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The Vile Acts Medal is an item obtained in Silent Hill: Homecoming. It is one of three medals used to solve the Medal Puzzle in the Otherworld Shepherd House, it is located attached to a mannequin in the attic.
When examined, it is revealed that the Vile Acts Medal is awarded "For the atrocities committed". It likely references Alex Shepherd's act of accidentally killing his brother Joshua. It may also represent Adam Shepherd's mistreatment of Alex, and his plans to sacrifice him, since one of the memos used to solve the puzzle is Adam's. In Adam's case, the Vile Acts Medal would be an inversion of the "Good Conduct Award" Adam received.
- The medal bears the shape of the Bogeyman's distinctive helmet.