 There are 46 achievements with a total of 1000 points.
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 | You've Wasted Your Life | 5  | ||||
| Idle for five minutes. |  | |||||
 | You've Been Served | 10 | ||||
| First kill with a Table Leg. |  (5) | |||||
 | You'll Need This Afterwards | 10 | ||||
| First kill with a Crutch. | | |||||
 | Would You Like To Know More? | 20 | ||||
| Find your first Asylum File. | | |||||
| Whoops! | 10 | ||||
| First kill with a Stun Mine. | (5) | |||||
| Who Is The Jigsaw Killer? | 15 | ||||
| Find your first Patient File. | | |||||
| Wait For The Boom | 10 | ||||
| First kill with an Explosive Mine. | (4) | |||||
 | Treasure! | 10 | ||||
| Unlock first container. | (1) | |||||
 | Surgeon | 10 | ||||
| First kill with a Scalpel. | | |||||
 | Splitting Headache | 10 | ||||
| First kill with Scissors. | (3) | |||||
 | Sometimes It Sticks | 10 | ||||
| First kill with a Nail Bat. | | |||||
 | Self-Defense | 15 | ||||
| Kill 10 minions. | (1) | |||||
 | Say Hello To My Little Friend | 10 | ||||
| First kill with a Gun. | | |||||
| Professional | 50 | ||||
| Unlock 20 locked doors. | (3) | |||||
| Pipe Dream | 10 | ||||
| First kill with a Pipe. | | |||||
 | Penetrated | 10 | ||||
| First kill with a Syringe. | (6) | |||||
 | Merciless | 20 | ||||
| Stomped five Minions to death. | (22) | |||||
 | Locksmith | 20 | ||||
| Unlock 5 locked doors. | | |||||
| Lights Off | 10 | ||||
| First kill with a Table Lamp. | | |||||
| Kill Or Be Killed | 30 | ||||
| Killed a Collared Minion with a collar detonation. | | |||||
| Just Experimenting | 10 | ||||
| Used Health Syringe for the first time | | |||||
 | It Was An Accident | 10 | ||||
| Kill first minion. | | |||||
 | I'm In Charge | 10 | ||||
| Fought first NPC. | | |||||
| I Can Stop Anytime | 20 | ||||
| Used 20 Health Syringes. | (1) | |||||
 | Homerun | 10 | ||||
| First kill with a Bat. | | |||||
 | Hatchet Job | 10 | ||||
| First kill with a Hatchet. | (7) | |||||
| Grave Digger | 10 | ||||
| First kill with a Shovel. | | |||||
 | Give Me Five! | 10 | ||||
| First kill with a Mannequin Arm. | | |||||
 | Forced Entry | 10 | ||||
| Unlocked first door. | | |||||
 | Fire Hazard | 10 | ||||
| First kill with fire | (4) | |||||
 | Duress | 20 | ||||
| Kill 20 minions. | | |||||
 | Darwin Would Be Proud | 20 | ||||
| Died once. | | |||||
 | Curb Stomp | 10 | ||||
| Stomped first Minion to death. | | |||||
| Cleaning Up | 10 | ||||
| First kill with a Mop Handle. | | |||||
| Choked Up | 10 | ||||
| First kill with a Gas Mine. | | |||||
Secret Achievements | ||||||
 | What Was That?!? | 5 | ||||
| First encounter with Pighead. | (1) | |||||
 | Violence Begets Violence | 40 | ||||
| Kill the Pighead | (5) | |||||
 | Never Truly Free | 100 | ||||
| Complete game using Freedom Door. | (5) | |||||
 | It's A Trap! | 40 | ||||
| Complete Reverse Bear Trap | | |||||
 | Hit And Run | 40 | ||||
| Release Jennings from his Trap | (2) | |||||
 | Eager Student | 40 | ||||
| Release Obi from his Trap | (1) | |||||
 | Damaged Goods | 40 | ||||
| Release Amanda from her trap | (2) | |||||
 | Cost of the Truth | 100 | ||||
| Complete Game using Truth Door | (5) | |||||
 | Born Victim | 40 | ||||
| Release Jeff from his Trap | | |||||
 | Aphasia | 40 | ||||
| Release Oswald from his Trap | (3) | |||||
 | Absent Parent | 40 | ||||
| Release Melissa from her Trap | (1) | |||||
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