Items

Items are an integral part of the game-play of The Binding of Isaac: Rebirth. They modify Isaac's attributes, grant or modify tear effects, and much more.

Items are classified into several distinct types and groups. Some items are passive, which add an effect permanently to Isaac, while others only activate when used. The original The Binding of Isaac had 196 items. Rebirth has a total of 341 items. Afterbirth added 95 new items, for a total of 436 items. Afterbirth † added 111 new items, for a total of 547 items. Repentance added 169 new items, for a total of 716 items. In Afterbirth † and prior, 13 items are considered special and will be less likely to appear if the player has already come across other special items. The Repentance expansion removed the Special Item mechanic, replacing it with the item weight and item quality mechanics.

For a list of which items can potentially appear in a given special room or under certain conditions, see item pool and Item Tags.

For the grids of items that appear in the stats menu, see Collection Page.

Not to be confused with cards and runes, pills, and trinkets.

Activated Collectibles
Unless the player has, only one activated item can be held at a time, with the old collectible being placed on a pedestal if a new activated item is picked up. Most activated items need to recharge before use, with the recharge bar filling either by clearing rooms or recharging over time. Other activated items do not have a charge bar, and, with a few exceptions (such as ), will instead either disappear after a single use or require resources such as coins or health. Some activated items will also grant passive effects as long as they are equipped.

In some special circumstances, activated items can be placed in the consumable slot instead of the standard activated item slot. This counts as both an extra activated item slot and an extra consumable slot, meaning that other activated items and consumables can be picked up as normal. Items in this slot are used with the consumable key, and can't be lost through any means. Otherwise, they function the same as other activated items.

Passive Collectibles
An unlimited amount of passive collectibles can be held at a time, and the effects they grant are permanent. Their effects are vast and diverse, from simple stat and health increases to completely changing the way Isaac's tears behave.

Trivia

 * Wiggle Worm was an item in the original The Binding of Isaac; however, in Rebirth, it was changed into a trinket.
 * was a trinket in the original The Binding of Isaac, but was changed into an item. Interestingly, these changes keep the count of items and trinkets from the original game the same.
 * There are a total of 170 active items, with 74 in Rebirth, 19 in Afterbirth, 30 in Afterbirth+, and 47 in Repentance. Of those, 138 items utilize a charge bar, with 61 items in Rebirth, 16 in Afterbirth, 24 in Afterbirth+, and 37 in Repentance.
 * There are a total of 547 passive items, with 267 in Rebirth, 76 in Afterbirth, 81 in Afterbirth+, and 123 in Repentance.
 * From Rebirth to Afterbirth+, there has been about a 1:4 ratio of active items to passive items.
 * Afterbirth+'s original item count was 89. The Booster Packs added 42 items.