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 red heart or less of health.
Teleports Isaac to the Shop. If there is no Shop, this will act as a random teleport. If the Shop has not yet been accessed, this card will unlock the door without requiring a key (as long as the player exits through the main entrance).
Grants the effect of Magic Mushroom (increases all of Isaac's stats except tears), but adds one (temporary) Red Heart container for the current room as opposed to a permanent one and does not restore health like Magic Mushroom does.
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).
Teleports Isaac to the Treasure Room. If there is no Treasure Room, this will act as a random teleport. Randomly chooses a Treasure Room on Curse of the Labyrinth. If the Treasure Room has not yet been accessed, this card will unlock the door without requiring a key (as long as the player exits through the main entrance). Can also teleport Isaac to the Planetarium.
XVIII - The Moon
5.300.19
May you find all you have lost
Teleports the player to the Secret Room. This card will open one random wall once inside the Secret Room, so you can leave even if you don't have any bombs available.
XIX - The Sun
5.300.20
May the light heal and enlighten you
Restores Isaac's full health, deals 100 damage to all enemies in the room, and reveals the map for the current floor, except the Super Secret Room. Removes Curse of Darkness for the current floor.
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, the narrator sound clip reversed, and give different effects.
Teleports Isaac into an extra Boss Room from the boss pool two floors deeper than the current floor. 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?.
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.
"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.
Gain Spirit of the Night and +1.5 damage for the current level. Turns Isaac's red hearts into bone hearts, but they revert once the effect ends. Also causes Curse of Darkness that cannot be dispelled.
Doubles your bombs. If you have no bombs, gives you 2 instead.
2 of Diamonds
5.300.24
Always available
Item multiplier
Doubles your coins. If you have no coins, gives you 2 instead.
2 of Spades
5.300.25
Always available
Item multiplier
Doubles your keys. If you have no keys, gives you 2 instead.
2 of Hearts
5.300.26
Always available
Item multiplier
Doubles Isaac's current number of Red Hearts. Does not affect Eternal Hearts, Soul Hearts, or Black Hearts. Doesn't add new Red Heart containers, just fills empty ones.
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.
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 are all unlocked by beating both Hush and Boss Rush as their respective Tainted character. They count as runes for the purposes of duplication with Clear Rune, and Rune Bag and other sources for generation.
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.
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.
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.
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.
Spawns The Forgotten as a temporary secondary character, controlled at the same time as Isaac. He dies if his two bone hearts run out, with no further consequence, and disappears when Isaac leaves the room.
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.
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.
Using the Blank Card with the ? Card teleports the player to the I AM ERROR room of the current floor. This consumes both the Blank Card and the ? Card.
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.
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 or Angel Room appearing when used like with the Book of Belial.
Blood of the Martyr grants its additional 1.5x damage multiplier with The Devil card.
Using the Joker card in The Womb II or Utero II will instantly teleport the player 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 The Womb II, Utero II, and 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 you use the Strength card with only Soul, Black, or Bone Hearts left, and lose the non-Red Hearts while in the same room, you retain the full Red Heart container that Strength grants after you leave.
The foot summoned by The High Priestess can destroy rocks and open doors, including the entrance to Secret Rooms.
The damage dealt by The High Priestess counts as explosion damage, meaning it will not damage Isaac when possessing Host Hat or Pyromaniac.
Using the Strength card as ??? will give you a permanent Soul Heart instead of a temporary one. When Keeper has only one Coin Heart, he can use the Strength card to gain a second one which is also permanent.
While Curse of the Maze is active, The Fool, Moon, Hermit, and Stars cards may fail and leave the player in a different room than intended. The Joker card still works normally.
Using the Temperance card can, in rare cases, spawn the Blood Donation Machine directly on the player, forcing them to use it once. Caution should be taken when using Temperance as The Lost (or when on half a heart of health), as this will instantly kill the player regardless of the Holy Mantle.
All teleportation cards except The Fool are unavailable in Greed Mode.
Rune Shards spawn in place of a Rune that hasn't been unlocked yet. Once all Runes are unlocked, Rune Shards no longer appear.
