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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: TarotCard.png

Name ID Icon Message Description
0 - The Fool 5.300.1 Pickup 0 - The Fool icon.png Where journey begins Teleports Isaac back to the starting room of a floor.
I - The Magician 5.300.2 Pickup I - The Magician icon.png May you never miss your goal Grants homing tears and Dlc r indicator.png +3 Range for the current room (same effect as Collectible Telepathy for Dummies icon.png Telepathy for Dummies).
II - The High Priestess 5.300.3 Pickup II - The High Priestess icon.png 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 Pickup III - The Empress icon.png May your rage bring power Triggers the Collectible Whore of Babylon icon.png 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 Pickup IV - The Emperor icon.png Challenge me! Teleports Isaac into the Boss Room Icon.png Boss Room of a floor. Dlc r indicator.png In Stage Home icon.png Home, this will act as a random teleport.
V - The Hierophant 5.300.6 Pickup V - The Hierophant icon.png Two prayers for the lost Drops 2 full Soul Heart.png Soul Hearts on the ground.
VI - The Lovers 5.300.7 Pickup VI - The Lovers icon.png May you prosper and be in good health Drops 2 full Red Heart.png Red Hearts on the ground.
VII - The Chariot 5.300.8 Pickup VII - The Chariot icon.png May nothing stand before you Grants the temporary invulnerability effect of Collectible My Little Unicorn icon.png My Little Unicorn.
VIII - Justice 5.300.9 Pickup VIII - Justice icon.png May your future become balanced Drops a random Red Heart.png Red Heart, Key (except Key Ring), Bomb, and Coin pickup on the ground. Sometimes drops an Eternal-, Gold- Soul-, or Rotten Heart in place of the Red Heart. Sometimes drops a Troll Bomb.png Troll Bomb or Mega Troll Bomb.png Mega Troll Bomb in place of the Bomb.
IX - The Hermit 5.300.10 Pickup IX - The Hermit icon.png May you see what life has to offer Teleports Isaac to the Shop Icon.png Shop. If there is no Shop, this will act as a random teleport.
X - Wheel of Fortune 5.300.11 Pickup X - Wheel of Fortune icon.png Spin the wheel of destiny Creates a Slot Machine.png Slot Machine or Fortune Telling Machine.png Fortune Telling Machine near Isaac.
XI - Strength 5.300.12 Pickup XI - Strength icon.png May your power bring rage Grants the effects of Collectible Magic Mushroom icon.png 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 Pickup XII - The Hanged Man icon.png May you find enlightenment Removes Isaac's body, allowing him to fly around for the duration of the room (same effect as Collectible Transcendence icon.png Transcendence).
XIII - Death 5.300.14 Pickup XIII - Death icon.png Lay waste to all that oppose you Deals 40 damage to all enemies in the room (same effect as Collectible The Necronomicon icon.png The Necronomicon).
XIV - Temperance 5.300.15 Pickup XIV - Temperance icon.png May you be pure in heart Creates a Blood Donation Machine.png Blood Donation Machine near Isaac. Dlc a indicator.png Spawns a Devil Beggar.png Devil Beggar instead in Greed mode.
XV - The Devil 5.300.16 Pickup XV - The Devil icon.png Revel in the power of darkness Grants Isaac a temporary +2 increase to Damage for the current room (same effect as Collectible The Book of Belial icon.png The Book of Belial).
XVI - The Tower 5.300.17 Pickup XVI - The Tower icon.png Destruction brings creation Drops 6 Troll Bomb.png Troll Bombs randomly around the room (same effect as the Collectible Anarchist Cookbook icon.png Anarchist Cookbook).
XVII - The Stars 5.300.18 Pickup XVII - The Stars icon.png May you find what you desire Teleports Isaac to the Treasure Room Icon.png 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.png Curse of the Labyrinth. Dlc r indicator.png If there is a Planetarium Icon.png Planetarium, teleports Isaac there instead.
XVIII - The Moon 5.300.19 Pickup XVIII - The Moon icon.png May you find all you have lost Teleports Isaac to the Secret Room Icon.png 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 Bomb.png Bombs available. Dlc a indicator.png Does nothing in Greed Mode.
XIX - The Sun 5.300.20 Pickup XIX - The Sun icon.png 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 Icon.png Super Secret Room. Dlc r indicator.png Removes Curse of Darkness.png Curse of Darkness for the current floor and does not reveal the Ultra Secret Room Icon.png Ultra Secret Room.
XX - Judgement 5.300.21 Pickup XX - Judgement icon.png Judge lest ye be judged Spawns a Beggar.png Beggar or, more rarely, a Devil Beggar.png Devil Beggar near Isaac.
XXI - The World 5.300.22 Pickup XXI - The World icon.png Open your eyes and see Reveals the entire floor, except for the Super Secret Room Icon.png Super Secret Room. Dlc r indicator.png Does not reveal the Ultra Secret Room Icon.png Ultra Secret Room.

