A stylistic departure; sometimes it works, sometimes it doesn't
This new SH chapter has your character venturing without his normal light-and-radio combo. It also seems more focused on combat than the predecessors, as you are now faced with more enemies and are given a power meter (the more you beat the hell out of something in succession, the more damage you do). You have a limit to how many items you can carry now, which gets to be pretty frustrating. The first-person perspective you get in your apartment is the most welcome of the changes, and as the game goes on, it really adds to the immensely horrific mood.
Sadly, Akira's music seems to have been going downhill since SH2. SH3 had some great songs (actually some of the best) but wasn't nearly as good as SH2, and SH4's soundtrack is a big step down from SH3. Fortunately the industrial and ambient tracks are perhaps at their best here, so rather than getting some good tunes from this game, we are given a spookiness that can only be matched by the original SH. In fact, this game is the first of the Silent Hill sequels to spook me out as much as the original. Giant two-headed parapelegic babies, anyone? Yes, this game also contains some of the most outlandish visuals, setting the bar for how appallingly strange the little cursed resort town can actually be.
If you're new to SH and want some good survival horror, stick with Resident Evil 4. It's much better. But SH4 is considerably scarier and requires a good deal more intellect to complete. But for fans, this is worth having in your collection.