Gives Isaac a chance to visually turn into Azazel when clearing a room. Isaac keeps his hearts and items, but changes his tears to be a short range Brimstone, grants a x1.5 damage multiplier and gains the ability to fly.
The effect lasts until clearing and leaving another room.
The effect can be taken to the next floor.
When playing as Azazel, the effect instead increases the width of his Brimstone, identical to his Birthright effect.
Notes[ | ]
Dropping the trinket after this transformation will not reverse it until a new room is cleared.
The trinket only changes Isaac's appearance to be as Azazel's but doesn't change the actual character. This means that the trinket cannot be used to unlock achievements for Azazel.
The effect will not change Isaac's health mechanics. For example, The Lost will retain his zero health and Holy Mantle.
When entering the area in Mines/Ashpit to obtain Knife Piece 2 while in the Azazel form, you will still be able to fly and fire Brimstone despite visually reverting. This allows you to quickly move through the area towards the Knife Piece.
However, because picking up the Knife Piece triggers a a room clear, you will be reverted as soon as you leave the room, forcing you to escape the area like normal.
Synergies[ | ]
Golden Trinket: The chance of Isaac turning into Azazel is multiplied.
Rock Bottom: Isaac retains the damage multiplier and base speed increase after the effect ends. Also removes the tear delay multiplier when transformed into Azazel.
Interactions[ | ]
Birthright as Azazel: Azazel's Stump has no further effect.
The Forgotten: Grants flight, but still use his regular bone club attack while in skeleton form. The Soul will work as expected, and use the short range Brimstone.
Tainted Forgotten: The bone pile will visually turn into Azazel, with no gameplay effects.
Azazel when clearing a room. Isaac keeps his hearts and items, but changes his tears to be a short range 
Tainted Azazel Unlocks 
Mother Unlocks 
The Binding of Isaac: Rebirth