Dlc r indicator.png 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: ReverseTarotCard.png

Name ID Icon Unlock method Message Description
0 - The Fool? 5.300.56 Pickup 0 - The Fool? icon.png Achievement The Fool icon.png Defeat Ultra Greedier as Character Tainted Lost icon.png 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 Collectible A Quarter icon.png A Quarter and Collectible Boom! icon.png Boom!.
I - The Magician? 5.300.57 Pickup I - The Magician? icon.png Achievement The Magician icon.png Defeat Ultra Greedier as Character Tainted Judas icon.png Tainted Judas May no harm come to you Grants a repelling blue aura for one minute, like Collectible The Soul icon.png The Soul but stronger and with a wider area of effect.
II - The High Priestess? 5.300.58 Pickup II - The High Priestess? icon.png Achievement The High Priestess icon.png Defeat Ultra Greedier as Character Tainted Lilith icon.png Tainted Lilith Run Mom's leg starts stomping down repeatedly for one minute, like holding Collectible Broken Shovel 1 icon.png Broken Shovel.
III - The Empress? 5.300.59 Pickup III - The Empress? icon.png Achievement The Empress icon.png Defeat Ultra Greedier as Character Tainted Eve icon.png Tainted Eve May your love bring protection Grants 2 temporary Red Heart Containers and +1.35 Tears for one minute, along with Character Magdalene icon.png Magdalene's hairstyle. The effect does not stack with itself. On characters that can't have Red Heart Containers, they will get Soul Heart.png Soul Hearts / Black Heart.png Black Hearts / Bone heart.png Bone Hearts accordingly. When the effect ends, if the removal of the Heart Containers would kill Isaac, he gets left with one instead.
IV - The Emperor? 5.300.60 Pickup IV - The Emperor? icon.png Achievement The Emperor icon.png Defeat Ultra Greedier as Character Tainted ??? icon.png Tainted ??? May you find a worthy opponent Teleports Isaac into an extra Boss Room Icon.png Boss Room from the boss pool two floors deeper than the current floor (but never a final boss). 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 it.
V - The Hierophant? 5.300.61 Pickup V - The Hierophant? icon.png Achievement The Hierophant icon.png Defeat Ultra Greedier as Character Tainted Bethany icon.png Tainted Bethany Two prayers for the forgotten Drops 2 Bone heart.png Bone Hearts on the ground.
VI - The Lovers? 5.300.62 Pickup VI - The Lovers? icon.png Achievement The Lovers icon.png Defeat Ultra Greedier as Character Tainted Magdalene icon.png 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 Heart.png Soul Hearts into a Broken Heart, potentially fatally; no downside for any character who has no health bar. Character Keeper icon.png Keeper and Character Tainted Keeper icon.png 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 Pickup VII - The Chariot? icon.png Achievement The Chariot icon.png 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 Pickup VIII - Justice? icon.png Achievement Justice icon.png Complete Cantripped (challenge #43) May your sins come back to torment you Creates 2 to 4 Locked Chest.png Locked Chests near Isaac.
IX - The Hermit? 5.300.65 Pickup IX - The Hermit? icon.png Achievement The Hermit icon.png 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 Icon.png Shop price, spawning a matching amount of Coins. If there is nothing to sell, drops a Penny.png Penny.
X - Wheel of Fortune? 5.300.66 Pickup X - Wheel of Fortune? icon.png Achievement Wheel of Fortune icon.png Defeat Ultra Greedier as Character Tainted Cain icon.png Tainted Cain Throw the dice of fate Invokes a random Dice Room Icon.png Dice Room effect.
XI - Strength? 5.300.67 Pickup XI - Strength? icon.png Achievement Strength icon.png Defeat Ultra Greedier as Character Tainted Samson icon.png 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 Pickup XII - The Hanged Man? icon.png Achievement The Hanged Man icon.png Defeat Ultra Greedier as Character Tainted Keeper icon.png Tainted Keeper May your greed know no bounds Isaac turns visually into Character Keeper icon.png Keeper for 30 seconds, with triple shot, no damage bonus, and -0.1 Speed. Killed enemies drop random Coins.
XIII - Death? 5.300.69 Pickup XIII - Death? icon.png Achievement Death icon.png Defeat Ultra Greedier as Character Tainted Forgotten icon.png Tainted Forgotten May life spring forth from the fallen Invokes the Collectible Book of the Dead icon.png Book of the Dead effect.
XIV - Temperance? 5.300.70 Pickup XIV - Temperance? icon.png Achievement Temperance icon.png 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 Pickup XV - The Devil? icon.png Achievement The Devil icon.png Defeat Ultra Greedier as Character Tainted Azazel icon.png Tainted Azazel Bask in the light of your mercy Invokes Collectible The Bible icon.png The Bible (which can kill Mom), and grants Isaac flight and a Collectible Seraphim icon.png Seraphim familiar for 30 seconds.
XVI - The Tower? 5.300.72 Pickup XVI - The Tower? icon.png Achievement The Tower icon.png Defeat Ultra Greedier as Character Tainted Apollyon icon.png Tainted Apollyon Creation brings destruction Creates 6 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 Pickup XVII - The Stars? icon.png Achievement The Stars icon.png Defeat Ultra Greedier as Character Tainted Isaac icon.png 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 Pickup XVIII - The Moon? icon.png Achievement The Sun and the Moon icon.png Defeat Ultra Greedier as Character Tainted Jacob icon.png Tainted Jacob May you remember lost memories Teleports Isaac to the Ultra Secret Room Icon.png Ultra Secret Room. The pathway back to the normal rooms will be made of Red Room Icon.png Red Rooms.
XIX - The Sun? 5.300.75 Pickup XIX - The Sun? icon.png Achievement The Sun and the Moon icon.png Defeat Ultra Greedier as Character Tainted Jacob icon.png Tainted Jacob May the darkness swallow all around you Gain Collectible Spirit of the Night icon.png 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.png Curse of Darkness that cannot be dispelled.
XX - Judgement? 5.300.76 Pickup XX - Judgement? icon.png Achievement Judgement icon.png Defeat Ultra Greedier as Character Tainted Lazarus icon.png Tainted Lazarus May you redeem those found wanting Creates a Shop Restock Machine.png Shop Restock Machine near Isaac.
XXI - The World? 5.300.77 Pickup XXI - The World? icon.png Achievement The World icon.png Defeat Ultra Greedier as Character Tainted Eden icon.png Tainted Eden Step into the abyss Creates a trap door which always leads to a Crawl Space Icon.png Crawl Space.

