Cards and Runes

Pickups

Hearts

Coins

Bombs

Keys

Batteries

Pills

Cards/Runes

Chests

Sacks

Cards and runes are usable items with a wide variety of effects. They take up the same slot as Pills.

Runes and special cards are unlocked by completing challenges.

Cards

Major Arcana Cards

When on the ground, these cards look like:

Name	ID	Icon	Message	Description
0 - The Fool	5.300.1		Where journey begins	Teleports Isaac back to the starting room of the floor that he is currently on.
I - The Magician	5.300.2		May you never miss your goal	Grants homing tears for the current room. Grants homing tears and +3 Range for the current room.
II - The High Priestess	5.300.3		Mother is watching you	Mom's dismembered leg stomps on the enemy with the most health, dealing 300 damage and destroying obstacles in the area. If used in an empty room or during the Mom fight, stomps Isaac instead. Isaac can move to avoid the stomp.
III - The Empress	5.300.4		May your rage bring power	Triggers the Whore of Babylon effect (+1.5 Damage, +0.3 Speed) for the current room, regardless of Isaac's health total.
IV - The Emperor	5.300.5		Challenge me!	Teleports Isaac into the Boss Room.
V - The Hierophant	5.300.6		Two prayers for the lost	Drops 2 full Soul Hearts on the ground.
VI - The Lovers	5.300.7		May you prosper and be in good health	Drops 2 full Red Hearts on the ground.
VII - The Chariot	5.300.8		May nothing stand before you	Gives invulnerability and +0.28 speed for six seconds, removing the ability to shoot tears and replacing it with the ability to deal contact damage to enemies.
VIII - Justice	5.300.9		May your future become balanced	Drops a random type of Heart, Key, Bomb, and Coin pickup on the ground.
IX - The Hermit	5.300.10		May you see what life has to offer	Teleports Isaac to the Shop.
X - Wheel of Fortune	5.300.11		Spin the wheel of destiny	Creates a Slot Machine or Fortune Telling Machine near Isaac.
XI - Strength	5.300.12		May your power bring rage	Grants the effects of Magic Mushroom (minus the health restoration) for one room. The added Red Heart container is not removed if doing so would kill Isaac.
XII - The Hanged Man	5.300.13		May you find enlightenment	Grants flight for the duration of the room.
XIII - Death	5.300.14		Lay waste to all that oppose you	Deals 40 damage to all enemies in the room.
XIV - Temperance	5.300.15		May you be pure in heart	Creates a Blood Donation Machine near Isaac. Spawns a Devil Beggar instead in Greed mode.
XV - The Devil	5.300.16		Revel in the power of darkness	Grants +2 Damage for the current room.
XVI - The Tower	5.300.17		Destruction brings creation	Drops 6 Troll Bombs randomly around the room.
XVII - The Stars	5.300.18		May you find what you desire	Teleports Isaac to the Treasure Room. Randomly chooses a Treasure Room if there is an active Curse of the Labyrinth. If there is a Planetarium, teleports Isaac there instead.
XVIII - The Moon	5.300.19		May you find all you have lost	Teleports Isaac to the Secret Room. Opens one random wall inside the Secret Room, so Isaac can leave even if he doesn't have any Bombs. Randomly chooses a Secret Room if there are multiple (via Fragmented Card and/or Luna).
XIX - The Sun	5.300.20		May the light heal and enlighten you	Restores Isaac to full health, deals 100 damage to all enemies in the room, and reveals the map for the current floor, except for the Super Secret Room and Ultra Secret Room. Removes Curse of Darkness for the current floor.
XX - Judgement	5.300.21		Judge lest ye be judged	Spawns a Beggar or a Devil Beggar near Isaac. Has a 2% chance to spawn a Battery Bum, Rotten Beggar, Key Master, or Bomb Bum instead.
XXI - The World	5.300.22		Open your eyes and see	Reveals the entire floor, except for the Super Secret Room and Ultra Secret Room.

Reversed Major Arcana Cards

These cards share the same names as their counterparts (barring the question marks at the end of their names), but have the sprite upside-down, a different message, the narrator sound clip reversed, and give different effects.

When on the ground, these cards look like:

