Familiar

Familiars are small companions, usually generated by passive items, that follow and assist Isaac. Effects of familiars include (but are not limited to) pickup generation, shooting familiars that fire their own tears at enemies, and orbitals that act as projectile shields and/or deal contact damage.

Many of these familiars (especially pickup generation and shooting familiars) follow behind Isaac. When Isaac picks up multiple of these following familiars, they form a line behind him from oldest to newest (with closest familiar behind Isaac being the oldest one picked up) rather than constantly overlapping one another on the same spot behind Isaac.

• In addition to being chronologically ordered, certain familiars on the line take priority over others in how close their position is to Isaac. There are 6 priorities:
  • The 1st priority is taken by King Baby, making it always the closest familiar to Isaac.
  • The 2nd priority is taken by Incubus.
  • The 3rd priority is taken by Lil Brimstone and Lil Monstro.
  • The 4th priority is taken by Censer, Dry Baby, Lil Abaddon, and Mongo Baby.
  • The 5th priority is taken by most shooting familiars and some throwable familiars.
  • The 6th priority is taken by most pickup generation familiars and "quest item" familiars such as Key Piece 1. Boiled Baby also takes this priority.

Isaac cannot have more than 64 total familiars at once. This includes blue spiders and flies, familiar items such as Dry Baby, Tainted Eve's blood clots, etc. Gaining more than this will result in familiars being destroyed, with blue spiders and flies being destroyed first.

Temporary Familiars

Blue Flies

Blue Flies are familiars that will orbit around Isaac and rush towards nearby enemies, dealing damage and dying in the process. Blue Flies deal double Isaac's current tear damage.

Name	ID	Icon	Quote	Description	Quality
Guppy's Head	5.100.145		Reusable fly hive	Spawns 2-4 friendly Blue Flies that damage enemies.	2
Mom's Pad	5.100.41		Mass fear	Inflicts fear to all enemies in the room for 4 seconds. Spawns a blue fly.	0
Jar of Flies	5.100.434		Bug catcher	Killing an enemy adds a fly to the jar, up to a maximum of 20. On use, releases Blue Flies equal to the number of flies in the jar.	2
Compost	5.100.480		Gain more friends!	Doubles Isaac's Blue Flies and Blue Spiders, or spawns one if Isaac has none. Converts pickups in the current room into Blue Flies or Blue Spiders.	1
Everything Jar	5.100.720		Anything is possible	Spawns certain pickups based on how many charges it has. If fully charged, instead has one of many unique effects.	3

Name	ID	Icon	Quote	Description	Quality
Infestation	5.100.148		Fly revenge	1-3 Blue Flies randomly spawn every time Isaac gets hit. 2-6 Blue Flies randomly spawn every time Isaac gets hit.	0
Mom's Underwear	5.100.29		Range up	+5.25 range, +0.5 tear falling speed. +2.5 range. Spawns 3-6 Blue Flies on pickup.	1
Rotten Baby	5.100.268		Infested friend	Spawns a familiar that spawns a Blue Fly when Isaac shoots. It can only have one Fly at a time.	3
The Mulligan	5.100.151		They grow inside	Tears have a 1/6 chance of spawning allied Blue Flies when they hit an enemy.	3
Parasitoid	5.100.461		Egg tears!	Adds a chance to fire an egg sack which creates slowing creep and spawns a Blue Fly or Blue Spider upon hitting an enemy.	3
Lil Portal	5.100.681		It hungers	A familiar that flies forward, consuming pickups in its path. Each one will increase its size and damage and spawn a Blue Fly. Every four pickups, it opens a portal that leads to an unexplored room.	1
The Swarm	5.100.693		Infest	Spawns eight orbital flies, which turn into Blue Flies after they block a shot. Each time a room is cleared, spawns another orbital fly.	2

Name	ID	Icon	Quote	Description
Fish Head	5.350.29		It stinks	Spawns a Blue Fly every time Isaac takes damage.
Lil Larva	5.350.86		The poop is moving...	Spawns a Blue Fly from every pile of Poop that Isaac destroys.
Fish Tail	5.350.94		It also stinks!	Items and trinkets that generate Blue Flies or Locusts will generate twice as many.
Rotten Penny	5.350.126		Wealth of flies	Spawns a Blue Fly every time a coin is picked up.

