10 HypochondriacUsed 20 First Aid Kits.
100 Capital PunishmentCompleted the game on the hard game difficulty setting, any ending.
100 Puzzle MasterCompleted the game on the hard puzzle difficulty setting, any ending.
100 Silent Hill Tour GuideCompleted all side quests.
20 Fight or Flight?Escaped from 20 monsters.
20 LockdownKilled or incapacitated 10 Prisoner Minions.
20 Piñata PartyKilled or incapacitated 10 Weeping Bats.
20 Shadow BoxerKilled or incapacitated 10 Dolls.
20 Silence is GoldenKilled or incapacitated 10 Screamers.
20 The Bigger They Are…Killed or incapacitated 10 Prisoner Juggernauts.
25 Gun ControlKilled 25 monsters with the Pistol or Shotgun.
25 Stay of ExecutionIncapacitated 20 monsters without killing them.
5 Art AppreciationCompleted 'The Art Collector' side quest.
5 BirdmanCompleted the 'Bird Cage' side quest.
5 Calling All CarsCompleted the 'All Points Bulletin' side quest.
5 Cutting Room FloorCompleted the 'Cinéma Vérité' side quest.
5 Dust to DustCompleted the 'Ashes to Ashes' side quest.
5 Long Walk, Short PierCompleted the 'Ribbons' side quest.
5 Neighborhood WatchCompleted the 'Stolen Goods' side quest.
5 Silent AlarmCompleted 'The Bank' side quest.
5 Spot the DifferenceCompleted the 'Mirror, Mirror' side quest.
5 Telltale HeartCompleted the 'Dead Man's Hand' side quest.
5 Turn Back TimeCompleted 'The Gramophone' side quest.
5 Useless TrinketsCompleted the 'Digging up the Past' side quest.
5 What's Your Sign?Completed the 'Shadow Play' side quest.
5 Will Work For FoodCompleted the 'Homeless' side quest.
50 Good BehaviorCompleted the game on any difficulty without killing any monsters.
50 Silent Hill Historic SocietyCompleted Murphy's Journal with all Mysteries.