Name	ID	Icon	Unlock method	Message	Description
0 - The Fool?	5.300.56		Defeat Ultra Greedier as Tainted Lost	Let go and move on	Drops all Hearts and pickups Isaac currently possesses on the floor, leaving Isaac at half a heart. Pickups may be dropped as items such as A Quarter and Boom!.
I - The Magician?	5.300.57		Defeat Ultra Greedier as Tainted Judas	May no harm come to you	Grants a repelling blue aura for one minute, like The Soul but stronger and with a wider area of effect.
II - The High Priestess?	5.300.58		Defeat Ultra Greedier as Tainted Lilith	Run	Mom's leg starts stomping down repeatedly (targeting Isaac, not the enemies) for one minute, like holding Broken Shovel.
III - The Empress?	5.300.59		Defeat Ultra Greedier as Tainted Eve	May your love bring protection	Grants 2 temporary Red Heart Containers, +1.5 Fire Rate, and -0.1 Speed for one minute, along with Magdalene's hairstyle. The effect does not stack with itself. When the effect ends, if the removal of the Heart Containers would kill Isaac, he is left with one instead.
IV - The Emperor?	5.300.60		Defeat Ultra Greedier as Tainted ???	May you find a worthy opponent	Teleports Isaac into an extra Boss Room from the boss pool two floors deeper than the current floor (but never a final boss). The boss will drop a reward. Exiting the room returns Isaac to where he used the card.
V - The Hierophant?	5.300.61		Defeat Ultra Greedier as Tainted Bethany	Two prayers for the forgotten	Drops 2 Bone Hearts on the ground.
VI - The Lovers?	5.300.62		Defeat Ultra Greedier as Tainted Magdalene	May your heart shatter to pieces	Creates a random item from the current room's item pool. Turns one Red Heart Container or two Soul Hearts into a Broken Heart.
VII - The Chariot?	5.300.63		Complete Hot Potato (challenge #42)	May nothing walk past you	Isaac becomes an invincible statue with 4× fire rate for 10 seconds. The statue can be nudged slightly by moving and is affected by knockback.
VIII - Justice?	5.300.64		Complete Cantripped (challenge #43)	May your sins come back to torment you	Creates 2 to 4 Locked Chests near Isaac.
IX - The Hermit?	5.300.65		Complete Red Redemption (challenge #44)	May you see the value of all things in life	Turns items and pickups in the room into Coins, matching their normal shop price. If there is nothing to sell, drops a Penny.
X - Wheel of Fortune?	5.300.66		Defeat Ultra Greedier as Tainted Cain	Throw the dice of fate	Invokes a random Dice Room effect.
XI - Strength?	5.300.67		Defeat Ultra Greedier as Tainted Samson	May you break their resolve	All enemies in the room are weakened, becoming slow and taking double damage. The effect lasts up to one minute or until the room is left.
XII - The Hanged Man?	5.300.68		Defeat Ultra Greedier as Tainted Keeper	May your greed know no bounds	Isaac turns visually into Keeper for 30 seconds, with triple shot and -0.1 Speed. Killed enemies drop random Coins.
XIII - Death?	5.300.69		Defeat Ultra Greedier as Tainted Forgotten	May life spring forth from the fallen	Creates a friendly Bony or temporary bone orbital for each enemy killed in the current room.
XIV - Temperance?	5.300.70		Complete DELETE THIS (challenge #45)	May your hunger be satiated	Forces Isaac to eat 5 random Pills in quick succession.
XV - The Devil?	5.300.71		Defeat Ultra Greedier as Tainted Azazel	Bask in the light of your mercy	Invokes The Bible (which can kill Mom). Grants Flight and spawns a Seraphim familiar for 30 seconds.
XVI - The Tower?	5.300.72		Defeat Ultra Greedier as Tainted Apollyon	Creation brings destruction	Creates 7 clusters of random rocks and other obstacles. Spawned clusters will often contain tinted rocks, with the possibility of finding more than one in the same room. The pathways between exits can't be blocked.
XVII - The Stars?	5.300.73		Defeat Ultra Greedier as Tainted Isaac	May your loss bring fortune	Removes Isaac's oldest passive item (ignoring starting items) and creates 2 random items from the current room's item pool. Does nothing if Isaac has no items.
XVIII - The Moon?	5.300.74		Defeat Ultra Greedier as Tainted Jacob	May you remember lost memories	Teleports Isaac to the Ultra Secret Room. The pathway back to the normal rooms will be made of Red Rooms.
XIX - The Sun?	5.300.75		Defeat Ultra Greedier as Tainted Jacob	May the darkness swallow all around you	Gain Spirit of the Night and +1.5 Damage for the current floor. Turns Isaac's Red Hearts into Bone Hearts, but they revert once the effect ends. Also causes Curse of Darkness that cannot be dispelled.
XX - Judgement?	5.300.76		Defeat Ultra Greedier as Tainted Lazarus	May you redeem those found wanting	Creates a Shop Restock Machine near Isaac.
XXI - The World?	5.300.77		Defeat Ultra Greedier as Tainted Eden	Step into the abyss	Creates a trap door which always leads to a Crawl Space.

