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This achievement can be earned at any time during your playthrough, specifically on the lethal High Chaos run.

Despite the achievement description not specifying whether "eliminated" means knocked out or killed, progress towards this achievement can only be made by killing ( [ Register or Signin to view external links. ] ) unaware enemies. This will more than likely come naturally over the course of a playthrough; stalk from the shadows and distract enemies if necessary with crossbow bolts or glass bottles. Just remember: despite playing lethally, do not always engage the enemy head-on in open combat, otherwise they will be aware of your presence. The achievement will unlock once you have killed a total of twenty unaware enemies.