There are 32 achievements for the Xbox 360, half of which are secret, for a total of 1,000 
.
General[edit]
| Picture | Name | Description | |
|---|---|---|---|
 |
Lock 'n' Load | Found Rifle | 25
|
 |
Sightseeing | Found 1 Photo | 10
|
 |
Josh's Gallery | Found ALL Photos | 50
|
 |
Alchemilla's Finest | Defeated 1 Nurse | 10
|
 |
Eddie's Legacy | Defeated 1 Feral | 10
|
 |
Lurk No More | Defeated 1 Lurker | 10
|
 |
To The Point | Defeated 1 Needler | 10
|
 |
Split Personality | Defeated 1 Schism | 10
|
 |
Shades of James | Defeated 1 Siam | 20
|
 |
Clear the Air | Defeated 1 Smog | 10
|
 |
Creeper Reaper | Defeated 1 Swarm | 10
|
 |
Out of Order | Defeated 1 Order member | 10
|
 |
Kaufmann's Handiwork | Found 1 Serum | 10
|
 |
Health Junkie | Found all Serums | 50
|
 |
The Old Gods... | .. Haven't Left This Place Complete game on HARD difficulty. | 100
|
 |
Nursery Rhymes | Found all the Children's Drawings | 50
|
Secret[edit]
| Picture | Name | Description | |
|---|---|---|---|
 |
Six Feet Under | Defeated Sepulcher | 50
|
 |
Blood Donor | Defeated Scarlet | 50
|
 |
Catch Your Breath | Defeated Asphyxia | 50
|
 |
Head Above Water | Defeated Amnion | 50
|
 |
Rising Tension | Found Circular Saw | 25
|
 |
Science Fiction | Found Laser Pistol | 25
|
 |
Smile | Achieved Ending 1 | 50
|
 |
In Water | Achieved Ending 2 | 50
|
 |
Judgement | Achieved Ending 3 | 50
|
 |
Intensive Care | Achieved Ending 4 | 50
|
 |
No Dogs Allowed | Achieved Ending 5 | 50
|
 |
Mercy | Alex ended his mother's suffering | 20
|
 |
Compassion | Alex could not end his mother's suffering | 20
|
 |
Forgiveness | Alex Forgives his father | 20
|
 |
Angela's Choice | Alex does not forgive his father | 20
|
 |
Now About Those Drinks | Saved Wheeler | 25
|