Playing Cards

When on the ground, these cards look like:

Name	ID	Icon	Unlock method	Message	Description
2 of Clubs	5.300.23		Always available	Item multiplier	Doubles Isaac's Bombs. If he has no bombs, gives him 2 instead.
2 of Diamonds	5.300.24		Always available	Item multiplier	Doubles Isaac's Penny. If he has no coins, gives him 2 instead.
2 of Spades	5.300.25		Always available	Item multiplier	Doubles Isaac's Keys. If he has no keys, gives him 2 instead.
2 of Hearts	5.300.26		Always available	Item multiplier	Doubles Isaac's current number of Red Hearts. Doesn't add new Red Heart containers, just fills empty ones. If Isaac has only empty Red Heart containers, he is healed for 1 Red Heart. Doubles Tainted Bethany's Blood Charges.
Ace of Clubs	5.300.27		Get a 3-win streak	Convert all	Turns all Pickups, Chests, and non-boss enemies in the room into random Bomb pickups, including Troll Bombs.
Ace of Diamonds	5.300.28		Defeat The Lamb in under 20 minutes	Convert all	Turns all Pickups, Chests, and non-boss enemies in the room into random Coin pickups.
Ace of Spades	5.300.29		Defeat The Lamb without taking Hearts, Coins, or Bombs through the entire run. Letting certain familiars (e.g. Bum Friend, Dark Bum, Bumbo or Lil Portal) or bosses (e.g. Bumbino) pick up the consumables fails this condition as well.	Convert all	Turns all Pickups, Chests, and non-boss enemies in the room into random Key pickups.
Ace of Hearts	5.300.30		Complete a Chapter (floors I and II) after Basement, start-to-finish, with only half a Heart total (can use The Lost)	Convert all	Turns all Pickups, Chests, and non-boss enemies in the room into random Hearts.
Joker	5.300.31		Always available	???	Teleports Isaac to the Devil Room or Angel Room.
Suicide King	5.300.46		Complete Suicide King (challenge #7)	A true ending?	Kills Isaac and spawns lots of Pickups, items, and/or Chests in the same room.
Queen of Hearts	5.300.79		Defeat Mega Satan as Tainted Magdalene	<3	Drops 1-20 full Red Hearts on the ground.

Magic: The Gathering Cards

When on the ground, these cards look like:   

Name	ID	Icon	Unlock method	Message	Description
Chaos Card	5.300.42		Complete Demo Man (challenge #9)	???	Throws the card in the direction Isaac is moving, which opens doors, breaks obstacles, and instantly kills any enemy in its path.
Huge Growth	5.300.52		Increase in size 5 times in a single run via Magic Mushroom, "One makes you larger" pills, XI - Strength, etc.	Become immense!	For the current room, makes Isaac larger, allows him to crush obstacles he walks on, and grants +7 flat Damage and +30 Range. For the current room, makes Isaac larger, allows him to crush obstacles he walks on, and grants +7 flat Damage and +3 Range.
Ancient Recall	5.300.53		Use Cards and Runes 20 times	Draw 3 cards	Spawns 3 random cards.
Era Walk	5.300.54		Add both the Broken Watch and the Stop Watch to your collection	Savor the moment	For the current room, enemies are slowed, Isaac's speed is increased by 0.50, and his shot speed is decreased by 1.00.

Credit Card

When on the ground, this card looks like:   

Name	ID	Icon	Unlock method	Message	Description
Credit Card	5.300.43		Complete Cursed! (challenge #10)	Charge it!	Makes all pickups and items that cost money or health in the room free.

Other Playing Cards

When on the ground, these cards look like:

Name	ID	Icon	Unlock method	Message	Description
Rules Card	5.300.44		Complete Glass Cannon (challenge #11)	???	Displays a cryptic statement on the screen, similar to a Fortune Telling Machine. These messages (often) provide hints on bosses, bonus areas, etc.
? Card	5.300.48		Always available	Double active	When used, copies the effect of Isaac's currently held activated collectible.

Card Against Humanity

When on the ground, this card looks like:   

Name	ID	Icon	Unlock method	Message	Description
A Card Against Humanity	5.300.45		Complete When Life Gives You Lemons (challenge #12)	Something stinks...	Covers the entire room with Poop. The process is not instant, and the room will not get filled if Isaac leaves before it's done filling.

Monopoly Card

When on the ground, this card looks like:   

Name	ID	Icon	Unlock method	Message	Description
Get out of Jail Free Card	5.300.47		Complete SPEED! (challenge #22)	Open Sesame	Upon use, opens all doors in the current room, exactly like Dad's Key.

Holy Card

When on the ground, this card looks like:

Name	ID	Icon	Unlock method	Message	Description
Holy Card	5.300.51		Defeat Delirium as The Lost	You feel protected	Grants a shield that blocks the next hostile damage that would be taken in the current room. Has a chance to spawn another Holy Card on use. Grants a shield that blocks the next hostile damage that would be taken.

Uno Card

When on the ground, this card looks like:

Name	ID	Icon	Unlock method	Message	Description
Wild Card	5.300.80		Defeat Mega Satan as Tainted Eden	Again	When used, copies the effect of the most recently used Pill, Card, Rune, Soul Stone, or activated item.

