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Removed in RepentanceItem icon
Added in RepentanceItem icon
Item altar
"Needle shot"
Table dividing line 1.png
Item ID
Character Appearance
Character appearance
Table dividing line 2.png
Table dividing line 3.png
Collection Grid
Removed in Repentance(page 5, column 11, row 1)
Added in Repentance(page 5, column 12, row 1)
Unlock Method
Euthanasia Defeat Delirium as Lilith
Added in Afterbirth †

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

Effects[edit | edit source]

  • 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. At base luck (0), it is 3.33% and goes up to 100% at 15 luck.
      • Added in Repentance No longer a 100% chance at 15 luck.
  • This item belongs to the Spun set. Collecting three items from this set will transform Isaac into a buff berserker.

Notes[edit | edit source]

  • The needle tears can kill enemies that are normally invincible, such as Peep's eyes, Death's Heads, and Stoneys.
  • The needle tears can kill Grimaces, allowing the player to permanently remove any obstacle in a room.
    • Added in Repentance The needle tears kill Bomb Grimaces, resulting in 10 pink unlit bombs to be dropped. Recommend to avoid hitting them while in a boss room.
  • Possible needle tears in a burst from killing an enemy do not retain the instant kill and burst-causing capabilities, but still deal triple damage. This prevents chain reactions of bursts.
  • The tears in the burst are larger than normal but do not have a damage bonus.
  • Unless piercing is obtained, Knights from the front will still block the needles.

Interactions[edit | edit source]

  • 15►Brimstone Brimstone / 15►Dr. Fetus Dr. Fetus / / 15►Mom's Knife Mom's Knife / 15►Technology Technology / 15►Trisagion Trisagion: No appearance change, tear burst or instant kill, but triple damage still works.
  • 15►Compound Fracture Compound Fracture / 15►Haemolacria Haemolacria / 15►Pop! Pop!: Overrides Euthanasia's appearance, but the effects work normally.
  • 15►Godhead Godhead: The aura of a needle tear will also do triple damage, but does not cause tear burst or instant kill.
  • 15►Ipecac Ipecac: No tear burst or instant kill, but triple damage still works.
  • 15►Little Horn Little Horn: If a tear has both the Euthanasia and Little Horn effects and instantly kills an enemy, it does not cause a tear burst.
  • 15►Tech.5 Tech.5: The tears that Isaac fires work normally, and the laser has a chance to deal triple damage with no other effects.
  • 15►Tech X Tech X: Completely overrides Euthanasia. No triple damage, no tear burst or instant kill.
  • 15►Technology 2 Technology 2: The tears that Isaac fires work normally, but the laser is completely unaffected.
  • 15►Epic Fetus Epic Fetus : can still tear burst but seems rarer

In-game Footage[edit | edit source]

Trivia[edit | edit source]

  • 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 15►Experimental Treatment Experimental Treatment are the only 2 syringe items that need to be unlocked.

Seeds[edit | edit source]

PC Normal and hard modes only LH27 889W (Treasure Room adjacent to spawn)

Switch Greed mode only DSX3 LF12 (First Golden Treasure Room)

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