Name	ID	Icon	Message	Description
Rune of Berkano	5.300.38		Companionship	Summons 3 friendly Blue Flies and 3 friendly Blue Spiders.
Black Rune	5.300.41		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.

Other sources of Blue Flies

• Red Chest: Has a chance to spawn 3 Blue Flies.
• Dark blue champion: Will create 3 Blue Flies when defeated.
• Guppy: Isaac will create Blue Flies whenever his tears or his familiars' tears hit enemies.
• Guppy: Isaac's tears have a 66% chance to create Blue Flies whenever they hit enemies.
• Beelzebub: Some types of enemy flies become Blue Flies.
• Friends Till The End! pill: Spawns 3 Blue Flies.
• As Keeper or Tainted Keeper, all heart pickups turn into Blue Flies.
• Rotten Heart: After clearing a room, a maximum of 2 Blue Flies spawn for each Rotten Heart in Isaac's life bar.
• Corny Poops created by Tainted ??? or IBS spawn a Blue Fly every two seconds, up to a maximum of 3.
• Rotten Beggars can spawn Blue Flies as a reward.

Locusts

Locusts are variants of Blue Flies that are spawned by Locust trinkets and 7 Seals. They behave like regular Blue Flies but have additional special effects. Red Locusts explode on contact with an enemy, dealing an extra 60 damage in the radius (explosions are affected by certain bomb modifiers). Green Locusts poison the enemy. Yellow Locusts slow the enemy. Black Locusts deal quadruple Isaac's damage instead of double. White Locusts are identical to Blue Flies, but are generally spawned in high quantities.

Name	ID	Icon	Quote	Description	Quality
7 Seals	5.100.526		Lil harbingers!	Spawns a random Harbinger familiar that changes every 10 seconds. Harbingers have different behaviors and spawn themed Locusts.	2

Name	ID	Icon	Quote	Description
Fish Tail	5.350.94		It also stinks!	Items and trinkets that generate Blue Flies or Locusts will generate twice as many.
Locust of Conquest	5.350.117		I bring Conquest	Upon entering a room with enemies, spawns 1-4 White Locusts which damage enemies.
Locust of Death	5.350.116		I bring Death	Upon entering a room with enemies, spawns a Black Locust that does a very high amount of damage.
Locust of Famine	5.350.115		I bring Famine	Upon entering a room with enemies, spawns a Yellow Locust that damages and slows enemies.
Locust of Pestilence	5.350.114		I bring Pestilence	Upon entering a room with enemies, spawns a Green Locust which damages and poisons enemies.
Locust of War	5.350.113		I bring War	Upon entering a room with enemies for the first time, spawns a Red Locust which detonates upon impact with enemies.
Cricket Leg	5.350.185		Infested	Adds a chance to spawn a random locust when killing an enemy.

Name	ID	Icon	Message	Description
Soul of Apollyon	5.300.94		Bringer of calamity	Spawns 15 random locusts.

Blue Spiders

Blue Spiders are familiars similar to Blue Flies that crawl erratically and rush towards nearby enemies, dealing damage and dying in the process.

Blue Spiders deal 2.5 times Isaac's current tear damage. Blue Spiders deal twice Isaac's current tear damage.

Unlike Blue Flies, Blue Spiders cannot attack over obstacles such as rocks and pits.

Bug!	3DS Exiting the game and re-entering will cause all Blue Spiders to disappear.