Runes

Left Pointing Runes

When on the ground, these runes look like:

Name	ID	Icon	Unlock method	Message	Description
Rune of Hagalaz	5.300.32		Complete Pitch Black (challenge #1)	Destruction	Destroys all breakable objects in the room. Does not affect Key Blocks.
Rune of Jera	5.300.33		Complete High Brow (challenge #2)	Abundance	Clones all pickups and Chests in the room (including Shop pickups; the clones can then be picked up for free). Cloned chests will contain exactly the same type of items: if the original contains a pickup, so will the clone; the same is true for collectibles. Cannot clone other Jera runes and trinkets.
Rune of Ehwaz	5.300.34		Complete Head Trauma (challenge #3)	Passage	Creates a trapdoor leading to the next floor. Has an estimated 1/12 (8%) chance to create a trapdoor leading to a Crawl Space instead. Guaranteed to create a trap door to a Crawl Space if used on floor tiles containing certain patterns. Will not create trapdoors if used on the end floor of a challenge.
Rune of Dagaz	5.300.35		Complete Darkness Falls (challenge #4)	Purity	Removes any Curses from the current floor and grants a Soul Heart. (This will not remove Curse of the Labyrinth.)

Right Pointing Runes

When on the ground, these runes look like:

Name	ID	Icon	Unlock method	Message	Description
Rune of Ansuz	5.300.36		Complete The Tank (challenge #5)	Vision	Reveals the whole map, including the Secret Room and the Super Secret Room. (This will not remove Curse of the Lost.) Does not reveal the Ultra Secret Room
Rune of Perthro	5.300.37		Complete Solar System (challenge #6)	Change	Rerolls all item pedestals in the room (the same effect as The D6).
Rune of Berkano	5.300.38		Complete Purist (challenge #20)	Companionship	Summons 3 friendly Blue Flies and 3 friendly Blue Spiders.
Rune of Algiz	5.300.39		Complete Cat Got Your Tongue (challenge #8)	Resistance	Grants a shield which lasts for 30 seconds. Grants a shield which lasts for 20 seconds.
Blank Rune	5.300.40		Complete Onan's Streak (challenge #29) Complete The Guardian (challenge #30)	???	Grants a random rune effect excluding Black Rune. Has a 25% chance to drop another Blank Rune on the ground upon use.

Other Runes

Rune Shards can be encountered only as replacements for runes that have not been unlocked. Once 6 runes of any kind (including soul stones) are available, Rune Shards cease to spawn.

Name	ID	Icon	Unlock method	Message	Description
Black Rune	5.300.41		Defeat Ultra Greedier as Apollyon	Void	Deals 40 damage to all enemies in the room. Consumes all pickups in the room and turns them into Blue Flies and Spiders. Consumes all pedestal items in the room and turns them into random stat upgrades.
Rune Shard	5.300.55		Always available	It still glows faintly	Activates a random, weak rune effect: Algiz grants a 3 second shield, Ansuz reveals the map up to 3 rooms away (including Ultra Secret Room), Berkano gives 1 blue fly and spider, Dagaz gives half a Soul Heart, Ehwaz makes a trapdoor, Hagalaz destroys some rocks, Jera duplicates one pickup, and Perthro rerolls one item.

Soul Stones

Soul Stones are all unlocked by beating both Hush and Boss Rush as their respective Tainted character. They count as runes for the purposes of Clear Rune and Rune Bag and can spawn anywhere a rune can.

