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In addition to the soundtrack, the album also included a bonus disk with the Japanese audio drama "Inescapable Rain in Yoshiwara". "Tender Sugar", "Your Rain", "Room of Angel", and "Waiting For You ~ LIVE AT 'Heaven's Night' ~" are sung by Mary Elizabeth McGlynn, while "Cradle of Forest" is performed by both Joe Romersa and McGlynn. Inescapable Rain in Yoshiwara is narrated by Teisui Ichiryusai.
Later in the year, a soundtrack called Silent Hill 4: The Room Limited Edition Soundtrack was released with 13 exclusive tracks.
- Tender Sugar (5:32)
- Waverer (2:54)
- Fortunate Sleep - Noone Disturb Her Dead - (2:06)
- Melancholy Requiem (3:53)
- Confinement (2:27)
- Drops of Shame (2:49)
- The Suicidal Clock Chime (1:10)
- Silent Circus (2:55)
- Traversing The Portals Of Reality (2:03)
- Into The Depths Of Self Discovery (2:55)
- Cradle of Forest (6:30)
- Resting Comfortably (0:51)
- Nightmarish Waltz (3:09)
- Pulsating Ambience (3:04)
- Your Rain (4:42)
- The Last Mariachi (1:37)
- Wounded Warsong (3:12)
- Underground Dawn - Never Come - (2:12)
- Fever Chill (2:28)
- Remodeling (2:54)
- Room of Angel (7:08)
- Waiting For You ~ LIVE AT "Heaven's Night" ~ (6:19)
- Ichikotsu (D) (7:18)
- Tangin (E) (Instrumental) (1:37)
- Hyoujou (F) (8:47)
- Shosetsu (F Sharp) (5:35)
- Shimomu (G) (Instrumental) (2:19)
- Soujou (G Sharp) (4:26)
- Fushou (A) (4:38)
- Oushiki (A Sharp) (7:07)
- Rankei (B) (2:54)
- Banshiki (C) (3:39)
- Shinsen (C Sharp) (4:36)
- Kamimu (D) (4:08)
The soundtrack was re-released in Europe as Silent Hill 4: The Room Original Soundtrack on September 17th, 2004. The CD was packed in a jewel case inserted in paper box with different cover art, and the bonus disc was not included.