Leaving Trinkets in a Boss Room or a 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 The Depths II or XL. When destroyed, it will always drop The Fool card (Or an identified Telepills if Little Baggy has been picked up).
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.
Esau spawned using Soul of Jacob and Esau spawns with random items based on the pools of the items that Isaac currently holds.
Using The Fool? while having all empty heart containers with soul hearts will cause the soul hearts to all be dropped on the ground, killing the player.
Huge Growth - Increase in size 5 times in a single run. Sources of increased size include "One Makes you Larger" pills, XI - Strength, and Magic Mushroom.
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.
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.
The Reverse Tarot Cards refer to tarot card readings, where a reversed card has a different meaning to an upright one.
Typing the command "giveitem k0" into the Debug Console will reveal a secret usable item called "NULL". Executing the command, however, does not give anything.
Rune of Hagalaz will open Secret Room doors in L-shaped rooms.
Bug!
Entering a trapdoor created by Rune of Ehwaz on Corpse II will result in a black screen. Continuing after this will result in the floor restarting. Completion mark for Mother will not be received even if you have defeated her prior to entering the trapdoor.
Bug!
Using IV - The Emperor? on ??? (floor) and defeating the extra boss will validate the completion mark for Hush.
Bug!
Using IV - The Emperor? on Caves 2 will teleport Isaac to the Mom fight, which will not spawn an exit door, resulting in a softlock.
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 and corrupt the save file
Bug!
If the Esau spawned by Soul of Jacob and Esau spawns with Birthright, the game will instantly crash.
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 ??? will leave him at one half soul heart when the effect wears off.
Bug!
Using Joker in the Mirrored World causes the game to crash
Bug!
Curse of the Maze may interfere with the effects of teleporting cards, such as IV - The Emperor.
Sacks
+3 range for the current room (same effect as 
Telepathy for Dummies).
Whore of Babylon effect (+1.5 damage, +0.3 speed) for the current room, but without the need for Isaac to have a red heart or less of health.
If used in a Black Heart or Eternal Heart-containing Super Secret Room, it will spawn those types of hearts instead.
My Little Unicorn.
Magic Mushroom (increases all of Isaac's stats except tears), but adds one (temporary) Red Heart container for the current room as opposed to a permanent one and does not restore health like 
Transcendence).
The Necronomicon).
The Book of Belial).
Anarchist Cookbook).
Defeat Ultra Greedier as 
Tainted Lost
A Quarter and 
Boom!.
Defeat Ultra Greedier as 
Tainted Judas
The Soul but stronger and with a wider area of effect.
Defeat Ultra Greedier as 
Tainted Lilith
Broken Shovel.
Defeat Ultra Greedier as 
Tainted Eve
Defeat Ultra Greedier as 
Tainted ???
Defeat Ultra Greedier as 
Tainted Bethany
Defeat Ultra Greedier as 
Tainted Magdalene
Complete Hot Potato (challenge #42)
Complete Cantripped (challenge #43)
Complete Red Redemption (challenge #44)
Defeat Ultra Greedier as 
Tainted Cain
Defeat Ultra Greedier as 
Tainted Samson
Defeat Ultra Greedier as 
Tainted Keeper
Defeat Ultra Greedier as 
Tainted Forgotten
Book of the Dead effect.
Complete DELETE THIS (challenge #45)
Defeat Ultra Greedier as 
Tainted Azazel
The Bible, giving Isaac flight, and grants a 
Seraphim familiar for 30 seconds.
Defeat Ultra Greedier as 
Tainted Apollyon
Defeat Ultra Greedier as 
Tainted Isaac
Defeat Ultra Greedier as 
Tainted Jacob
Spirit of the Night and +1.5 damage for the current level. Turns Isaac's red hearts into bone hearts, but they revert once the effect ends. Also causes Curse of Darkness that cannot be dispelled.
