched on separately, an adjustable subtitle background, the separate combat and puzzle difficulty settings, and toggles for the adaptive trigger effect, auto aim, the letterbox frame and an on-screen play time. One reviewer of the PlayStation 5 version found that controls could not be remapped. Neither Konami nor Screen Burn has published an options list of its own as of September 27, 2026.