The Suffering: Ties That Bind is a 2005 first and third-person shooter psychological horror video game, developed by Surreal Software and published by Midway Games for PlayStation 2, Xbox and Microsoft Windows. The game was released in North America in September and in Europe in October. It is a sequel to the 2004 game The Suffering. In 2017, it was released on GOG.com.

The game continues the story of Torque, a man sentenced to death for murdering his ex-wife and two children. In the original game, after arriving on death row in Abbot State Penitentiary on Carnate Island, off the coast of Maryland, an earthquake rocks the island, and the prison is attacked by strange supernatural creatures. During the mayhem, Torque escapes. Ties That Bind continues his story, as he flees the island and heads back to his home town of Baltimore, where Torque must once again battle the creatures from Carnate, now terrorizing Baltimore, while facing his past misdeeds and confronting his nemesis, a mysterious criminal kingpin known as Blackmore, who is connected to Torque's past and his family's deaths. Players who have a saved game from The Suffering can choose one of three different openings, based upon the ending they received in the first game. As with the original game, Ties That Bind also features three different endings, depending on the players' actions throughout the game.

Ties That Bind received favorable reviews, but was generally criticized as being too similar to the original game. Some critics felt the game would only appeal to fans of the first game, while others argued the more complex storyline and serious moral issues made it worthwhile on its own merits. Despite mostly positive reception, the game saw underwhelming sales. For a time Surreal Software initially spoke about the possibility of expanding The Suffering franchise into a multi-game series, however Ties That Bind remained the final installment to the series.