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 a floor.
I - The Magician	5.300.2		May you never miss your goal	Grants homing tears and +3 range for the current room (same effect as Telepathy for Dummies).
II - The High Priestess	5.300.3		Mother is watching you	Mom's dismembered leg is called down to deal 300 damage to anything it stomps. It will always stomp on the enemy with the most health. If used in an empty room or during the fight with Mom, it will stomp Isaac instead.
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, but without the need for Isaac to have a half a Red Heart or less of health.
IV - The Emperor	5.300.5		Challenge me!	Teleports Isaac into the Boss Room of a floor. In Home, this will act as a random teleport.
V - The Hierophant	5.300.6		Two prayers for the lost	Spawns 2 Soul Hearts.
VI - The Lovers	5.300.7		May you prosper and be in good health	Spawns 2 Red Hearts.
VII - The Chariot	5.300.8		May nothing stand before you	Grants the temporary invulnerability effect of My Little Unicorn.
VIII - Justice	5.300.9		May your future become balanced	Spawns one of each consumable drop (a Red Heart, a Key, a Bomb, and a Penny). Hearts have a chance to spawn as either a Half Red Heart or a Double Heart. Bombs have a chance to spawn as a Troll Bomb.
IX - The Hermit	5.300.10		May you see what life has to offer	Teleports Isaac to the Shop. If there is no Shop, this will act as a random teleport.
X - Wheel of Fortune	5.300.11		Spin the wheel of destiny	Spawns a Slot Machine or Fortune Telling Machine.
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 removed upon leaving the room.
XII - The Hanged Man	5.300.13		May you find enlightenment	Removes Isaac's body, allowing him to fly around for the duration of the room (same effect as Transcendence).
XIII - Death	5.300.14		Lay waste to all that oppose you	Deals 40 damage to all enemies in the room (same effect as The Necronomicon).
XIV - Temperance	5.300.15		May you be pure in heart	Spawns a Blood Donation Machine. Spawns a Devil Beggar in Greed mode.
XV - The Devil	5.300.16		Revel in the power of darkness	Grants Isaac a temporary +2 increase to damage for the current room (same effect as The Book of Belial).
XVI - The Tower	5.300.17		Destruction brings creation	Spawns 6 Troll Bombs randomly around the room (same effect as the Anarchist Cookbook).
XVII - The Stars	5.300.18		May you find what you desire	Teleports Isaac to the Treasure Room. If there is no Treasure Room, this will act as a random teleport. 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. This card will open one random wall once inside the Secret Room, so Isaac can leave even if he doesn't have any Bombs available. Does not work in Greed and Greedier mode.
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. Removes Curse of Darkness for the current floor and does not reveal the Ultra Secret Room.
XX - Judgement	5.300.21		Judge lest ye be judged	Spawns a Beggar.
XXI - The World	5.300.22		Open your eyes and see	Reveals the entire floor, except for the Super Secret Room or Ultra Secret Room. Has no effect if under the effect of Curse of the Lost or Amnesia.

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 on the floor, leaving Isaac at half a heart. Will kill Isaac if he has only Soul Hearts and all empty Red Heart Containers. Pickups may be spawned 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 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 and +1.35 tears for one minute, along with Magdalene's hairstyle. Does not stack.
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 (including final bosses if the final floor is two floor ahead or less). The boss will drop a reward, but the room has no trapdoor, so Isaac cannot enter the next floor. The room has an exit door, which leads Isaac back to where he used IV - The Emperor?.
V - The Hierophant?	5.300.61		Defeat Ultra Greedier as Tainted Bethany	Two prayers for the forgotten	Spawns 2 Bone Hearts.
VI - The Lovers?	5.300.62		Defeat Ultra Greedier as Tainted Magdalene	May your heart shatter to pieces	Spawns a random item from the current room's item pool. Turns 1 Red Heart Container or 2 Soul Hearts into a Broken Heart, potentially fatally; no downside for any character who has no health bar. Keeper and Tainted Keeper lose a Coin Heart and gain a Broken Coin Heart; that lost Coin Heart can't be replaced while the Broken Coin Heart remains.
VII - The Chariot?	5.300.63		Complete Hot Potato (challenge #42)	May nothing walk past you	Isaac becomes an invincible statue with extreme 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	Spawns 2 to 4 Golden Chests.
IX - The Hermit?	5.300.65		Complete Red Redemption (challenge #44)	May you see the value of all things in life	"Sells" items and pickups in the room for their usual Shop price, spawning a matching amount of Coins. Does not affect Grab Bags. If there is nothing to sell, spawns 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 take 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 a triple shot, no damage bonus, 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	Invokes the Book of the Dead effect.
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), and grants Isaac flight and a Seraphim familiar for 30 seconds.
XVI - The Tower?	5.300.72		Defeat Ultra Greedier as Tainted Apollyon	Creation brings destruction	Spawns 6 clusters of random rocks and other obstacles. Spawned clusters will often contain tinted rocks, with the possibility of more than one spawning in one 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, including starting items, and spawns 2 random items from the current room's item pool. Doesn't spawn anything 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	Spawns a Shop Restock Machine.
XXI - The World?	5.300.77		Defeat Ultra Greedier as Tainted Eden	Step into the abyss	Spawns a trap door 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 Coins. 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.
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 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 Pennies.
Ace of Spades	5.300.29		Defeat The Lamb without taking Hearts, Coins, or Bombs through the entire run	Convert all	Turns all Pickups, Chests, and non-boss enemies in the room into Keys.
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	Spawns 1-20 full Red Hearts.