Playing Cards

When on the ground, these cards look like: FaceCard.png

Name ID Icon Unlock method Message Description
2 of Clubs 5.300.23 Pickup 2 of Clubs icon.png Always available Item multiplier Doubles Isaac's Bombs. If he has no bombs, gives him 2 instead.
2 of Diamonds 5.300.24 Pickup 2 of Diamonds icon.png Always available Item multiplier Doubles Isaac's Coins. If he has no coins, gives him 2 instead.
2 of Spades 5.300.25 Pickup 2 of Spades icon.png Always available Item multiplier Doubles Isaac's Keys. If he has no keys, gives him 2 instead.
2 of Hearts 5.300.26 Pickup 2 of Hearts icon.png 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.
Dlc a† indicator.png Ace of Clubs 5.300.27 Pickup Ace of Clubs icon.png Achievement Hat trick! icon.png Get a 3-win streak Convert all Turns all Pickups, Chests, and Dlc r indicator.png non-boss enemies in the room into random Bomb pickups, including Troll Bomb.png Troll Bombs.
Dlc a† indicator.png Ace of Diamonds 5.300.28 Pickup Ace of Diamonds icon.png Achievement ZIP! icon.png Defeat The Lamb in under 20 minutes Convert all Turns all Pickups, Chests, and Dlc r indicator.png non-boss enemies in the room into random Coin pickups.
Dlc a† indicator.png Ace of Spades 5.300.29 Ace of Spades (Card) Icon.png Achievement It's the Key icon.png Defeat The Lamb without taking Hearts, Coins, or Bombs through the entire run Convert all Turns all Pickups, Chests, and Dlc r indicator.png non-boss enemies in the room into random Key pickups (except Key Rings).
Dlc a† indicator.png Ace of Hearts 5.300.30 Pickup Ace of Hearts icon.png Achievement Living on the edge icon.png Complete a Chapter (floors I and II) after Stage Basement icon.png Basement, start-to-finish, with only half a Heart total (can use Character The Lost icon.png The Lost) Convert all Turns all Pickups, Chests, and Dlc r indicator.png non-boss enemies in the room into random Hearts.
Joker 5.300.31 Pickup Joker icon.png Always available ??? Teleports Isaac to the Devil Room Icon.png Devil Room or Angel Room Icon.png Angel Room.
Suicide King 5.300.46 Pickup Suicide King icon.png Achievement Suicide King icon.png Complete Suicide King (challenge #7) A true ending? Kills Isaac and spawns lots of Pickups, items, and/or Chests in the same room.
Dlc r indicator.png Queen of Hearts 5.300.79 Pickup Queen of Hearts icon.png Achievement Queen of Hearts icon.png Defeat Mega Satan as Character Tainted Magdalene icon.png Tainted Magdalene <3 Drops 1-20 full Red Hearts on the ground.