Name	ID	Icon	Quote	Description	Quality
Box of Spiders	5.100.288		It's a box of spiders	Spawns 1-4 Blue Spiders that deal 2.5× Isaac's damage to enemies. Spawns 4-8 Blue Spiders that deal 2× Isaac's damage to enemies.	1
Compost	5.100.480		Gain more friends!	Doubles Isaac's Blue Flies and Blue Spiders, or spawns one if Isaac has none. Converts pickups in the current room into Blue Flies or Blue Spiders.	1
Everything Jar	5.100.720		Anything is possible	Spawns certain pickups based on how many charges it has. If fully charged, instead has one of many unique effects.	3

Name	ID	Icon	Quote	Description	Quality
Dark Bum	5.100.278		He wants to take your life	Spawns a familiar that follows Isaac around and collects Red Hearts. For every 1½ Red Hearts collected, Dark Bum will give a reward.	3
Infestation 2	5.100.234		Infestation shot	Spawns allied Blue Spiders from killed enemies.	3
Juicy Sack	5.100.266		Sticky babies	Spawns a familiar that follows Isaac and drips a trail of slow creep, spawning 1-2 Blue Spiders after each room.	2
Mom's Wig	5.100.217		You feel itchy...	Adds a chance to spawn Blue Spiders when firing tears. Restores 1 Red Heart.	2
Sissy Longlegs	5.100.280		She loves you	Spawns a familiar that wanders randomly, occasionally spawning Blue Spiders. Briefly charms enemies on contact.	1
Spiderbaby	5.100.211		Spider revenge	Spawns 1-2 Blue Spiders when Isaac takes damage. Spawns 3-5 Blue Spiders when Isaac takes damage.	0
Spider Mod	5.100.403		Mod buddy!	Displays Isaac's tear damage and enemy health bars. Spawns a familiar that wanders around and inflicts random status effects on enemies it touches. Can spawn a Lil' Battery/Blue spider upon clearing a room.	1
Sticky Bombs	5.100.367		Egg sack bombs!	+5 Bombs. Bombs stick to enemies and spawn 2-4 Blue Spiders if they kill an enemy. They also leave a long-lasting puddle of slowing white creep.	2
Parasitoid	5.100.461		Egg tears!	Adds a chance to fire an egg sack which creates slowing creep and spawns a Blue Fly or Blue Spider upon hitting an enemy.	3
Keeper's Kin	5.100.717		Under a rock	Rocks and other Obstacles spawn blue spiders over time while in a room with enemies, and spawn two blue spiders when destroyed.	2
Strawman	5.100.667		A helping hand	Spawns a controllable Keeper to fight enemies alongside Isaac, functioning similarly to Jacob and Esau. If Keeper dies, he spawns 5 blue spiders and Strawman is removed from Isaac's inventory.	2
The Intruder	5.100.575		Invasive friend	A familiar burrows in Isaac's head, firing 4 slowing tears. Upon taking damage, there's a chance it will burst out of Isaac's head, spawning blue spiders and chasing enemies for the current room.	3
Tinytoma	5.100.645		Itching for revenge	Gives Isaac a Teratoma orbital that blocks shots, deals contact damage, and splits into smaller versions of itself upon taking damage. The smaller versions break into blue spiders.	1

Name	ID	Icon	Quote	Description
Louse	5.350.70		Itchy, tasty...	Occasionally spawns a Blue Spider.
Apple of Sodom	5.350.140		It feels empty	Picking up Red Hearts, even while at full health, can convert them into blue spiders. The effect may consume hearts needed for healing.

Name	ID	Icon	Message	Description
Rune of Berkano	5.300.38		Companionship	Summons 3 friendly Blue Flies and 3 friendly Blue Spiders.
Black Rune	5.300.41		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.

Other sources of Blue Spiders

• Infested? pill: Spawns Blue Spiders equal to the number of enemies in the room.
• Infested! pill: Spawns a Blue Spider under Isaac and every pile of poop in the room.
• Rotten Beggars and Hell Games can spawn Blue Spiders as a reward.
• Red Chest: Has a chance to spawn 3 Blue Spiders.

Dips

Dips are temporary familiars that are spawned when destroying poops. They move erratically around the room and behave similarly to their hostile counterpart dealing contact damage to enemies and blocking projectiles. There are a variety of Dips with unique effects that correlate to different types of Poops.

Name	ID	Icon	Quote	Description	Quality
Dirty Mind	5.100.576		Filthy friends	Destroying poop spawns Dip Familiars that follow Isaac and damage enemies. Destroying different types of poop spawns different Dips with special effects.	1

Name	ID	Icon	Quote	Description
Dingle Berry	5.350.163		Oops!	Spawns a Dip Familiar upon clearing a room.

