Masahiro Ito, the creature designer for the original three Silent Hill games, presented his most famous work, Pyramid Head, in several subsequent Silent Hill games, as well as the film series, and other Konami licensed games.
Ito joined Konami in 1997 and became a member of Team Silent, where he worked as a background and creature designer on Silent Hill 2, art director and creature designer on Silent Hill 3, and art director and background designer on Silent Hill 3.
The concept for Silent Hill 2 was shared early on in the design process. At the end of the message, it states, "This figure eventually became Pyramid Head."
Ito shared a second idea, called "3328," that he created before designing Pyramid Head. And here are some of the company's prototypes at the bottom of the image.