Name	ID	Icon	Unlock method	Message	Description
Soul of Isaac	5.300.81		Defeat Hush and Boss Rush as Tainted Isaac	Reroll... or not	Rerolls the items in the room like The D6, but they cycle back to their original form after one second, repeating. If more uses are stacked, an additional item per use will be cycled through.
Soul of Magdalene	5.300.82		Defeat Hush and Boss Rush as Tainted Magdalene	Give me your love!	Surrounds Isaac with a bubbling red aura for the current room. All enemies killed drop Half Red Hearts that disappear in 2 seconds.
Soul of Cain	5.300.83		Defeat Hush and Boss Rush as Tainted Cain	Opens the unopenable	Opens all doors in the room. Additionally, creates a Red Room like the Red Key on all valid walls. This also destroys the mirror located in Downpour / Dross II.
Soul of Judas	5.300.84		Defeat Hush and Boss Rush as Tainted Judas	Right behind you	Increases Isaac's speed and makes him invulnerable for 3 seconds and allows him to pass through enemies. Damages all enemies and destroys all projectiles Isaac ran through when the effect ends, and grants a temporary Damage bonus for each enemy and projectile hit.
Soul of ???	5.300.85		Defeat Hush and Boss Rush as Tainted ???	Chemical warfare	Causes 8 poison farts that leave lingering brown creep, then plants a trail of 7 Butt Bombs in quick succession. Standing on the creep gives +1.5 Fire Rate and +1 Damage.
Soul of Eve	5.300.86		Defeat Hush and Boss Rush as Tainted Eve	Your very own murder	14 Dead Bird familiars fly in and attack enemies. They leave after all enemies are dead or Isaac leaves the room.
Soul of Samson	5.300.87		Defeat Hush and Boss Rush as Tainted Samson	Slay a thousand	Isaac turns berserk for 10 seconds, replacing his tears with a melee bone club and gaining +0.4 Speed, some Tears, and +3 flat Damage.
Soul of Azazel	5.300.88		Defeat Hush and Boss Rush as Tainted Azazel	Demon rage!	Activates Mega Blast for 7.5 seconds.
Soul of Lazarus	5.300.89		Defeat Hush and Boss Rush as Tainted Lazarus	Life after death	Isaac dies, and is immediately revived at half a Heart in the same room, with some invincibility time. The soul stone is automatically used upon taking fatal damage. Has the highest priority of all Revival items.
Soul of Eden	5.300.90		Defeat Hush and Boss Rush as Tainted Eden	Embrace chaos	Uses The D6 and D20. The rerolled items use random pools, as if Chaos were active.
Soul of the Lost	5.300.91		Defeat Hush and Boss Rush as Tainted Lost	Leave your body behind	Isaac "dies" and turns into a ghost for the current room, with all of The Lost's benefits and weaknesses. The Holy Mantle effect gained from this can be stacked with multiple uses.
Soul of Lilith	5.300.92		Defeat Hush and Boss Rush as Tainted Lilith	Motherhood	Adds one permanent familiar from the Baby Shop pool, except Stitches. Can give familiars that Isaac already has. Unique familiars can be received only once.
Soul of the Keeper	5.300.93		Defeat Hush and Boss Rush as Tainted Keeper	$$$	Drops 1-25 random Coins on the ground.
Soul of Apollyon	5.300.94		Defeat Hush and Boss Rush as Tainted Apollyon	Bringer of calamity	Spawns 15 random locusts.
Soul of the Forgotten	5.300.95		Defeat Hush and Boss Rush as Tainted Forgotten	Skeletal protector	Spawns The Forgotten as a temporary secondary character, controlled at the same time as Isaac. He dies with no consequences if his health run out, and disappears when Isaac leaves the room. The bone swing deals high damage, and reflects tears.
Soul of Bethany	5.300.96		Defeat Hush and Boss Rush as Tainted Bethany	Friends from beyond	Spawns 6 Book of Virtues wisps with random properties.
Soul of Jacob and Esau	5.300.97		Defeat Hush and Boss Rush as Tainted Jacob	Bound by blood	Spawns Esau as a temporary secondary character, controlled at the same time as Isaac. He dies with no consequences if his health runs out, and disappears when Isaac leaves the room. Esau has random items equal to the number of items Isaac has, each based on the pools of the items Isaac's were obtained from.

Other

These are items other than cards and runes (and Pills) that take up the consumable slot. When on the ground, each of these items are uniquely identifiable by their respective icon. These consumables cannot be replicated by either Blank Card or Clear Rune, and Tarot Cloth has no effect on them, but the D1 will always duplicate these into themselves. Despite this,Deck of Cards can produce all of these items, albeit rarely.

Name	ID	Icon	Unlock method	Message	Description
Dice Shard	5.300.49		Always available	D6 + D20	Upon use, invokes the effects of The D6 and the D20 at the same time, re-rolling all item pedestals and pickups in the room.
Emergency Contact	5.300.50		Always available	Help from above	When used, will cause two Mom's Hands to come down and grab two random enemies, dealing damage and, if they have 40 or more HP, pinning them to the ground temporarily.
Cracked Key	5.300.78		Open Mom's Chest in Home	???	Creates a room adjacent to a viable wall, like Red Key.

Probabilities

Cards that spawn as random ones, i.e. with a sub-type of 0, have the following probabilities:

• Any tarot card (1-22) - 66.66%
  • A specific tarot card - 3.03%
• Any reverse tarot card (56-77) - 11.22%
  • A specific reverse tarot card - 0.51%
• Any face card (23-31) - 7.74%
  • A specific face card (23-31) - 0.86%
• Queen of Hearts (79) - 0.86% (same as a specific face card)
• Any special card (42-54) - 3.51%
  • A specific special card - 0.27%
• Cracked Key (78) - 0.27% (same as a specific special card)
• Wild Card (80) - 0.27% (same as a specific special card)
• Any rune (32-41) - 3.60%
  • A specific rune - 0.36%
• Any soul stone (81-97) - 5.95%
  • A specific soul stone - 0.35%
• Rune shard (55) - 0.00% (never spawns on a fully completed save file, chosen only as a replacement otherwise)