Other sources of Dips

• Destroying a Charming Poop spawns a few Dip Familiars.

Wisps

Wisps are temporary orbital familiars that are mostly associated with Bethany. By default, they orbit Isaac, blocking shots and dealing contact damage. They also fire spectral tears that deal 1.6-2.4 damage. Normal wisps have 2 health. There are many variants of wisps, most of which can be spawned randomly or through combinations with Book of Virtues. See here for a full list of wisps.

Other unique variants of wisps include item wisps from Lemegeton which only mimic the effects of passive items while alive, and red wisps from Vengeful Spirit, which are invulnerable, but disappear upon entering a new floor.

Name	ID	Icon	Quote	Description	Quality
Book of Virtues	5.100.584		Spiritual companionship	Spawns a destroyable orbiting wisp familiar that fires tears and deals contact damage. Also acts as a passive item that causes other active items to spawn themed wisps.	3
Jar of Wisps	5.100.685		Your faith grows	Spawns random wisps that shoot various tears, block shots, and deal contact damage. The number of wisps spawned increases every time the jar is used.	2
Lemegeton	5.100.712		Item summoner	Spawns a wisp representing a random passive item, which orbits Isaac but can be destroyed. While the wisp is alive, Isaac gains that item's effects. Generation uses the current room's item pool 25% of the time, otherwise a random pool.	3

Name	ID	Icon	Quote	Description	Quality
Vengeful Spirit	5.100.702		Hot blooded	After taking damage, spawns an orbital wisp that lasts for the entire floor, up to a maximum of six. They fire tears but do not block shots.	1

Name	ID	Icon	Quote	Description
Beth's Essence	5.350.182		Virtue's reward	Upon entering an Angel Room, spawns 5 wisp orbitals. Giving money to Beggars can spawn wisps.
Beth's Faith	5.350.142		My faith protects me	At the beginning of each floor, spawn 4-8 wisps that orbit Isaac and fires tears alongside him.

Name	ID	Icon	Message	Description
Soul of Bethany	5.300.96		Friends from beyond	Spawns 6 Book of Virtues wisps with random properties.

Other sources of Wisps

• Picking up Birthright as Tainted Bethany spawns 4 item wisps with increased health.

Ghosts

Ghosts are temporary familiars that are summoned by various items. Most ghosts (except those created by Vade Retro) will automatically attack enemies after being summoned, quickly homing in on nearby enemies. All ghosts attack enemies by exploding, though some also deal contact damage shortly before doing so. Explosions from ghosts do not damage terrain or hurt Isaac. Unlike other temporary familiars, ghosts do not persist across rooms.

Name	ID	Icon	Quote	Description	Quality
Vade Retro	5.100.653		Begone!	While held, enemies leave behind ghosts on death. Stronger enemies leave bigger ghosts. Using the item causes the ghosts to explode and damage nearby enemies, and instantly kills all ghost enemies with less than 50% HP.	2

Name	ID	Icon	Quote	Description	Quality
Ghost Bombs	5.100.727		Spooky blast +5 bombs	+5 Bombs. Bombs become spectral and spawn ghosts that deal contact damage to enemies and explode after 10 seconds.	2
Hungry Soul	5.100.684		Out for blood	Enemies have a chance to spawn ghosts on death, which chase and deal contact damage to enemies and explode after a short time.	2
Purgatory	5.100.634		Help from beyond	While in a room with enemies, spawns red cracks in the ground. Walking over these cracks summons ghosts that launch themselves at enemies and explode.	2

Chasing Familiars

Familiars in this category actively chase enemies, dealing contact damage to them.

