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Data from Steam — Steam Web API Terms of Use. Last updated .
| Achievement | How to unlock | Unlocked by | Rarity |
|---|---|---|---|
| Have at least one of each type of ambulance fully upgraded in the same hospital. | 0.3% | Ultra rare | |
| Collect 20 patients in one trip with a Pantomobile. | 0.3% | Ultra rare | |
| Earn 108 Gold Stars | 0.4% | Ultra rare | |
| Complete Wave 42 on Topless Mountain | 0.5% | Ultra rare | |
| Earn 99 Gold Stars |
| Ultra rare |
| Complete Superbug Project "Learning Machine Learning" | 0.6% | Ultra rare |
| Maximise your Green Energy capacity in Windsock | 0.7% | Ultra rare |
| Reach the top of every league table at once for 3 months | 0.7% | Ultra rare |
| Train Roderick Cushion to Level 5 at Plywood Studios | 0.7% | Ultra rare |
| Unlock every plot in Overgrowth | 0.7% | Ultra rare |
| Activate every Robo-Janitor prototype in Chasm 24 | 0.8% | Ultra rare |
| — | 0.8% | Ultra rare |
| Earn 90 Gold Stars | 0.8% | Ultra rare |
| Complete 50 Research Nodes | 0.9% | Ultra rare |
| Achieve a high VIBE rating at Fitzpocket Academy | 0.9% | Ultra rare |
| — | 1% | Very rare |
| Earn 81 Gold Stars | 1% | Very rare |
| Complete Wave 18 at Mudbury Festival | 1% | Very rare |
| Earn 1 Star at each hospital in Speedy Recovery | 1.1% | Very rare |
| Send 100 cured patients through the Yesterizer in Clockwise-above-Thyme | 1.2% | Very rare |
| Earn 72 Gold Stars | 1.3% | Very rare |
| Complete R.E.M.I. X versions of Mitton University, Tumble & Flemington | 1.3% | Very rare |
| Earn 1 Star at each hospital in A Stitch In Time | 1.4% | Very rare |
| Earn 1 Star at each hospital in Off The Grid | 1.5% | Very rare |
| Cure a patient with Lightheadedness, Beheadedness, Hotheadedness, and Byteheadedness in Clockwise-above-Thyme | 1.5% | Very rare |
| Earn 1 Star at each hospital in Culture Shock | 1.5% | Very rare |
| Earn 1 Star at each hospital in Close Encounters | 1.6% | Very rare |
| Expose 50 Alien Infiltrators | 1.7% | Very rare |
| Earn 63 Gold Stars | 1.7% | Very rare |
| Complete R.E.M.I. X versions of Hogsport, Lower Bullocks & Flottering | 1.9% | Very rare |
| Receive the highest possible Eco Rating | 2% | Very rare |
| Earn 1 Star at each hospital on Pebberley Island | 2.1% | Very rare |
| — | 2.1% | Very rare |
| Cure a patient in the Herb Garden | 2.2% | Very rare |
| Cure a patient with Frogborne | 2.2% | Very rare |
| Earn 54 Gold Stars | 2.3% | Very rare |
| — | 2.7% | Very rare |
| Cure 100 patients from time portals in a single year | 2.7% | Very rare |
| Earn 1 Star at each hospital in the Pointy Mountains | 3.2% | Very rare |
| — | 3.4% | Very rare |
| Train a World-Class Surgeon | 3.5% | Very rare |
| Earn 45 Gold Stars | 3.6% | Very rare |
| Run 50 Marketing Campaigns | 5.6% | Rare |
| Win every award in a single hospital | 6.6% | Rare |
| Train a World-Class Psychiatrist | 6.7% | Rare |
| Train a World-Class Researcher | 6.9% | Rare |
| Earn 30 Gold Stars | 7.8% | Rare |
| Complete 50 Research Projects | 9% | Rare |
| Reach $50,000,000 Organisation Value | 9.5% | Rare |
| Complete Superbug Project "Hair Removal" | 10.5% | Rare |
| Complete a Multiplayer Challenge | 14.4% | Rare |
| — | 16.3% | Rare |
| Earn 10,000 Kudosh | 16.4% | Rare |
| Have a Level 20 Hospital | 18.6% | Rare |
| Earn 15 Gold Stars | 23.2% | Uncommon |
| Capture 100 Ghosts | 24.2% | Uncommon |
| — | 31.3% | Uncommon |
| Conduct 25 Machine Upgrades | 34.4% | Uncommon |
| Cure 1000 Patients | 35% | Uncommon |
| Have a Level 10 Hospital | 58.5% | Common |