For those who know the videogame, it's an amazing adaptation. Most of the changes did not detract, even the inclusion of the Pyramid Head monster who was supposed to be specific to the protagonist of the videogame Silent Hill 2, which had a separate story. Changing the protagonist to a mother instead of a father was just fine. Jodelle Ferland was great delivering otherwise fairly cheesy dialogue of Dark Alessa, and getting the insane genius of Akira Yamaoka to contribute to the movie's soundtrack and atmosphere was vital.
I appreciate the movie, especially for being faithful to the spirit of the video games.