Magic: The Gathering Card Backs

When on the ground, these cards look like: Dlc na† indicator.png FaceCard.png    Dlc a†nr indicator.png MagicCard.png Dlc r indicator.png MagicCardRepentance.png

Name ID Icon Unlock method Message Description
Chaos Card 5.300.42 Pickup Chaos Card icon.png Achievement Chaos Card icon.png Complete Demo Man (challenge #9) ??? Throws the card to kill nearly anything in its path. Opens doors as if a Bomb exploded.
Dlc a† indicator.png Huge Growth 5.300.52 Pickup Huge Growth icon.png Achievement Huge Growth icon.png Increase in size 5 times in a single run via Collectible Magic Mushroom icon.png Magic Mushroom, "One Makes you Larger" pills, Pickup XI - Strength icon.png XI - Strength, etc. Become immense! Makes Isaac large for the current room, increases damage by 7, increases range by Dlc nr indicator.png 30 Dlc r indicator.png 3, and allows Isaac to walk over obstacles to destroy them.
Dlc a† indicator.png Ancient Recall 5.300.53 Pickup Ancient Recall icon.png Achievement Ancient Recall icon.png Use Cards and Runes 20 times Draw 3 cards Spawns 3 random cards.
Dlc a† indicator.png Era Walk 5.300.54 Pickup Era Walk icon.png Achievement Era Walk icon.png Have both the Collectible Broken Watch icon.png Broken Watch and the Collectible Stop Watch icon.png 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: Dlc na† indicator.png FaceCard.png    Dlc a† indicator.png CreditCard.png

Name ID Icon Unlock method Message Description
Credit Card 5.300.43 Pickup Credit Card icon.png Achievement Credit Card icon.png Complete Cursed! (challenge #10) Charge it! Converts all items in the Shop Icon.png Shop, Devil Room Icon.png Devil Room, or Black Market Icon.png 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: FaceCard.png

Name ID Icon Unlock method Message Description
Rules Card 5.300.44 Pickup Rules Card icon.png Achievement Rules Card icon.png 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.
Dlc a indicator.png ? Card 5.300.48 Pickup Q Card icon.png 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: Dlc na† indicator.png FaceCard.png    Dlc a† indicator.png HumanityCard.png

Name ID Icon Unlock method Message Description
A Card Against Humanity 5.300.45 Pickup A Card Against Humanity icon.png Achievement Card Against Humanity icon.png 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.

Dlc a indicator.png Chance Card Back

When on the ground, this card looks like: Dlc na† indicator.png FaceCard.png    Dlc a† indicator.png ChanceCard.png

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

Dlc a† indicator.png Holy Card Back

When on the ground, this card looks like: HolyCard.png

Name ID Icon Unlock method Message Description
Holy Card 5.300.51 Pickup Holy Card icon.png Achievement Holy Card icon.png Defeat Delirium as Character The Lost icon.png The Lost You feel protected Grants a one-time Collectible Holy Mantle icon.png Holy Mantle effect. Dlc nr indicator.png It lasts for the current room.