Notes

• The game counts runes as cards for the purposes of Blank Card, and Tarot Cloth.
  • Even though runes no longer count as cards as of Repentance, Little Baggy still prevents new runes from appearing except through forced drops (such as from Mom's Ring or Clear Rune). Runes that already existed prior to picking up Little Baggy will not be converted.
  • Starter Deck does not prevent runes/soul stones from generating, will sometimes turn pills into either, and allows holding two of them.
• XV - The Devil card's effect does not stack with multiple uses, nor does it stack with The Book of Belial.
  • Blood of the Martyr grants its additional 1.5× damage multiplier with XV - The Devil.
  • It also does not increase the chance of a Devil Room or Angel Room appearing when used like with the Book of Belial.
• The damage dealt by II - The High Priestess counts as explosion damage, meaning it will not damage Isaac when possessing Host Hat or Pyromaniac.
  • The foot summoned by The High Priestess still counts as explosion damage, even though Host Hat or Pyromaniac won't prevent the damage. This means that the card can destroy rocks and open doors, including the entrance to Secret Rooms.
  • If there are no enemies in a room, II - The High Priestess will target Shopkeepers before targeting Isaac.
• Using XI - Strength as ??? will give him a permanent Soul Heart instead of a temporary one. When Keeper has only one Coin Heart, he can use XI - Strength to gain a second one which is also permanent. Both of the mentioned characters will lose the temporary health granted by XI - Strength.
• If Isaac uses XI - Strength card with only Soul, Black, or Bone Hearts left, and loses the non-Red Hearts while in the same room, he retains the full Red Heart Container that XI - Strength grants.
• The heart container granted by XI - Strength cannot be used to purchase a devil deal. However, if Isaac has no other red heart containers to spend, then one granted by XI - Strength can be used this way. This also works if the devil deal costs 2 hearts, but Isaac only has 1 before activating the Strength card.
  • III - The Empress? also works this way.
• Runes will be replaced with cards if no runes are unlocked.
  • However, items that normally spawn runes (e.g. Rune Bag or Clear Rune) can spawn Rune Shards before any runes are unlocked.
• The Emperor, The Stars, The Hermit, The Moon, and The Moon? will act as a random teleport in cases where there isn't a boss room, treasure room, shop, secret room, or ultra secret room to teleport to.
• Using IV - The Emperor on a Curse of the Labyrinth floor will teleport Isaac to the second Boss Room.
• III - The Empress card's effect can be stacked with multiple uses of the same card (including uses by Blank Card), and also stacks with the Whore of Babylon.
  • The damage bonus is the number of uses squared, e.g. +1.5 × 4 × 4 damage for using the card via a Blank Card, with Tarot Cloth and Car Battery equipped.
• Using the Joker card in Womb / Utero II will instantly teleport Isaac to the Devil Room or Angel Room with a trapdoor leading to Sheol or to the Cathedral. This can be used to skip Mom's Heart and will not count as a kill.
  • After unlocking It Lives, Devil or Angel Rooms in Womb / Utero / Scarred Womb II no longer contain trapdoors and instead have their normal contents.
• Using The Joker card can allow Isaac to encounter Devil Rooms or Angel Rooms on floors they otherwise cannot appear on, such as the first floor, or Corpse II.
• While Curse of the Maze is active, 0 - The Fool, IV - The Emperor, IX - Hermit, XVII - The Stars, and XVIII - The Moon may fail and leave Isaac in a different room than intended. The Joker card still works normally.
• Using XIV - Temperance can, in rare cases, spawn the Blood Donation Machine directly on Isaac, forcing him to use it once. This happens more often if Isaac is against a wall when the card is used.
• All teleportation cards except 0 - The Fool, XVII - The Stars, and Joker are unavailable in Greed Mode.
• If alternate versions of consumables have been unlocked (for example, Charged Keys or Mega Chests), any cards that can spawn that type of consumables (for example, Ace of Spades or VIII - Justice?) have a chance of being replaced with those rarer consumables.
  • Key Rings are the only exception to this.
  • Cards that are explicitly stated to spawn a type of consumable (such as VI - The Lovers spawning red hearts) will almost always drop that exact type of consumable, unless they're used in specific Secret Room.
• Using a Black Rune to absorb items in Boss Rush or Challenge Rooms counts as taking the items and will cause waves of bosses or enemies to start spawning.
• Using XV - The Devil? during the Satan fight in Sheol will instantly kill Isaac, as it invokes the Bible effect.
• Using the Blank Card with the ? Card teleports Isaac to the I AM ERROR room of the current floor. This consumes both the Blank Card and the ? Card.
• Black Rune, unlike Void, will grant stat ups for sacrificing active items. This makes Black Rune useful even while holding Void, as any active item that would be detrimental to absorb can instead be absorbed by Black Rune.
