The Great Knife is a recurring object in the Silent Hill series, appearing both as a weapon and as a non-usable item. It is indisputably the most powerful melee weapon in the the entire saga, and is essentially an oversized chef's knife.

In Silent Hill 2, the Great Knife is an over-sized blade similar in design to Angela Orosco's kitchen knife, despite obvious size differences. The Great Knife was wielded by Pyramid Head, but he later switches to a lightweight spear as his weapon of choice. The weapon is extremely heavy and rusty, and is often seen being dragged across the ground by its wielder, making horrific screeching noises. The sheer weight of the weapon is enough to cause terminal damage to its victims, with even Pyramid Head himself swinging this weapon fairly slowly. An overhead swing from Pyramid Head can kill James Sunderland in one hit, even on the Beginner difficulty.

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