Dlc r indicator.png Uno Card Back

When on the ground, this card looks like: WildCardBack.png

Name ID Icon Unlock method Message Description
Wild Card 5.300.80 Pickup Wild Card icon.png Achievement Wild Card icon.png Defeat Mega Satan as Character Tainted Eden icon.png 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: Rune2.png

Name ID Icon Unlock method Message Description
Rune of Hagalaz 5.300.32 Hagalaz Icon.png Achievement Rune of Hagalaz icon.png Complete Pitch Black (challenge #1) Destruction Destroys all breakable objects in the room. Does not affect Key Blocks.
Rune of Jera 5.300.33 Jera Icon.png Achievement Rune of Jera icon.png Complete High Brow (challenge #2) Abundance Clones all pickups and Chests in the room (including Shop Icon.png 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 Ehwaz Icon.png Achievement Rune of Ehwaz icon.png 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 Icon.png Crawl Space instead.
Rune of Dagaz 5.300.35 Dagaz Icon.png Achievement Rune of Dagaz icon.png Complete Darkness Falls (challenge #4) Purity Removes any Curses from the current floor and grants a Soul Heart.png Soul Heart. (This will not remove Curse of the Labyrinth.png Curse of the Labyrinth.)

Right Pointing Runes

When on the ground, these runes look like: Rune1.png

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

Other Runes

Dlc r indicator.png 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
Dlc a† indicator.png Black Rune 5.300.41 Pickup Black Rune icon.png Achievement Black Rune icon.png Defeat Ultra Greedier as Character Apollyon icon.png 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 Icon.png Shop items.
Dlc r indicator.png Rune Shard 5.300.55 Pickup Rune Shard icon.png 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 re-rolls one item.

Dlc r indicator.png Soul Stones

Soul Stones are all unlocked by beating both Boss Hush ingame.png Hush and Boss Rush Icon.png Boss Rush as their respective Tainted character. They count as runes for the purposes of Collectible Clear Rune icon.png Clear Rune and Collectible Rune Bag icon.png Rune Bag.

