| Achievement | How to unlock
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| Absent Parent | Release Melissa from her Trap.
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| Aphasia | Release Oswald from his Trap.
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| Born Victim | Release Jeff from his Trap.
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| Choked Up | First kill with a Gas Mine.
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| Cleaning Up | Five kills with a Mop Handle.
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| Cost of the Truth | Complete game using Truth door.
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| Curb Stomp | Stomped first Minion to Death.
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| Damaged Goods | Release Amanda from her Trap.
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| Darwin Would Be Proud | Died three times.
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| Duress | Kill 20 Minions.
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| Eager Student | Release Obi from his Trap.
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| Forced Entry | Unlocked First Door.
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| Give Me Five! | Five kills with a Mannequin Arm.
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| Grave Digger | First kill with a Shovel.
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| Hatchet Job | Five kills with a Hatchet.
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| Hit and Run | Release Jennings from his Trap.
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| Homerun | Four kills with a Bat.
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| I Can Stop Anytime | Used 20 Health Syringes.
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| I'm In Charge | Fought first NPC.
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| It Was An Accident | Kill first Minion.
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| It's a Trap! | Complete Reverse Bear Trap.
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| Just Experimenting | Used Health Syringe for the first time.
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| Kill or Be Killed | Killed a Collared Minion with a collar detonation.
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| Lights Off | Five kills with a Table Lamp.
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| Lock Smith | Unlock 5 locked doors.
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| Merciless | Stomped five Minions to Death.
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| Never Truly Free | Complete game using Freedom door.
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| Penetrated | First kill with a Syringe.
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| Pipe Dream | Five kills with a Pipe.
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| Professional | Unlock 20 locked doors..
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| Say Hello To My Little Friend | First kill with a Gun.
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| Self-Defense | Kill 10 Minions.
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| Sometimes It Sticks | Five kills with a Nail Bat.
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| Splitting Headache | First kill with a Scissors.
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| Stop, Drop, And Roll | First kill with a Molotov.
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| Surgeon | First kill with a Scalpel.
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| Treasure! | Unlock First Container.
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| Violence Begets Violence | Kill the Pighead.
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| Wait For The Boom | First kill with an Explosive Mine.
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| What Was That?!? | First encounter with Pighead.
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| Who is the Jigsaw Killer? | Find your first Patient File.
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| Whoops! | First kill with a Stun Mine.
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| Would You Like To Know More? | Find your first Asylum File.
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| You'll Need This Afterwards | First kill with a Crutch.
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| You've Been Served | Five kills with a Table Leg.
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| You've Wasted Your Life | Idle for five minutes.
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