Name	ID	Icon	Quote	Description	Quality
The Pinking Shears	5.100.107		Cut and run	Separates Isaac's head from his body for the current room, granting flight and turning the body into a familiar that chases enemies.	2

Name	ID	Icon	Quote	Description	Quality
Ball of Bandages	5.100.207		Gotta lick 'em all!	Creates an orbital familiar. Collecting additional copies gives it the ability to shoot Charm tears, then chase enemies to deal contact damage, then deal even more contact damage.	2
Cube of Meat	5.100.73		Gotta meat 'em all!	Creates an orbital familiar. Collecting additional copies gives it the ability to shoot tears, then chase enemies to deal contact damage, then deal even more contact damage.	2
Daddy Longlegs	5.100.170		Daddy's love	Daddy Long Legs' shadow follows Isaac and occasionally stomps enemies for 40 damage total.	3
Dead Bird	5.100.117		Protective buddy	After Isaac takes damage, spawns a flying familiar that chases enemies for the current room, dealing ~4 damage per second.	0
Gemini	5.100.318		Conjoined friend	Spawns a conjoined familiar which chases enemies close to Isaac, dealing ~6.43 damage per second.	1
Leech	5.100.270		Blood sucker	Spawns a leech familiar that chases enemies, dealing ~3 damage per second. Heals a Half Red Heart whenever Leech kills an enemy.	2
Lil Haunt	5.100.277		Fear him	Spawns a familiar that chases down enemies, dealing 4 damage per second and inflicting fear.	1
Smart Fly	5.100.264		Revenge fly	Spawns an orbital familiar that blocks enemy shots. Upon taking damage, the familiar will pursue enemies for the rest of the room, dealing 22.5 damage per second.	2
Bumbo	5.100.385		Bumbo want coin!	Spawns a beggar familiar which picks up any nearby coins, leveling up after collecting several coins. At level 2, Bumbo gains a body. At level 3, it begins to fire tears. At level 4, Bumbo follows enemies and gains contact damage.	1
7 Seals	5.100.526		Lil harbingers!	Spawns a random Harbinger familiar that changes every 10 seconds. Harbingers have different behaviors and spawn themed Locusts.	2
Bird Cage	5.100.610		Fat buddy	The first time Isaac takes damage in a room, a familiar leaps on an enemy, dealing damage and releasing a rock wave. For the rest of the room, it chases enemies similar to Dead Bird.	1
Blood Puppy	5.100.565		What a cute little thing!	Spawns a familiar that chases enemies. After killing enough enemies, it becomes more powerful but will also try to hurt Isaac, it will also generate Half Red Hearts on enemy kills. It can increase in power one more stage after killing even more enemies. Dealing enough damage to it returns it to normal.	1
The Intruder	5.100.575		Invasive friend	A familiar burrows in Isaac's head, firing 4 slowing tears. Upon taking damage, there's a chance it will burst out of Isaac's head, spawning blue spiders and chasing enemies for the current room.	3

Name	ID	Icon	Quote	Description
Eve's Bird Foot	5.350.60		Revenge from beyond	5% chance to spawn a Dead Bird familiar for the current room each time an enemy dies.
Umbilical Cord	5.350.33		Fetal Protection	When brought down to only a Half Red Heart, spawns a Little Steven familiar for the current room. Adds a high chance to spawn a Gemini familiar for the current room after taking damage.

Name	ID	Icon	Message	Description
Soul of Eve	5.300.86		Your very own murder	14 Dead Bird familiars fly in and attack enemies. They leave after all enemies are dead or Isaac leaves the room.

Note: Only third and fourth stage Cube of Meat and Ball of Bandages chase enemies.

Note: Only fourth stage Bumbo chases enemies.

Note: Only War and Death in 7 Seals chase enemies.

Orbital Familiars

Familiars that orbit Isaac, absorbing enemy projectiles and/or dealing contact damage. Despite their different apparent sizes, most of them have the same effective size with regard of blocking shots or damaging enemies.

Name	ID	Icon	Quote	Description	Quality
Book of the Dead	5.100.545		Rise from the grave	Creates a friendly Bony, Black Bony, or an orbital bone for each enemy killed in the current room. Creates a friendly Bony, Black Bony, Bone Fly, Revenant, or an orbital bone for each enemy killed in the current room.	3
Spin to Win	5.100.655		Let it rip!	Gives +0.5 speed and greatly increases the rotation speed and damage of orbitals for 3 seconds. Passively gives Isaac a spinning top orbital that blocks enemy shots and deals contact damage.	1

