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Silent Hill 2 Remake X-Ray puzzle and combination lock code

Guides
By Joel Franey last updated 5 December 2025

The 3F X-Ray puzzle is solved using ink markers to reveal the combination lock code

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Silent Hill 2 Remake Combination lock and x ray viewer
(Image credit: Konami)
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The Silent Hill 2 Hospital X-Ray puzzle and Combination Lock code on 3F are both linked, as solving the X-Ray and Radiograph puzzle gives you the combination lock code across the hall and lets you progress. It'll take a while to solve though, as you'll need to find a missing radiograph to properly complete the puzzle, and that's also covered in mold you'll need to clean off.

I'll explain how to find all the pieces and solve the X-Ray puzzle in Silent Hill 2 below, as well as help you with the combination lock code. Keep in mind that there's a lot of danger ahead while pursuing this route, so if you haven't found the Silent Hill 2 Remake shotgun yet, now might be the time to go grab it.

Silent Hill 2 Remake Hospital combination lock code

Silent Hill 2 Remake Hospital combination lock code

(Image credit: Konami)
More Silent Hill 2 Remake guides

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The code to the hospital combination lock in Silent Hill 2 is 4-37-12 on normal puzzle difficulty. To enter it, turn the lock right, left, right to the three numbers, then press X to "Accept" (it can be a little hard to see the specific digits, so you might have to lean into the screen a little).

Article continues below
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The code itself, however, is found by completing the X-Ray Viewer puzzle in the room across the hall. I'll go through it all below, just keep in mind that this is a far longer puzzle than the Silent Hill 2 Remake hospital generator you needed to complete to get to this point.

How to solve the X-Ray Viewer puzzle in the Silent Hill 2 Remake

How to solve the X-Ray Viewer puzzle in the Silent Hill 2 Remake

(Image credit: Konami)

The X-Ray Viewer puzzle in Silent Hill 2 can't be solved when you first find it, as you're missing some essential parts.

The puzzle is all about arranging several radiograph X-Rays so that the markings on them reveal the combination to the lock. However, you need all of them to reveal the full combination, and you'll have to find, and in some cases clean, the radiographs first.

Here's the full walkthrough to solve this puzzle.

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Silent Hill 2 X-ray and mold remover locations

(Image credit: Konami)
  1. After finding the X-Ray Viewer, immediately make sure you get the Radiograph of a Pelvis on the bed behind you in the same X-Ray Room.
  2. Get the Keypad Combination Note pinned to the notice board in the 1F Doctor's Lounge.
  3. Using this information, open the 2F Nurse's Station Keypad with the code 3578.
  4. Now you need to head to the 2F Treatment Room next to the Nurse's office.
  5. In the bath in the corner you'll find the Moldy Radiograph. However, you can't use this in the puzzle yet.
  6. Head to the 1F Pantry, at the bottom of which you'll find a bottle of Mold Remover surrounded by bugs.
  7. Combine the Moldy Radiograph and the Mold Remover in your inventory to get the Cleaned Up Radiograph, showing somebody's hand.
  8. Now with all the Radiographs, head back to the 3F X-Ray Room and go into the viewer, then press "Inventory" to add them to the board.

Silent Hill 2 x-ray puzzle solved

(Image credit: Konami)
  1. Arrange all the Radiographs according to the pattern above to reveal the full combination code.

The key to solving this X-ray puzzle in Silent Hill 2 is using the little scratches on the radiographs to line them all up with the marks on the board. that will help you work out where they go and once you match everything up the code will reveal itself.

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Joel Franey
Joel Franey
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Guides Editor, GamesRadar+

Joel Franey is a writer, journalist, podcaster and Very Tired Man with a BA from Brunel University, a Masters from Sussex University and a decade working in games journalism, often focused on guides coverage but also in reviews, features and news. His love of games is strongest when it comes to groundbreaking narratives like Disco Elysium, UnderTale and Baldur's Gate 3, as well as innovative or refined gameplay experiences like XCOM, Sifu, Arkham Asylum or Slay the Spire. He is a firm believer that the vast majority of games would be improved by adding a grappling hook, and if they already have one, they should probably add another just to be safe. You can find old work of his at Eurogamer, Gfinity, USgamer, SFX Magazine, RPS, Dicebreaker, VG247, and more.

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