• If Tarot Cloth is held, and the currently held card has Tarot Cloth effects, the card will flash, indicating that it will be amplified by Tarot Cloth.
• Using any teleport cards while inside of The Beast fight will simply move Isaac instantly to a different spot in the same room. This also includes the Joker card.
• Leaving Trinkets in a Boss Room or Treasure Room will transform them into a Cracked Key when on the Ascent to Home, if the Red Key is unlocked. This allows Isaac to unlock a Tainted Character without needing the Red Key.
• If a Black Rune is used while Isaac is holding an item above his head, it will consume the item. This allows him to immediately absorb passive items bought from Devil Rooms, Black Markets, or Shops. This also can be used to give Isaac a chance to see what an unknown item is before deciding if he wants to consume it.
• If Isaac uses the Black Rune to absorb items from a room with choice pedestals, it will only absorb one item, and the other item vanishes as if Isaac took it.
• The Black Rune can be used to absorb Knife Piece 1 if Mother isn't the goal of the run. Can also be used to absorb Key Piece 1 or Key Piece 2.
• Using the Rune of Jera on a Wild Card will copy the Wild Card, allowing Isaac to infinitely copy any other consumables in the room.
• Once Mother is defeated, a unique marked skull will spawn on Depths / Necropolis / Dank Depths II or XL. When destroyed, it will always drop 0 - The Fool card (or an identified Telepills if Little Baggy has been picked up).
• Soul of Cain's effect can open any door that Cracked Orb can, including the Strange Door and door to Mega Satan.
• Using Soul of The Lost and then beating a boss for a completion mark within the same room will not count as a completion mark for The Lost. Instead, the completion mark and achievement will go to the character who used the soul stone.
• Using IV - The Emperor? in Womb / Utero/ Scarred Womb / Corpse I or II will teleport Isaac to a boss fight from the current boss pool.
  • Using it in Sheol / Cathedral / Dark Room / Chest / The Void / Home / will teleport Isaac to a random room.
  • Using it in ??? will teleport Isaac to a boss fight from the Womb boss pool.
  • Using it in an I AM ERROR room will take Isaac to the last room he was in when exited, allowing him to further explore the floor.
  • It can be used to skip Boss Rush after touching a pedestal item. After defeating the extra boss, leaving the room will lead Isaac to the regular, locked Mom boss room.
• Using IV - The Emperor? again on the same floor after defeating the boss it spawns takes Isaac back to the same cleared Boss room.
• For the purposes of tracking Heartbreak's effect on The Lost / Tainted Lost, VI - The Lovers? doesn't add any hidden Broken Hearts to their healthbar, allowing them to use the card without penalty.
• Items granted by Soul of Lilith do not count as collected, and can still spawn in any pool they're in. Familiars obtained this way contribute toward transformations such as Conjoined.
• Soul of Lilith takes its familiars from the Baby Shop item pool; however, when Isaac's stuff is rerolled, those familiars are rerolled in the Treasure Room item pool.
• Items granted by Soul of Lilith can be destroyed by Void / Abyss for their respective bonuses right after using the soul stone while the pedestal pickup animation is playing.
• Characters granted by Souls of the Forgotten / Jacob & Esau can interact with Blood Donation Machines, Devil Beggars, and Hell Games, allowing The Lost and Tainted Lost to safely use them without dying, or a form of invulnerability.
• Characters granted by Souls of the Forgotten / Jacob & Esau can't be used to leave a room, thus they can't be used to negate damage from exiting a Curse Room.
  • They also cannot pick up items, nor can they pick up things such as pills/cards/soul stones. They can pick up hearts, however Soul of the Forgotten can only replenish its bone hearts by collecting a bone heart pickup.
• Items granted to Esau when summoned from the Soul of Jacob and Esau will remove those items from their respective pools as if the player had obtained them. This also prevents future uses of the soul stone from giving that item to Esau.
• When the Soul of Jacob and Esau is used, some items given to Esau will also apply to Isaac for the floor. This happens with Black Candle and mapping items such as The Compass, for example.
  • If Esau is given PHD, pills will remain identified for the rest of the run, even if negative pills aren't converted into positive ones.
• Items granted to the player by Eden's Blessing are considered starting items by the effect of "XVII - The Stars?". Thus, only the first item picked up within the current run is removed.
• Before using the IX - The Hermit? card, dropping every unwanted card/pill/rune/trinket from the floor into the same room can generate heaps of extra money.
• As Tainted Lost, every card has a roughly 10% chance to be replaced with a Holy Card.
• You can use Joker to know whether the Devil Room or the Angel Room will spawn.