Name ID Icon Unlock method Message Description
Soul of Isaac 5.300.81 Pickup Soul of Isaac icon.png Achievement Soul of Isaac icon.png Defeat Hush and Boss Rush Icon.png Boss Rush as Character Tainted Isaac icon.png Tainted Isaac Reroll... or not Rerolls the items in the room like Collectible The D6 icon.png 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 Pickup Soul of Magdalene icon.png Achievement Soul of Magdalene icon.png Defeat Hush and Boss Rush Icon.png Boss Rush as Character Tainted Magdalene icon.png Tainted Magdalene Give me your love! Surrounds Isaac with a bubbling red aura for the current room. All enemies killed drop Half Red Heart.png Half Red Hearts that disappear in 2 seconds.
Soul of Cain 5.300.83 Pickup Soul of Cain icon.png Achievement Soul of Cain icon.png Defeat Hush and Boss Rush Icon.png Boss Rush as Character Tainted Cain icon.png Tainted Cain Opens the unopenable Opens all doors in the room. Additionally, creates a Red Room Icon.png Red Room like the Collectible Red Key icon.png Red Key on all valid walls. This also destroys the mirror located in Stage Downpour icon.png Downpour / Stage Dross icon.png Dross II.
Soul of Judas 5.300.84 Pickup Soul of Judas icon.png Achievement Soul of Judas icon.png Defeat Hush and Boss Rush Icon.png Boss Rush as Character Tainted Judas icon.png Tainted Judas Right behind you Stops time for 3 seconds and invokes Collectible Dark Arts icon.png 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 Pickup Soul of ??? icon.png Achievement Soul of ??? icon.png Defeat Hush and Boss Rush Icon.png Boss Rush as Character Tainted ??? icon.png Tainted ??? Chemical warfare Causes 8 poison farts that leave lingering brown creep, then plants a trail of 7 Collectible Butt Bombs icon.png Butt Bombs in quick succession. Standing on the creep gives +1.35 Tears and +1 Damage.
Soul of Eve 5.300.86 Pickup Soul of Eve icon.png Achievement Soul of Eve icon.png Defeat Hush and Boss Rush Icon.png Boss Rush as Character Tainted Eve icon.png Tainted Eve Your very own murder 14 Collectible Dead Bird icon.png 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 Pickup Soul of Samson icon.png Achievement Soul of Samson icon.png Defeat Hush and Boss Rush Icon.png Boss Rush as Character Tainted Samson icon.png Tainted Samson Slay a thousand Isaac turns berserk (similar to using Collectible Berserk! icon.png 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 Pickup Soul of Azazel icon.png Achievement Soul of Azazel icon.png Defeat Hush and Boss Rush Icon.png Boss Rush as Character Tainted Azazel icon.png Tainted Azazel Demon rage! Activates Collectible Mega Blast icon.png Mega Blast for 7.5 seconds.
Soul of Lazarus 5.300.89 Pickup Soul of Lazarus icon.png Achievement Soul of Lazarus icon.png Defeat Hush and Boss Rush Icon.png Boss Rush as Character Tainted Lazarus icon.png 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 Pickup Soul of Eden icon.png Achievement Soul of Eden icon.png Defeat Hush and Boss Rush Icon.png Boss Rush as Character Tainted Eden icon.png Tainted Eden Embrace chaos Uses Collectible The D6 icon.png The D6 and Collectible D20 icon.png D20. The rerolled items use random pools, as if Collectible Chaos icon.png Chaos were active.
Soul of the Lost 5.300.91 Pickup Soul of the Lost icon.png Achievement Soul of the Lost icon.png Defeat Hush and Boss Rush Icon.png Boss Rush as Character Tainted Lost icon.png Tainted Lost Leave your body behind Isaac "dies" and turns into a ghost (similar to Character The Lost icon.png The Lost) for the current room, with all The Lost's benefits and weaknesses. He returns to normal upon leaving the room. Allows him to take 1 Devil Room Icon.png Devil Room items for free, after which the other items vanish. Also allows him to enter the Stage Mausoleum icon.png Mausoleum / Stage Gehenna icon.png Gehenna door for free. The Collectible Holy Mantle icon.png Holy Mantle effect gained from this can be stacked with multiple uses.
Soul of Lilith 5.300.92 Pickup Soul of Lilith icon.png Achievement Soul of Lilith icon.png Defeat Hush and Boss Rush Icon.png Boss Rush as Character Tainted Lilith icon.png Tainted Lilith Motherhood Adds one permanent familiar from the Baby Shop pool, except Collectible Stitches icon.png Stitches. Unique familiars can be received only once.
Soul of the Keeper 5.300.93 Pickup Soul of the Keeper icon.png Achievement Soul of the Keeper icon.png Defeat Hush and Boss Rush Icon.png Boss Rush as Character Tainted Keeper icon.png Tainted Keeper $$$ Drops 1-25 random Coins on the ground.
Soul of Apollyon 5.300.94 Pickup Soul of Apollyon icon.png Achievement Soul of Apollyon icon.png Defeat Hush and Boss Rush Icon.png Boss Rush as Character Tainted Apollyon icon.png Tainted Apollyon Bringer of calamity Spawns 15 random locusts.
Soul of the Forgotten 5.300.95 Pickup Soul of the Forgotten icon.png Achievement Soul of the Forgotten icon.png Defeat Hush and Boss Rush Icon.png Boss Rush as Character Tainted Forgotten icon.png Tainted Forgotten Skeletal protector Spawns Character The Forgotten icon.png The Forgotten as a temporary secondary character, controlled at the same time as Isaac. He dies if his 3 Bone heart.png Bone Hearts run out, with no further consequence, and disappears when Isaac leaves the room.
Soul of Bethany 5.300.96 Pickup Soul of Bethany icon.png Achievement Soul of Bethany icon.png Defeat Hush and Boss Rush Icon.png Boss Rush as Character Tainted Bethany icon.png Tainted Bethany Friends from beyond Spawns 6 Collectible Book of Virtues icon.png Book of Virtues wisps with random properties.
Soul of Jacob and Esau 5.300.97 Pickup Soul of Jacob and Esau icon.png Achievement Soul of Jacob and Esau icon.png Defeat Hush and Boss Rush Icon.png Boss Rush as Character Tainted Jacob icon.png Tainted Jacob Bound by blood Spawns Character Esau icon.png 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. Dlc r indicator.png These consumables cannot be replicated by either Collectible Blank Card icon.png Blank Card or Collectible Clear Rune icon.png Clear Rune, and Collectible Tarot Cloth icon.png Tarot Cloth has no effect on them.

