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Heal 7 Kill 78 Secret15/15 Save1 BonusItemUse 0
I actually got A when I has less kill count. So more kill is better not less.
Not sure about minimum save. (Need more testing)
Weapon that come with Costume like the crossbow also count as a Bonus Item so don't even use em.
No new unlockable as far I'm aware. It's just cool flex image at the end.
https://x.com/SFBTom/status/1794476443994353664
Minimum is 5 heals i think. (i only used 3 though) Also you can spam the healing spring water for the mushroom eating secret, which doesn't count towards the healing limit. I just backtracked 2-3 times so I didn't waste any healing when doing the last secret. Be sure to grab the pistol upgrade on the last mushroom and then walk back to spring while injured/poisoned. (You wont be locked out of the pistol upgrade). So you can essentially get hit 1-2 times through your run and be fine.
Overall, i got all 15 secrets with 3 heals by the end game spring method.
The point of no return is the long ass ladder just past the spring.
I think 3 saves is the limit from what I've read around, but i just avoided saving to be safe.
No bonus items or weapons.
I tried to kill as much as I could. Ended up saving grenades/shotguns for lumbers/spindles/grinners and used my pistol for environmental kills as much as possible. Avoid fighting bosses if you can, all those resources for +1 kill ain't worth it. Also try to prioritize the main travelling rooms to kill, so you can transverse way easier, mainly the final courtyard with the animatronic crow and the area where you find the first injured NPC, which will make it easier to back track from healing spring -> mushroom king
IMO the areas i always got hit in were the witch garden because they can hit through walls and the damn torture chamber. Strongly suggest getting the shotgun before getting the trident. Otherwise, you can avoid getting hit by running around or resetting the room.
You don't really need to save the injured dude for S+. If you leave him him there, enemies won't spawn till so you get a bit free roam early.
Healing spring doesn't count toward the heal count but you will lock yourself out of pistol upgrade.
Can confirm that 3 saves are fine.
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Tips
Try to get thing done the first time you visit Restaurant & Swan Boat since enemy will only spawn on your 2nd visit. Have the trident & egg ready before you go there.
Skip south west lift after you get the battery since the room will be filled up with mobs & spike. Try north west lift instead.
Edit: you get a different ending screen picture depending on your rank
No it just 1 flex image at the end. You unlock crow (head) costume with crossbow (weapon) by just beating the hard mode at any rank.
I finished the game with 5 heals (got poisoned..), no saves, in 40 minutes and 14/15 secrets so I only got an S
Healing 3 times and getting 14/15 secrets should net the S+
Healing minimum is 5 heals since there the other guy with S+ with 5 heals 15/15 secret.
3 Save minimum is confirmed by the dev himself. (Both posts are on twitter)
Correct, but if you skip the mushroom secret you can still get S+ by using less healing items. I think it has to be 2 or 3 maximum.
Point being is that it is a tradeoff - 2-3 Heals and 14/15 secrets, or 5 heals and 15/15 secrets
Skipping the mushroom secret is a good way to save time and healing uses