Defeat Ultra Greedier as 
Tainted Lazarus
Defeat Ultra Greedier as 
Tainted Eden
Ace of Clubs
Get a 3-win streak
Defeat The Lamb in under 20 minutes
Defeat The Lamb without taking hearts, coins, and bombs through an entire run
Complete a Chapter (floors I and II) after The Basement, start-to-finish, with only half a heart of health (can use 
The Lost)
Complete Suicide King (challenge #7)
Defeat Mega Satan as 
Complete Demo Man (challenge #9)
Increase in size 5 times in a single run. Sources of increased size include "One Makes you Larger" pills, XI - Strength, and Magic Mushroom
Use cards and runes 20 times
Have both the 
Broken Watch and the 
Stop Watch in your collection
Complete Cursed (challenge #10)
Complete Glass Cannon (challenge #11)
Complete When Life Gives You Lemons (challenge #12)
Complete SPEED! (challenge #22)
Defeat Delirium as 
Holy Mantle effect. 
Defeat Mega Satan as 
Complete Pitch Black (challenge #1)
Complete High Brow (challenge #2)
Complete Head Trauma (challenge #3)
Complete Darkness Falls (challenge #4)
Complete The Tank (challenge #5)
Complete Solar System (challenge #6)
The D6.)
Complete Purist (challenge #20)
Complete Cat Got Your Tongue (challenge #8)
Defeat Ultra Greedier as 
Apollyon
Clear Rune, and 
Rune Bag and other sources for generation.
Defeat Hush and Boss Rush as 
Defeat Hush and Boss Rush as 
Defeat Hush and Boss Rush as 
Dad's Key, opening all existing doors in the room. Additionally, creates a red room like the 
Red Key for every possible red exit.
Defeat Hush and Boss Rush as 
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.
Defeat Hush and Boss Rush as 
Butt Bombs in quick succession. Standing on the creep gives +1.35 tears and +1 damage.
Defeat Hush and Boss Rush as 
Dead Bird familiars fly in and attack enemies. They leave after all victims are dead or Isaac leaves the room.
Defeat Hush and Boss Rush as 
Defeat Hush and Boss Rush as 
Mega Blast for 7.5 seconds.
Defeat Hush and Boss Rush as 
Defeat Hush and Boss Rush as 
D20. The rerolled items use random pools, as if 
Chaos were active.
Defeat Hush and Boss Rush as 
Defeat Hush and Boss Rush as 
Stitches. Unique familiars can be received only once.
Defeat Hush and Boss Rush as 
Defeat Hush and Boss Rush as 
Defeat Hush and Boss Rush as 
The Forgotten as a temporary secondary character, controlled at the same time as Isaac. He dies if his two bone hearts run out, with no further consequence, and disappears when Isaac leaves the room.
Defeat Hush and Boss Rush as 
Book of Virtues wisps with random properties.
Defeat Hush and Boss Rush as 
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.
Blank Card or 
Tarot Cloth has no effect on them.
Open the large version of Mom's Box in Home
Starter Deck, 
Blood of the Martyr grants its additional 1.5x damage multiplier with The Devil card.
The Womb II or 
Utero II will instantly teleport the player 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.
Scarred Womb II no longer contain trapdoors and instead have their normal contents.
Host Hat or 
Pyromaniac.
??? will give you a permanent Soul Heart instead of a temporary one. 
Keeper has only one Coin Heart, he can use the Strength card to gain a second one which is also permanent.
Home, if the Red Key is unlocked.
The Depths II or XL. When destroyed, it will always drop The Fool card (Or an identified Telepills if 
Little Baggy has been picked up).
The Necronomicon - Use XIII - Death 4 times.
Cain in the original Antibirth mod.
Birthright had when taken as 
Eve in the original Antibirth mod.
Bug!
Rune of Hagalaz will open Secret Room doors in L-shaped rooms.
Rune of Ehwaz on Corpse II will result in a black screen. Continuing after this will result in the floor restarting. Completion mark for Mother will not be received even if you have defeated her prior to entering the trapdoor.
IV - The Emperor? on ??? (floor) and defeating the extra boss will validate the completion mark for Hush.
Soul of Jacob and Esau spawns with 
III - The Empress? as Keeper will not grant extra heart containers, but will permanently remove two when the effect wears off.
Joker in the Mirrored World causes the game to crash
IV - The Emperor.
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