Magic: The Gathering Card Backs

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 to kill nearly anything in its path. Opens doors as if a Bomb exploded.
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!	Makes Isaac large for the current room, increases damage by 7, increases range by 30 3, and allows Isaac to walk over obstacles to destroy them.
Ancient Recall	5.300.53		Use Cards and Runes 20 times	Draw 3 cards	Spawns 3 random cards.
Era Walk	5.300.54		Have both the Broken Watch and the Stop Watch unlocked	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 Back

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!	Converts all items in the Shop, Devil Room, or Black Market into pickups or items on pedestals, allowing them to be picked up for free.

Other Playing Card Backs

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 Teller. 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 Back

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.

Chance Card Back

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 Back

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 one-time Holy Mantle effect. It lasts for the current room.

Uno Card Back

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 a 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 spawn a door to a Crawl Space instead.
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. (This is 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 20 seconds.
Blank Rune	5.300.40		Complete Onan's Streak (challenge #29) Complete The Guardian (challenge #30)	???	Grants a random rune effect excluding the Black Rune. Has a 25% chance to spawn another Blank Rune upon use.

Other Runes

Rune Shards can be encountered only as replacements for runes that have not been unlocked. Once all runes 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. No effect on Shop items.
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, 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.

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	Stops time for 3 seconds and invokes Dark Arts, turning Isaac into a phantom that can pass through enemies to paralyze them, then attack them for quickly increasing chained damage and damage bonuses.
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 +1.35 tears 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 victims 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 (similar to using Berserk!) for 10 seconds, gaining +0.4 speed, some tears and +3 flat damage along with his melee attack.
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 remaining in the same room, with some invincibility time. The soul stone is automatically used upon taking fatal damage, functioning as a minimal extra life.
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 (similar to The Lost) for the current room, with all The Lost's benefits and weaknesses. He returns to normal upon leaving the room. Does not allow him to take Devil Room items for free. 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. Unique familiars can be received only once.
Soul of the Keeper	5.300.93		Defeat Hush and Boss Rush as Tainted Keeper	$$$	Spawns 1-25 random Coins.
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 if his three Bone Hearts run out, with no further consequence, and disappears when Isaac leaves the room.
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 if his health runs out, with no further consequence, and disappears when Isaac leaves the room. Esau also has 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.

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.

