| Achievement | How to unlock
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| - Obtained the Arms Barrier!
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| - Completed Boss Attack in Less Than 10:00.
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| - Completed Boss Attack in Less Than 12:00.
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| - Completed Boss Attack in Less Than 15:00.
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| - Completed Boss Attack in Less Than 8:00.
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| - Obtained the 290 Counter!
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| - Beat Omega with Jenka's Puppy.
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| - Defeated the Undead Core!
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| - Obtained the Machine Gun!
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| - Played Cave Story on April 29th!
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| - Obtained the Alien Medal!
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| - Returned Mister Little back home.
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| - Found and collected all Life Capsules.
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| - Accumulated XX,XXX of damage.
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| - Obtained chako's lip stick!
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| - Obtained the Missile Launcher!
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| - Defeated the Muscle Doctor!
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| - Defeated the Twin Dragons!
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| - Obtained curly's panties!
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| - Defeated balrog, yet again...
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| - Completed Blood Stained Sanctuary in Less Than 4:00.
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| - Completed Blood Stained Sanctuary in Less Than 5:00.
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| - Completed Blood Stained Sanctuary in Less Than 6:00.
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| - Completed Blood Stained Sanctuary in Less Than 3:00.
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| - Obtained the Whimsical Star!
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- Super, thanks for asking!
| - Obtained the Super Missile Launcher!
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| - Completed blood stained sanctuary.
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| - Obtained the Turbocharge!.
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| - No life capsules (best ending).
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| - No life capsules (good ending).
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- Weapons of Mass Destruction
| - Found and collected all Missile upgrades.
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| - Defeated balrog, again...
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| - Completed Wind Fortress in Less Than 5:00.
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| - Completed Wind Fortress in Less Than 6:00.
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| - Completed Wind Fortress in Less Than 7:00.
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| - Completed Wind Fortress in Less Than 4:00.
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