| Bad Conductor (Silver) | Complete all CHALLENGES for 'Scream Train' |
| Ballistic Trauma (Bronze) | Complete 'Ballistic Trauma' in Story Mode |
| Be My Valentine, Jill (Gold) | Unlock all unlockables and purchase all weapons |
| Boom Headshot! (Bronze) | Decapitate 200 mutants |
| Caesar's Salad (Silver) | Complete all CHALLENGES for 'Papa's Palace of Pain' |
| Carny (Bronze) | Complete 'Carny' in Story Mode |
| Clown Shoes (Silver) | Complete all CHALLENGES for 'Carny' |
| Creeping Flesh (Bronze) | Complete 'Creeping Flesh' in Story Mode |
| De-Generation (Bronze) | Collect 10 LPs |
| Decom-Poster Child (Bronze) | Collect 15 posters |
| Dis-Figurine Collection (Bronze) | Collect 15 figurines |
| Do You Feel Lucky? (Gold) | Complete all levels in Classic Mode without using any continues |
| Doctors and Nurses (Silver) | Complete all CHALLENGES for 'Ballistic Trauma' |
| Extreme Hardcore (Gold) | Complete all Director's Cut levels in Hardcore Mode |
| Fully Loaded (Bronze) | Fully upgrade any weapon |
| Goregasm! (Bronze) | Achieve a Goregasm |
| Graphic Horror (Bronze) | Collect 17 comic book pages |
| Hardcore (Bronze) | Complete any level in Director's Cut without using any continues |
| I'll Try Anything Once (Bronze) | Play each minigame through to completion once |
| Jail Bird (Silver) | Complete all CHALLENGES for 'Jailhouse Judgment' |
| Jailhouse Judgment (Bronze) | Complete 'Jailhouse Judgment' in Story Mode |
| Lab Rat (Silver) | Complete all CHALLENGES for 'Overkill' |
| Lights, Camera, Headshot! (Silver) | Complete all levels in Director's Cut |
| Meat Packer (Silver) | Complete all CHALLENGES for 'Creeping Flesh' |
| Merchant of Menace (Bronze) | Buy a new weapon |
| Naked Terror (Bronze) | Complete 'Naked Terror' in Story Mode |
| Never Runs Dry (Silver) | Complete a level without triggering an enforced reload (i.e. reaching zero bullets) |
| Overkill (Bronze) | Complete all levels in Story Mode |
| Papa's Palace of Pain (Bronze) | Complete 'Papa's Palace of Pain' in Story Mode |
| Perfect Victory (Gold) | Achieve an S rank for all levels in Story Mode or Director's Cut |
| Power of the Mind (Bronze) | Complete any level with the targeting crosshair off |
| Private Dance (Silver) | Complete all CHALLENGES for 'Naked Terror' |
| Scream Train (Bronze) | Complete 'Scream Train' in Story Mode |
| Suffer Like G Did (Bronze) | Complete any level with only one health segment remaining |
| Swamp Monster (Silver) | Complete all CHALLENGES for 'The Fetid Waters' |
| The Fetid Waters (Bronze) | Complete 'The Fetid Waters' in Story Mode |
| The House of the Dead: Overlord (Platinum) | Unlock all trophies |
| Toasty! (Bronze) | Kill 5 or more mutants with one grenade |
| Weak At The Knees (Bronze) | Maintain a Goregasm for 2 minutes |
| Yakuza (Bronze) | Kill 100 mutants 'Gangster Style' (holding gun sideways) |
