The survival horror genre has been a staple in the video game industry for decades. Franchises like Resident Evil and Dead Space have chilled gamers to the bone and given them plenty of sleepless nights. But the one series that ranks above them in all in terms of being unsettling and gruesome is Silent Hill.

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The first installment of this Konami series hit stores in 1999 for the original PlayStation. It changed the landscape of horror video games forever. Each monster was more terrifying than usual because the protagonist wasn't an expert fighter; he was a normal guy who was in way over his head. But some of the creatures you'd face would scare even the toughest people. With that in mind, here are the ten most terrifying Silent Hill monsters.

10 Grey Child

Grey Child in Silent Hill

At first glance, you're probably wondering why this would make the list. The Grey Child is one of the smallest monsters in the series. They are Alessa Gillespie's manifestations of the abusive children from her school who tormented her. And they're honestly pretty easy to dispatch.

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But what makes them scary is their psychotic nature. These little things carry knives and attempt to stab you at every turn. There's also their laugh, which sounds like the creepy giggle of someone dying. In non-North American versions of the original Silent Hill, they were replaced due to their horrifying nature.

9 Nurse

Possibly due to their use in the Silent Hill film, the Nurses have become something of a series icon. First appearing in Silent Hill 2, these creatures represented something dark. When Mary Sunderland got her terminal illness, she spent her remaining days in a hospital.

The Nurses' representation goes further. The revealing clothes and bubble-headed nature show the sexual frustrations of a man who could no longer be attracted to his once beautiful wife. The combination of their unsettling movements, random lurching, and their choice of weapon are the things that make them so scary.

8 Mannequin

This is just unnerving. Silent Hill 2 is in consideration for the best installment of the franchise, so it stands to reason that it would feature some of the sickest monsters. The Mannequins appear early in the story and aren't that difficult to take out, but it doesn't make them any less creepy.

These monsters are comprised of two lower halves of mannequins fused at the waist. That means that it walks on two legs while flailing the legs on the top half at you. Seeing them charge at you from the darkness is terrifying. They also play a major role in one of the most disturbing moments in the franchise.

7 Gum Head

Gross. Just taking one look at a Gum Head will make you understand their position on this list. These things are just disgusting. From Silent Hill 4: The Room, the Gum Heads had a face that looked melted and a hideous tumor-like thing protruding from its chest. It almost looks like it is vomiting up another head.

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The Gum Heads are meant to represent the hatred for adults that the game's protagonist, Walter Sullivan, had. If this is how you envisioned adults, you'd hate them too. The only aspect that keeps these guys from ranking higher on the list is their sluggish movements, which make them less frightening.

6 Lying Figure

The mere thought of the Lying Figures is enough to give you the heebie-jeebies. They mostly look like normal people, except they are trapped in straitjackets made from their own skin. Now that's torture.

The Lying Figure writhes around as if it trying to escape from the confines of what happened to its skin. Their offense is limited to a poisonous gas they spray at you from their midsection. Honestly, they aren't all that dangerous but they're quite freaky to look at. That's enough to earn them this spot.

5 Robbie The Rabbit

Again, this is a monster that doesn't scare you at first glance. After all, it is just a seemingly cuddly and cute stuffed rabbit. But Robbie easily tops the list as the character who makes gamers feel the most uneasy. Robbie is the mascot for Lakeside Amusement Park and his presence in the game stands out.

Robbie is the lone bright and colorful thing in this world. In Silent Hill 3, he is repeatedly found slumped over in various locations. Is it a dead corpse inside? Is someone sitting in there watching you? We have no idea. Robbie has gone on to appear in multiple Silent Hill games.

4 Twin Victims

Almost anything that has two heads is going to put you off. It's just the kind of sight that will make your skin crawl. That was the case with the Twin Victims from Silent Hill 4: The Room. And it was more than just the sight of the two heads that made this a scary monster.

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The fact that the heads look like they belong to babies despite being on a big body with huge arms is the creepiest factor. The lifeless faces doesn't help things. They're an incarnation of young twin siblings that Walter Sullivan had murdered, returning to haunt him and our dreams.

3 Needler

This is flat out terrifying. The Needlers were designed to mimic childbirth and a closer look makes that pretty clear. If you notice, they resemble a headless person giving birth. Except that their head seems to be where the baby would come out of and they seem to have crab legs.

It is one of those monsters that just creeps you out as soon as you see it. It makes you take a step back and probably even pause the game to figure out what is standing before you. It scared the hell out of nearly everyone who played Silent Hill: Homecoming.

2 Asphyxia

Back-to-back monsters from Silent Hill: Homecoming. They're about equally terrifying. The Asphyxia is grotesque. For starters, it seems like a nod to The Human Centipede movie that came out about a decade ago. That is enough to make you run in the opposite direction.

The Asphyxia also has a bunch of hands that are used to cover its nudity. The multi-arm torso and tail that acts as a whip makes the Asphyxia one of the more dangerous villains of the series. The fact that it originates from someone being strangled is the cherry on top of this harrowing sundae.

1 Pyramid Head

Could it really be anyone else? First appearing in Silent Hill 2, Pyramid Head has become the icon of the franchise. The design is simple enough. He has a muscular male body, a massive pyramid for a head, and he drags a ridiculously long sword behind him. He shows up at random times and sometimes just stares at James, making him and the player uneasy.

Pyramid Head has gone on to appear in a handful of other games in the series and both film adaptations. His lack of a face, the giant weapon, and his tendency to violently attack the other monsters in town add to his imposing nature. He's a horror icon for a reason.

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