Fear is a universal emotion. Regardless of someone's culture, they likely can appreciate a touch of horror, even if only on a primal level. While there is definitely a difference between Japanese and American horror, there is a reason the former tends to be popular with the latter's audiences. Along with films like "The Ring" getting American versions, Japan is also responsible for some of the biggest horror gaming franchises of all time.
Region-exclusive titles are the bane of every gamer's existence, but the horror genre is nowhere near as frustrating in this regard as, say, RPGs. Horror is a niche genre that seldom produces mainstream games, and the few that exist are usually released worldwide. However, there are a couple of Japan-exclusive horror games that are worth seeking out.
Disclaimer: Games with fan translations will still be considered.
10 AX-2: Uchuu Yusousen Nostromo
Played today, AX-2: Uchuu Yusousen Nostromo is unlikely to impress anyone. However, the title earned its place in gaming history by being the first survival horror game to hit the market.
Now, that genre would not really become a thing until 1996's Resident Evil, but its roots can be traced back to this 1981 Commodore PET Japanese game about a guy trying to escape an alien ship. This one is worth tracking down just for the novelty of experiencing the birthplace of survival horror.
9 Clock Tower: The First Fear
Although later sequels would be released outside of Japan, Human Entertainment's 1995 original would never make the jump. Arguably superior to any of its successors, Clock Tower: The First Fear is an atmospheric and unbelievably creepy point-and-click survival horror game that has aged quite well.
Clock Tower: The First Fear's gameplay elements are not quite up to the same standard as its storytelling or visual style, but horror fans should still be able to find a lot to love here. It is miles better than Clock Tower II: The Struggle Within.
8 Mizzurna Falls
Mizzurna Falls is a PS1 horror game that is rough around the edges but has the distinction of being one of the earliest open-world titles. Set over the course of a week, the player is left to investigate the disappearance of a student in a town that is impressively lively.
Admittedly, Mizzurna Falls does struggle under the weight of its own ambition, but it deserves more recognition for what it tried to accomplish. Weirdly enough, it is set in America.
7 Ikenie No Yoru
Ikenie No Yoru, aka Night of Sacrifice, makes some good use of the Wii Balance Board, something few games can truly claim. Essentially a haunted house story, Night of Sacrifice is split into five parts, with each one being dedicated to a different teenager. The protagonist, who is only playable much later on in the campaign, is trying to piece together what happened to the other characters.
Although quite repetitive, Ikenie No Yoru is surprisingly immersive and, due to being a horror game without combat, manages to offer quite a few decent scares.
6 Nanashi no Game
The Nintendo DS does not exactly scream "horror" but that might have been different if Nanashi no Game had been localized by Square Enix. In this world, there is a cursed 8-bit RPG that, like The Ring, causes anyone who plays it to die after seven days.
Along with investigating the "real" world to learn more about this phenomenon, players also get the play the cursed game, which contains many mysteries waiting to be uncovered. Nanashi no Game is a great game that even spawned a few follow-up titles.
5 Hungry Ghosts
Hungry Ghosts is a ride through hell that every horror fan with a PlayStation 2 should consider taking. The story follows a warrior who dies and winds up in a dreary and depressing afterlife filled with spiteful spirits who might have been put there by the protagonist.
Through a challenging and immersive first-person adventure, the main character must face their demons and reach the Gates of Judgment to learn what their future holds.
4 Twilight Syndrome Series
Spanning five games, Twilight Syndrome has a decent legacy in Japan but has never been given the opportunity to officially reach a worldwide audience. The games follow different groups of teenagers as they investigate urban legends that primarily revolve around their schools.
The games are largely side-scrollers that present their stories through visual novel-type passages. Twilight Syndrome has consistently strong writing, and Suda51 even directed the first two games.
3 Sweet Home
Often regarded as the precursor to Resident Evil, 1989's Sweet Home was also developed by Capcom and featured many elements that would become standard for the genre.
Set in a mansion filled with various types of monsters, Sweet Home has all the nightmarish scenes, obtuse puzzles, and inventory management that would become synonymous with Capcom's more popular franchise. While there are similarities between Sweet Home and Resident Evil, the former is an RPG with turn-based combat.
2 Fatal Frame: Mask of the Lunar Eclipse
For whatever reason, Fatal Frame: Mask of the Lunar Eclipse is the only game in the series to not be released outside of Japan. While it is not quite as good as the first two Fatal Frame games, Mask of the Lunar Eclipse is a sight better than 2014's Maiden of Black Water and especially the 3DS's Spirit Camera.
Mask of the Lunar Eclipse does not exactly reinvent the wheel, but it is a confident entry in a franchise with a dedicated audience.
1 Doctor Hauzer
Released only in Japan and solely on the 3DO Interactive Multiplayer, Doctor Hauzer is a game that has a solid reputation despite not being the easiest to come by. Reminiscent of 1992's Alone in the Dark and its immediate sequels, Doctor Hauzer is a fully 3D adventure game that follows a reporter as he searches for the missing doctor.
Although not especially scary, Doctor Hauzer was impressive for its time and proved to be an important step in the development of survival horror.