Enemy from Silent Hill 2. He attacks James Sunderland several times across the game, but cannot be defeated until near the end of the game. Notably, there are two scenes in the game where he appears to be raping other monsters.
He takes the appearance of male figure wearing a pyramidal helmet way too large to be possibly worn by a human, and he's armed with an absurdly large knife.
Pyramid Head became the most iconic monster of the Silent Hill franchise due to its intimidating appearance and constant stalking of the player. He appeared in the Silent Hill movie and inspired very similar monsters in later Silent Hill games. The fanbase is known to reference his propensity for rape.
Pyramid Head is presumed to be a manifestation of James' guilt and desire for punishment for the crimes he commited.