Name ID Icon Unlock method Message Description
Dlc a indicator.png Dice Shard 5.300.49 Pickup Dice Shard icon.png Always available D6 + D20 Upon use, invokes the effects of Collectible The D6 icon.png The D6 and the Collectible D20 icon.png D20 at the same time, re-rolling all item pedestals and pickups in the room.
Dlc a indicator.png Emergency Contact 5.300.50 Pickup Emergency Contact icon.png 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.
Dlc r indicator.png Cracked Key 5.300.78 Pickup Cracked Key icon.png Achievement Red Key icon.png Open Mom's Chest in Stage Home icon.png Home ??? Creates a room adjacent to a viable wall, like Collectible Red Key icon.png Red Key.

Notes

  • Dlc nr indicator.png The game counts runes as cards for the purposes of Collectible Blank Card icon.png Blank Card, and Dlc a† indicator.png Collectible Tarot Cloth icon.png Tarot Cloth.
  • Collectible Starter Deck icon.png Starter Deck does not prevent runes from generating, and allows holding two of them.
  • Dlc a indicator.png Using the Blank Card with the ? Card teleports Isaac to the Error Room Icon.png 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 Collectible Whore of Babylon icon.png 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.
  • Dlc nr indicator.png XV - The Devil card's effect does not stack with multiple uses, nor does it stack with Collectible The Book of Belial icon.png The Book of Belial. It also does not increase the chance of a Devil Room Icon.png Devil Room or Angel Room Icon.png Angel Room appearing when used like with the Book of Belial.
  • Using the Joker card in Stage Womb icon.png Womb / Stage Utero icon.png Utero II will instantly teleport Isaac to the Devil Room or Angel Room with a trapdoor leading to Stage Sheol icon.png Sheol or to the Stage Cathedral icon.png Cathedral. This can be used to skip Mom's Heart and will not count as a kill.
    • Dlc a indicator.png After unlocking It Lives, Devil or Angel Rooms in Stage Womb icon.png Womb / Stage Utero icon.png Utero / Stage Scarred Womb icon.png 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 Room Icon.png Secret Rooms.
  • Dlc nr indicator.png The damage dealt by II - The High Priestess counts as explosion damage, meaning it will not damage Isaac when possessing Dlc a indicator.png Collectible Host Hat icon.png Host Hat or Collectible Pyromaniac icon.png Pyromaniac.
  • Using XI - Strength as Character ??? (Character) icon.png ??? will give him a permanent Soul Heart instead of a temporary one. Dlc a indicator.png When Character Keeper icon.png 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.png 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.png Blood Donation Machine directly on Isaac, forcing him to use it once.
  • All teleportation cards except 0 - The Fool are unavailable in Greed Mode.
  • Dlc r indicator.png Leaving Trinkets in a Boss Room Icon.png Boss Room or Treasure Room Icon.png Treasure Room will transform them into a Cracked Key when on the Ascent to Stage Home icon.png Home, if the Red Key is unlocked.
  • Dlc r indicator.png Once Mother is defeated, a unique marked skull will spawn on Stage Depths icon.png Depths / Stage Necropolis icon.png Necropolis / Stage Dank Depths icon.png Dank Depths II or XL. When destroyed, it will always drop 0 - The Fool card (Or an identified Telepills if Collectible Little Baggy icon.png Little Baggy has been picked up).
  • Dlc r indicator.png Soul of Cain's effect can open any door that Collectible Cracked Orb icon.png Cracked Orb can, including the Strange Door and door to Mega Satan.
  • Dlc r indicator.png 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 Character The Lost icon.png The Lost. Instead, the completion mark and achievement will go to the character who used the soul stone.
  • Dlc r indicator.png 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.
  • Dlc r indicator.png If Collectible Tarot Cloth icon.png Tarot Cloth is held, the currently held card will flash, indicating that it is being affected by Tarot Cloth.
  • Dlc r indicator.png If Mega Chests have been unlocked, each Golden Chest spawned by VIII - Justice? has a chance of being replaced with a Mega Chest.
  • Dlc r indicator.png Using IV - The Emperor? in Stage Womb icon.png Womb / Stage Utero icon.png Utero/ Stage Scarred Womb icon.png Scarred Womb / Stage Corpse icon.png Corpse I will spawn a boss from the current boss pool.
  • Dlc r indicator.png Using IV - The Emperor? again on the same floor after defeating the boss it spawns takes Isaac back to the same cleared boss room.
  • Dlc r indicator.png The effect of XIX - The Sun?, particularly flight, will persist even through the Collectible Knife Piece 2 icon.png Knife Piece 2 sequence.
  • Dlc r indicator.png Familiars gained from Soul of Lilith do not count as collected, and can still spawn in their appropriate pools.