Unlockable Achievements

• 

  The Necronomicon - Use XIII - Death 4 times.

• 

  Blinding Baby - Use Blank Card while holding XIX - The Sun.

• 

  Ancient Recall - Use Cards and Runes 20 times.

• 

  Huge Growth - Increase in size 5 times in a single run via Magic Mushroom, "One makes you larger" pills, XI - Strength, etc..

• 

  Baby-Bender - Use I - The Magician or Telepathy For Dummies while already having homing tears.

Gallery

• 

  The pop-up that appears whenever III - The Empress? activates.

Trivia

• The appearance of the tarot cards seems to be based on the Universal Tarot of Marseille deck produced by Lo Scarabeo, most clearly seen with the card backs as well as the splash image that appears when using The Sun.
• The runes and their names ingame are based on the Elder Futhark alphabet system and its reconstructed Proto-Germanic names. In popular culture, runes often signify that something is in some way magical.
  • IX - The Hermit?'s effect was based directly on the Rune of Fehu from Antibirth. No other Antibirth rune was adapted into Repentance.
• The Suicide King card is a nickname for the King of Hearts, referred to as such because its artwork depicts a king who seems to be sticking a sword into his own head.
• The Get out of Jail Free card is a reference to a card with the same name that appears in the table game Monopoly.
• The "A Card Against Humanity" card is a reference to the card game Cards Against Humanity.
• Ancient Recall, Era Walk, Huge Growth, and Chaos Card are all based on cards from Magic: The Gathering.
  • The Chaos Card is a reference to the card "Chaos Orb", which also instantly destroys enemies that it touches.
  • The "Ancient Recall" card is a reference to the card "Ancestral Recall", which also draws three cards.
  • The "Era Walk" card is a reference to the card "Time Walk", which allows players to take an extra turn.
  • The "Huge Growth" card is a reference to the card "Giant Growth", which buffs creatures summoned in the game. Its message might be a reference to the card "Become Immense", a card with a similar effect to Giant Growth.
• A NULL card with ID 0 exists, revealed by the "giveitem k0" Debug Console command. It can't be acquired or used in any way.
• Many cards were given new unique back sprites in Booster Pack #5, some originating from Antibirth.
• Soul of Cain's ability is likely a reference to Red Key being an unlock for Cain in the original Antibirth mod.
• Soul of Judas' description and ability are a reference to the Spy from Team Fortress 2.
• Soul of Samson's description is a reference to Judges: it is said that Samson killed an army of 1,000 Philistines using a donkey's jawbone.
• Soul of Eve's description is a reference to the original description Birthright had when taken as Eve in the original Antibirth mod.
  • Its effect was also probably inspired by the old original Birthright effect, which caused Eve to sometimes generate extra Dead Birds upon being hit that would persist between rooms.
• III - The Empress? will display a pop up saying "The morning sun has vanquished the horrible night", a reference to Castlevania II: Simon's Quest when night turns to day.
  • This is also a reference to Whore of Babylon's (and by extension III - The Empress) pop up being the day to night message in said game.
• When VII - The Chariot? is activated, the statue will sometimes look like Edith, a character from Antibirth that wasn't adapted into Repentance.
• The Reverse Tarot Cards refer to tarot card readings, where a reversed card has a contrary meaning to its upright variant.
• XVII - The Stars in actual tarot decks is just referred to as XVII - The Star.
• Rune Shards exist to counteract players who purposely avoided unlocking less useful runes. For example, prior to Repentance, it was possible to purposely avoid all rune unlocks except Jera, to make exploits involving Jera and Blank Card much easier. With the inclusion of the Rune Shard, avoiding rune unlocks to prioritize another is no longer possible.

Bugs

Bug!	Rune of Hagalaz will open Secret Room doors in L-shaped rooms.

Bug!	Using XVI - The Tower? in a Boss Room may block all paths to the trap door, resulting in a softlock if no bombs or flight are available.

Bug!	Using XVI - The Tower? can also trap certain familiars over the rocks such as Lost Fly until Isaac leaves the room.

Bug!	Any blue flies, blue spiders, friendly enemies, locusts, orbital bones, and wisps created by cards, runes, and soul stones can be multiplied when Glowing Hourglass teleports Isaac in a way that does not move him to a different room from the one he is currently in (such as by teleporting to the previous room then using it again).

Bug!	As Tainted Lazarus, all effects of XIX - The Sun? except bone heart conversion and sprite change will disappear when flipping.

Bug!	Entering the Knife Piece 2 area while under the effects of XIX - The Sun? will cause a visual bug wherein Isaac will revert to his default appearance but still be capable of flight and spectral tears.

Bug!	If an activated collectible on a pedestal is touched and then rerolled with Soul of Isaac, the alternate item(s) will also count as "already picked up": they will not drop pickups, grant health or transformations they normally would.

Bug!	If multiple Souls of the Forgotten / Jacob & Esau are used in the same room, only 1 Forgotten/Esau will be removed after leaving the room. For every room that is left, one copy of them will disappear.

Bug!	Using a Black Rune in a room with exactly one pickup and one item while being near the fly limit won't suck the item.

Bug!	Using IV - The Emperor? in a black market on Corpse II will result in a softlock trapping the player between the beaten boss room, crawlspace and black market.

The Binding of Isaac: Rebirth
Achievements Challenges Completion Marks Items Trinkets Characters Chapters Rooms Transformations Attributes Bosses Monsters Pickups Modes Curses Objects Seeds Effects Endings
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