Scarlet's Doll is an item obtained in Silent Hill: Homecoming. Alex Shepherd finds it inside a case in Scarlet Fitch's room at Dr. Fitch's Office. To obtain the doll, the player must first obtain the Small Key from the examination room to open the case, after which, Alex will black out and wake up in the Otherworld.
After Alex becomes seperated from Elle Holloway upon completing the Sewer level, Alex receives a radio call from Deputy Wheeler. They decide to meet at Dr. Fitch's office in hopes that Dr. Fitch would know of Elle's whereabouts.
When Alex arrives at Fitch's office, the doctor is nowhere to be found. Alex finds Scarlet's doll, and when he picks it up, the doll becomes disheveled. This transformation triggers the Otherworld, and upon blacking out, Alex wakes up in Hell Descent, the Otherworld manifestation of Dr. Fitch's mental state. It is here that Alex finds Dr. Fitch and hands him Scarlet's doll, it then transforms into the monstrous manifestation, known as Scarlet, and kills Fitch. Following it's defeat, Alex returns to the Fog World and discovers the Founders Key to have been inside- the now broken- Scarlet doll.
- Scarlet's doll bears an eerie resemblance to Scarlet Fitch herself.
- When the doll changes and the Otherworld shift is triggered, causing Alex to faint and drop the doll, it falls onto the floor in a position almost identical to the way Alex is.
- When the doll is given to Dr. Fitch, it looks at him and a child can be heard saying "Daddy?" The doll's lips do not move, therefore is unknown whether the doll actually says this or a vocal manifestation of Scarlet.