Achievement Description Instructions
I'm glad you're here. Start a new game in standard mode.
You made it this far! Make it to room 250 in standard mode.
Halfway There
Always forward, never back. Make it to room 500 in standard mode.
The Final Stretch
You'll need unlimited stamina to race to the end! Make it to room 750 in standard mode.
You Did It!
Just go towards the light! Make it to room 1000 in standard mode.
Achievement goodending
Welcome to the Army
Spooky believes in your potential! Get the good ending in standard mode.
Achievement badending2
It Was Never A Mask
Who is the real monster? Get the bad ending in standard mode.
Achievement axe
New AXEuisition
Extra-dimensionally choppy Get the Axe in standard mode.
Meta gamer
Spooky inception! Play all 3 of the arcade games in standard mode.
Avid reader
Avid Reader
These are their stories. Read all the notes in standard mode.
Speedrun Strats
I admire your confidence! Complete standard mode without saving.
Near-death expiriance
Near-Death Experience
Almost got you! Escape a chase with almost no health in standard or Endless Mode.
Specimen researcher
Specimen Researcher
Were you taking notes? Encounter all specimen in Endless Mode. (23)
Just keep moving Walk / run for 26 miles in standard mode, Endless mode or Karamari Hospital
Visiting hour
Visiting Hour
Welcome to Karamari Hospital! Get to the lobby in Karamari Hospital.
Karamari hospital good ending
You Should Go Now
This place should be shut down... Get the good ending in Karamari Hospital.
Karamari hospital bad ending
She Fears You
Please don't hurt me. Get the bad ending in Karamari Hospital.

These achievements are hidden and the following information contains spoilers. To view them, click the [Expand] tag.

Achievement Description Instructions
Death achievement
Game Over and Over
You just... can't stop dying can you? Die to all 12 hostile specimen in standard mode.
Try and restrain yourself Do not use your axe with the exception of cutting terrain and the boss fight in standard mode.
A rival
A_Rival Mode!
I am super scared! Reach room 1000 without turning on Specimen or Jump Scares in standard mode.
Brain power
Brain Power
Oops... Hit the Brain Tank with your weapon in standard or Endless Mode.
Clone wars
Seeing Double
Double the specimen, double the fun! Encounter two of the same enemy at the same time in Endless Mode
Room 1001
This Isn't The End?!
Just...just keep going! Reach room 1001 in Endless Mode.
Love is over... Successfully complete Sunshine Academy in Karamari Hospital.
Backseat gamer
Backseat Gamer
You're doing it wrong, give me the controller! Get killed by Monster 4 while playing Sunshine Academy in Karamari Hospital.
Knife to meet you
Knife To Meet You
Where did you get that sword? Complete New Game+ on Karamari Hospital.