Notes

• The game counts runes as cards for the purposes of Blank Card, and Tarot Cloth.
• Starter Deck does not prevent runes from generating, and allows holding two of them.
• 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.
• 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.
• XV - The Devil card's effect does not stack with multiple uses, nor does it stack with The Book of Belial. It also does not increase the chance of a Devil Room or Angel Room appearing when used like with the Book of Belial.
  • Blood of the Martyr grants its additional 1.5x damage multiplier with XV - The Devil.
• 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.
• 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 foot summoned by The High Priestess can destroy rocks and open doors, including the entrance to Secret Rooms.
• The damage dealt by II - The High Priestess counts as explosion damage, meaning it will not damage Isaac when possessing Host Hat or Pyromaniac.
• 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.
• While Curse of the Maze is active, 0 - The Fool, 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 the XIV - Temperance can, in rare cases, spawn the Blood Donation Machine directly on Isaac, forcing him to use it once.
• All teleportation cards except 0 - The Fool are unavailable in Greed Mode.
• 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.
• 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 0 - The Fool? while having all empty Heart Containers with Soul Hearts will cause the Soul Hearts to all be dropped on the ground, killing Isaac.
• If Tarot Cloth is held, the currently held card will flash, indicating that it is being affected by Tarot Cloth.
• If Mega Chests have been unlocked, each Golden Chest spawned by VIII - Justice? has a chance of being replaced with a Mega Chest.
• Using IV - The Emperor? in Womb / Utero/ Scarred Womb / Corpse I will spawn a boss from the current boss pool.
  • Using it in Womb II will spawn an extra Mom's Heart or It Lives fight.
  • Using it in Corpse II will lead Isaac to an extra Mother boss fight.
  • 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 an extra Monstro boss fight.
  • Using it in the Ascent version of Mausoleum II will spawn a beam of light leading to Depths II.
  • Using it in the Ascent version of Mines II will teleport Isaac a room containing Dad's Note.
  • Using it in the Ascent version of Caves II will teleport Isaac to an extra Mom boss fight. Unlike the normal version, he can exit this fight normally.
  • It can be used to skip Boss Rush after touching a pedestal item. After defeating the extra Mom's Heart, 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.
• The effect of XIX - The Sun?, particularly flight, will persist even through the Knife Piece 2 sequence.
• Familiars gained from Soul of Lilith do not count as collected, and can still spawn in their appropriate pools.

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.

Trivia

• 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 different meaning to an upright one.

Gallery

• YouTube - 22 NEW Reverse Tarot Cards!
• YouTube - NEW Soul Stone Consumables!

Bugs

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

Bug!	Using IV - The Emperor? on ??? and defeating Monstro will validate the completion mark for Hush.

Bug!	Using IV - The Emperor? on Caves / Mines / Ashpit II will teleport Isaac to the Mom fight, which will not spawn an exit door, resulting in a softlock. This does not happen in the Ascent.

Bug!	Using IV - The Emperor? on Mausoleum I has a chance to teleport Isaac to the Rotgut fight. Defeat it and the door will lead him to the 3rd phase of the fight.

Bug!	Using IV - The Emperor? on Gehenna I, due to the lack of a alternative variant for Corpse, will teleport Isaac to a green looking Gehenna room without walls where he fights Monstro.

Bug!	Using IV - The Emperor? on Mausoleum / Gehenna II will teleport Isaac to the Mother's fight access room; entering it will crash the game if used before fighting Mom. If used after fighting Mom, you can enter the Mother's entrance and fight Mom's Heart

Bug!	If the Esau spawned by Soul of Jacob and Esau spawns with Birthright, the game will instantly crash.

Bug!	If the Esau spawned with Soul of Jacob and Esau touches the end chest, the game will crash.

Bug!	If Soul of Jacob and Esau is used on Jacob and Esau and then the run is exited and resumed, the game will show a "controller disconnected" error and it can't be removed, resulting in a softlock.

Bug!	Using III - The Empress? as Keeper will not grant extra Heart Containers, but will permanently remove two when the effect wears off.

Bug!	Using III - The Empress? as ???, Tainted ???, Dark Judas, Tainted Bethany and Tainted Judas will leave them at one half Soul/Black Heart when the effect wears off.

Bug!	If Isaac has Heart Containers and they are all empty, using 0 - The Fool? will remove all of Isaac's Soul Hearts and kill him.

Bug!	Using XVIII - The Moon? can generate a Red Room attached to a Secret Room or a Super Secret Room, with none of the walls pre-bombed. It is possible for Isaac to have no way to exit (i.e. having 0 bombs with which to open one of the walls), resulting in a softlock.

Bug!	Using XVIII - The Moon? has a chance to softlock Isaac if it tries to generate a Red Room on the space that cannot have one.

Bug!	If the Forgotten spawned with Soul of the Forgotten touches the end chest, the game will crash.

Bug!	Using XVII - The Stars? can remove starting items in challenges.

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!	If Esau is holding Soul of Lazarus when either Jacob or Esau dies, they will respawn without consuming the Soul of Lazarus. This effect will continue as long as Esau is the one holding it.

The Binding of Isaac: Rebirth
Achievements	Attributes	Bosses	Cards and Runes	Challenges	Chapters
Characters	Co-op	Items	Item pools	Monsters	Objects
Pickups	Pills	Rooms	Seeds	Transformations	Trinkets