The music of File 47, composed by Dux, creates an unsettling and oppressive atmosphere, combining ambient sounds, distortions, and minimalist melodies to intensify the feeling of psychological horror. The soundtrack features dynamic pieces that evolve based on the protagonist's mental state, along with audio effects designed to generate constant tension. One standout composition is The Descent Into Madness, a 14-minute piece that merges the main themes of the game.