In order to immerse players in a world of horror, studios need to ensure the music, audio, atmosphere, and setting are absolutely spine-chillingly perfect, as they need to be suspenseful and scary to be successful. Settings that are abandoned and falling into disrepair are ripe for horror games, as they hold so much potential for setting up scares and tension.

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Asylums have become one of the most popular locations to set horror games in, as they are filled with terrifying or tragic history, and have fallen to dilapidation, now only inhabited by ghosts or memories, if players are lucky. Otherwise, they might find these abandoned asylums not as abandoned as they thought.

7 Get Even

This Abandoned Asylum is Home to Many Dangerous Inmates

Under the orders of the mysterious Red, Cole Black is tasked with infiltrating an abandoned asylum and reconstructing memories to uncover the secrets of the institution. Although abandoned and fallen into a state of disrepair, the player will still encounter some inmates that have been left forgotten in the crumbling rooms and hallways, with not all being friendly.

The asylum offers a creepy setting, and the hostile inmates players have a chance of encountering them only makes this game all the scarier. Thankfully, players are armed to allow for self-defense, but the gun is little comfort when faced with the suspense of navigating the hallways and floors.

6 Alice: Madness Returns

Blood and Torture Hold As Strong Themes Within Rutledge Asylum

Madness is the name of this game, and it acts as a central theme in the plot. Alice: Madness Returns takes the classic and charming tales of Alice's adventures in Wonderland and warps it into a nightmarish land that would even make Tim Burton shudder in horror.

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Rutledge Asylum is one of the key locations in Madness Returns, which housed Alice after she entered a catatonic state following the death of her parents. Though it is not abandoned per se, the asylum feels empty and devoid of life, with only a handful of other apathetic patients' houses in a ward, and the staff that when they aren't absent, are abusing their charges. The treatment rooms look more like torture chambers intended to harm the patients, rather than heal.

5 Neverending Nightmares

Tumble From One Bloody Nightmare to the Next

Drawing inspiration from the real-life struggles of the lead designer who suffers from depression and OCD, Neverending Nightmares is a test of endurance with its bleak atmosphere and unsettling visuals. The sketchy black and white art style is offset by the red blood that drips over every oppressive nightmare that Thomas wakes up in, witnessing himself or his little sister Gabby dying.

Thomas traverses to multiple locations in this never-ending nightmare cycle, one of the most unsettling being the asylum, which introduces one of the most terrifying enemies in the game--the Patient, who is a blind but deadly opponent. Though the game doesn't have flashy 3D graphics, it lives up to its name, proving to be a real nightmare for any who dare play it.

4 Call of Cthulhu

Players Will Need Wits and Bravery to Survive the Institution

In a game revolving around an old god that can bring about global madness, it makes sense that players would inevitably have to explore an asylum, and Darkwater Island hosts a terrifying one.

Players find their investigation of the eerie island and its peculiar inhabitants halted when they are thrown inside Riverside Institution and treated as inmates. Yet, in reality, it's just the islanders seeking to hide the mysteries surrounding the cult. Though Riverside Institute isn't technically abandoned, it might as well be from the eroded state of the place, and the malpractice committed by the guards who are as treacherous as monsters.

3 The Evil Within

Traps and Monsters Make Beacon Mental Hospital a Dangerous Place to Explore

With the mind of the Resident Evil creator behind it, The Evil Within was born for success. It follows Sebastian Castellanos entering a world of nightmares after investigating a mass murder that took place in Beacon Mental Hospital with his partners Joseph Oda and Juli Kidman.

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What should have been another day at the office devolves into much more than any of them bargained for as they enter a nightmare world that could rival that of Silent Hill. Though the game does take some detours to other eerie locations such as the church, Beacon Hospital still plays a major part in this unsettling game, and is home to many of Evil Within's scariest moments, such as the close encounter with the terrifying Laura.

2 Infliction

Terrifying Creatures and a Tense Atmosphere Hang Heavy in the Hallways of the Asylum

A once happy household fell to tragedy, and these oppressive memories have morphed the house into a waking nightmare, the mystery lingering in the rooms and hallways, alongside dangerous and undeniably terrifying entities intent on cutting the players' exploration short.

Although the story mostly centers around the suburban house in question, players will be dragged into other locations, one being a creepy and seemingly abandoned asylum which is smothered in the atmosphere, and not so abandoned as one might think, as there are dangerous and scary creatures players will want to avoid if they don't want to die of fright.

1 Outlast

The Inmates Have Taken Over the Asylum

Outlast has gone down in history as one of the greatest horror games of all time and has set the bar for asylum settings. Taking place in Mount Massive Asylum, reporter Miles Upsher has decided to investigate this run-down institution in hopes of finding his next big scoop, and what a story he gets.

From the moment players see the oppressive building looming into view, they know they are in for scares, which the game delivers thanks to the tenacious darkness, and the dangerous inhabitants that they must confront around every corner. Armed with only a video camera, players need to navigate the asylum and uncover the truth while avoiding the dangerous inmates that still inhabit the decrepit corridors.

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The Scariest Horror Video Games Of All Time, Ranked

From the torture of Doki Doki Literature Club to the eerieness of Resident Evil and Silent Hill, here are the scariest horror video games of all time.