Unlockable Achievements

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.
    • Dlc r indicator.png 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.
  • Dlc a indicator.png 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.
    • Dlc a† indicator.png The "Ancient Recall" card is a reference to the card "Ancestral Recall", which also draws three cards.
    • Dlc a† indicator.png The "Era Walk" card is a reference to the card "Time Walk", which allows players to take an extra turn.
    • Dlc a† indicator.png 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.
  • Dlc a† indicator.png Many cards were given new unique back sprites in Booster Pack #5, some originating from Antibirth.
  • Dlc r indicator.png Soul of Cain's ability is likely a reference to Collectible Red Key icon.png Red Key being an unlock for Character Cain icon.png Cain in the original Antibirth mod.
  • Dlc r indicator.png Soul of Judas' description and ability are a reference to the Spy from Team Fortress 2.
  • Dlc r indicator.png 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.
  • Dlc r indicator.png Soul of Eve's description is a reference to the original description Collectible Birthright icon.png Birthright had when taken as Character Eve icon.png Eve in the original Antibirth mod.
    • Its effect was also probably inspired by the old original Collectible Birthright icon.png Birthright effect, which caused Character Eve icon.png Eve to sometimes generate extra Collectible Dead Bird icon.png Dead Birds upon being hit that would persist between rooms.
  • Dlc r indicator.png 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 Collectible Whore of Babylon icon.png Whore of Babylon's (and by extension III - The Empress) pop up being the day to night message in said game.
  • Dlc r indicator.png When VII - The Chariot? is activated, the statue will sometimes look like Edith, a character from Antibirth that wasn't adapted into Repentance.
  • Dlc r indicator.png The Reverse Tarot Cards refer to tarot card readings, where a reversed card has a different meaning to an upright one.

Voiceovers

Major Arcana Cards

Tarot Card Voiceover Voiceover (Reverse)
0 - The Fool
I - The Magician
II - The High Priestess
III - The Empress
IV - The Emperor
V - The Hierophant
VI - The Lovers
VII - The Chariot
VIII - Justice
IX - The Hermit
X - Wheel of Fortune
XI - Strength
XII - The Hanged Man
XIII - Death
XIV - Temperance
XV - The Devil
XVI - The Tower
XVII - The Stars
XVIII - The Moon
XIX - The Sun
XX - Judgement
XXI - The World

Playing Cards

Card Voiceover
2 of Clubs
2 of Diamonds
2 of Spades
2 of Hearts
Ace of Clubs
Ace of Diamonds
Ace of Spades
Ace of Hearts
Joker
Suicide King
Queen of Hearts

Runes and Soul Stones

Rune or Soul Stone Voiceover
Hagalaz
Jera
Ehwaz
Dagaz
Ansuz
Perthro
Berkano
Algiz
Black Rune
Rune Shard
Soul of Isaac
Soul of Magdalene
Soul of Cain
Soul of Judas
Soul of ???
Soul of Eve
Soul of Samson
Soul of Azazel
Soul of Lazarus
Soul of Eden
Soul of the Lost
Soul of Lilith
Soul of the Keeper
Soul of Apollyon
Soul of the Forgotten
Soul of Bethany
Soul of Jacob and Esau

Other cards and consumables

Consumable Voiceover
Chaos Card
Huge Growth
Ancient Recall
Era Walk
Credit Card
Rules Card
A Card Against Humanity
Get out of Jail Free Card
? Card
Dice Shard
Emergency Contact
Holy Card
Wild Card
Cracked Key

Bugs

Collectible Undefined icon.png Bug! Dlc a†nr indicator.png Hagalaz Icon.png Rune of Hagalaz will open Secret Room Icon.png Secret Room doors in L-shaped rooms.
Collectible Undefined icon.png Bug! Dlc r indicator.png Using Pickup XVI - The Tower? icon.png XVI - The Tower? in a Boss Room Icon.png Boss Room may block all paths to the trap door, resulting in a softlock if no bombs or flight are available.
Collectible Undefined icon.png Bug! Dlc r indicator.png If Character Esau icon.png Esau is holding Pickup Soul of Lazarus icon.png Soul of Lazarus when either Character Jacob icon.png 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.

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