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The Video Tape is an item in Silent Hill and Silent Hill 2. In both occurrences, the tape can be viewed using a VCR. In Silent Hill 2, however, the tape must be viewed to progress in the story, whereas viewing it is optional in Silent Hill.
The tape can be inserted into the VCR in Room 302 on the third floor; however, the video will only show static, allowing the odd few words of the original footage to be heard. Once finished, the VCR will jam, preventing it from ejecting.
Later, while exploring Nowhere, Harry Mason will come across a room in the 1F Phaleg Hall also containing a VCR and this time, Harry can fully view the contents of the tape. The video only has one frame, showing a nurse in red, Lisa Garland, with her head down while she explains her disgust over the condition of a wounded patient. She describes one of the patients that she is caring for, saying that her eyes never open and all of her skin is charred, among other things. Through the symptoms she lists and her amazement of her condition, it can be discerned that the patient she is caring for is Alessa Gillespie, who was burned alive as a part of the ritual to bring about the descent of the god worshiped by the Order.
In addition to explaining Alessa's condition, Lisa asks to be freed from her situation, promising to not tell a soul about their secret. Who she addresses this to is not made clear. However, it was most likely Michael Kaufmann, as he was the director of the hospital, in addition to being a figure in the cult.
Silent Hill 2
The Videotape is found within an office safe on the first floor of the Lakeview Hotel. The videotape is first mentioned by Maria, while locked inside her cell in the Labyrinth. Apparently, the tape was made by James Sunderland, as he taped his and Mary Shepherd-Sunderland's vacation in Silent Hill. James recalls the event, but also remembers that he left the video behind in the hotel they stayed in.
After finding the videotape in the hotel, James is guided to Room 312, the room he and Mary stayed during their vacation. Inside the room is a VCR and a TV, where the videotape can be used to view the contents.
The video is split into two parts. The first is in James's perspective and simply films Mary talking about their time in Silent Hill and the town itself. Mary also states that they should return here again, but she is cut short and begins coughing, signaling she is becoming ill. The second part of the video reveals Mary's outcome and the truth about her death. After viewing the tape, James is left in a state of shock, but finally confronts his demons and continues searching for who, or what, called him to the town.
- The video tape could symbolize James' dissociation from the act of killing his wife, the experience feeling "unreal" as if watching a video in third person. James rediscovered what he did through a video tape instead other means (such as flashbacks or hearing voices like in various other scenes in the game) to symbolize this. This is further reflected when Mary transforms as she "flickers" up and down like a broken video tape, James dissociating from the event by imagining it as a video.
- The video tapes adds to the 20th century setting of Silent Hill and Silent Hill 2, when physical VHS tapes and VCRs were the main format of video/audio recording. Eventually, VHS tapes would be replaced by DVDs, and then Blu-rays and smartphones with cameras, digital files and YouTube.
- Part of the video viewed in Silent Hill of Lisa is also seen in Silent Hill 3, before Heather Mason enters the Otherworld version of Brookhaven Hospital.
- The second part of the video in Silent Hill 2 originally had audio of Mary screaming accompanying it; however, it was left out of the final version of the game.  This could be due to the controversial subject of euthanasia, or Team Silent may have found Mary's screaming to be too excessive/extreme/disturbing and wanted a more subtle approach.