Binding of Isaac: Rebirth Wiki

(in Afterbirth † and Repentance)

Euthanasia is an unlockable passive item added in The Binding of Isaac: Afterbirth †.

Effects[ | ]

  • Adds a chance to fire needles which deal triple Isaac's tear damage.
    • Needles will instantly kill regular enemies and cause them to burst into 10 more tears in all directions.
    • The chance to fire a needle depends on luck.
    • (except in Repentance) The formula used to determine the chance is:
      • At base luck (0), the chance is 3.33%, maxing out at 100% at 14.5 luck.
    • (in Repentance) The formula used to determine the chance is:
      • At base luck (0), the chance is 3.33%, maxing out at 25% at 13 luck.
    • The tears released upon an instant-kill also have a chance to be needles, though these ones do not have the instant-kill ability. They do retain the 3x damage, however.
  • This item belongs to the SpunSpun set. Collecting three items from this set will transform Isaac into a buff berserker.

Notes[ | ]

  • The needle tears can kill enemies that are normally invincible, such as Boss Peep ingamePeep's eyes, Death's HeadDeath's Heads, and StoneyStoneys.
  • The needle tears can kill Stone GrimaceStone Grimaces and (in Repentance) SpikeballSpikeballs, allowing Isaac to permanently remove any obstacle in a room.
    • (in Repentance) The needle tears can kill Bomb GrimaceBomb Grimaces, dropping 10 unlit Throwable Bombs. This can make it detrimental to shoot at them, since they are usually provided as a tool rather than an obstacle.
  • The tears in the burst are larger than normal but do not have a damage bonus.
  • Unless piercing is obtained, KnightKnights will still block the needles if shot from the front.

Interactions[ | ]

  • (except in Repentance)Collectible Brimstone iconBrimstone / (except in Repentance)Collectible Dr. Fetus iconDr. Fetus / Collectible Mom's Knife iconMom's Knife / Collectible Technology iconTechnology / Collectible Trisagion iconTrisagion: No appearance change, tear burst, or instant kill, but triple damage still works.
  • (in Repentance)Collectible Brimstone iconBrimstone / (in Repentance)Collectible Dr. Fetus iconDr. Fetus: Enemies killed by a needle burst into normal tears.
  • (except in Repentance)Collectible Godhead iconGodhead: The aura of a needle tear will also do triple damage, but does not cause tear burst or instant kill.
  • Collectible Ipecac iconIpecac: No tear burst or instant kill, but triple damage still works.
    • (in Repentance) Enemies killed by a needle burst into ipecac shots.
  • (in Repentance)Collectible Jacob's Ladder iconJacob's Ladder: The electric arcs released from a needle shot also retain the needle's instant kill and tear burst properties.
  • Collectible Little Horn iconLittle Horn: If a tear has both the Euthanasia and Little Horn effects and instantly kills an enemy, it does not cause a tear burst.
  • Collectible Tech.5 iconTech.5: The tears that Isaac fires work normally, and the laser has a chance to deal triple damage with no other effects.
  • (except in Repentance)Collectible Tech X iconTech X: Completely overrides Euthanasia. No triple damage, no tear burst, or instant kill.
    • (in Repentance) Laser Rings will sometimes deal triple damage/instantly kill regular enemies, and enemies killed by needles burst into normal tears.
  • (in Repentance) Collectible Technology iconTechnology: Killed enemies can burst into black tears normally.
  • Collectible Technology 2 iconTechnology 2: The tears that Isaac fires work normally, but the laser is completely unaffected.
    • (in Repentance) The laser has an extremely high chance of executing normal enemies.
  • (in Repentance)Collectible Spirit Sword iconSpirit Sword: Each swing of the sword has a chance to do 3x damage and instantly kill a non-boss enemy, causing a tear explosion.

In-game Footage[ | ]

Trivia[ | ]

  • Euthanasia is the act of intentionally ending a person or animal's life to end their pain and suffering. It is usually carried out by an injection, hence why this item has the appearance of a needle.
  • Euthanasia is the only syringe item that points upwards; all of the other syringes point downwards.
  • Euthanasia and Collectible Experimental Treatment iconExperimental Treatment are the only 2 syringe items that need to be unlocked.