Name	ID	Icon	Quote	Description	Quality
Ball of Bandages	5.100.207		Gotta lick 'em all!	Creates an orbital familiar. Collecting additional copies gives it the ability to shoot Charm tears, then chase enemies to deal contact damage, then deal even more contact damage.	2
Best Bud	5.100.274		Sworn protector	When hit, spawns a quickly orbiting attack fly similar to Forever Alone for the current room that deals high damage.	0
Big Fan	5.100.279		Fat protector	Spawns a large, slow-moving orbital familiar that blocks enemy shots and deals 30 damage per second to enemies. Reduces the speed other orbitals rotate at.	2
Cube of Meat	5.100.73		Gotta meat 'em all!	Creates an orbital familiar. Collecting additional copies gives it the ability to shoot tears, then chase enemies to deal contact damage, then deal even more contact damage.	2
Distant Admiration	5.100.57		Attack fly	Spawns an attack fly that circles further out than Halo of Flies, but closer than Forever Alone, dealing 75 damage per second.	2
Forever alone	5.100.128		Attack fly	Spawns an attack fly that orbits a long distance from Isaac, dealing 30 damage per second.	1
Guardian Angel	5.100.112		Extra protection	Spawns an orbital familiar that blocks enemy shots, deals 7 damage per tick on contact, and increases the speed of all orbital familiars.	2
Guillotine	5.100.206		DMG + tears up. An out-of-body experience!	Isaac's head becomes an orbital familiar that blocks shots and deals contact damage. Tears are still fired from the rotating head. +1 damage, -1 tear delay. +1 damage, +0.5 fire rate.	2
Halo of Flies	5.100.10		Projectile protection	Spawns two Pretty Flies that block enemy shots and deal contact damage to flies.	2
Sacrificial Dagger	5.100.172		My fate protects me	Spawns a dagger orbital familiar, blocking enemy shots and dealing a high amount of damage to enemies in contact.	2
Smart Fly	5.100.264		Revenge fly	Spawns an orbital familiar that blocks enemy shots. Upon taking damage, the familiar will pursue enemies for the rest of the room, dealing 22.5 damage per second.	2
Friend Zone	5.100.364		Friendly fly	Spawns a white attack fly that orbits somewhere between Distant Admiration and Forever Alone, dealing 45 damage per second.	1
Sworn Protector	5.100.363		Protective friend	Spawns an orbital familiar which does 105 damage per second and attracts and blocks enemy shots. Upon blocking 10 shots in a room, it drops an Eternal Heart.	3
Angelic Prism	5.100.528		Eclipsed by the moon	Spawns an orbital familiar with a large orbital radius. Tears that pass through the prism split into four multi-colored tears.	3
Bloodshot Eye	5.100.509		Bloody friend	Spawns an orbital familiar that deals contact damage and fires a tear every 2 seconds. Spawns an orbital familiar that deals contact damage, blocks shots, and fires tears at enemies in its line of sight.	1
Leprosy	5.100.525		You're tearing me apart!	Taking damage grants a body part orbital that blocks shots and deals contact damage, up to a maximum of three. The body parts are destroyed after blocking enough damage.	1
Mom's Razor	5.100.508		It's sharp!	Spawns an orbiting razor that deals contact damage and inflicts bleeding on enemies, causing them to slowly take damage over time.	2
Slipped Rib	5.100.542		Projectile shield	Spawns a bone familiar that circles around Isaac and reflects enemy shots.	2
Bot Fly	5.100.629		Defense drone	Spawns an orbiting fly familiar that fires shielded tears at incoming enemy projectiles.	3
Psy Fly	5.100.581		Flamboyant protector	Spawns a fly orbital familiar that seeks out incoming enemy shots and destroys them.	4
The Swarm	5.100.693		Infest	Spawns eight orbital flies, which turn into Blue Flies after they block a shot. Each time a room is cleared, spawns another orbital fly.	2
Tinytoma	5.100.645		Itching for revenge	Gives Isaac a Teratoma orbital that blocks shots, deals contact damage, and splits into smaller versions of itself upon taking damage. The smaller versions break into blue spiders.	1

Pills / Slot Machine

Name	Description
Pretty Fly	Grants 1 fly orbital that circles the player, blocking projectiles and damaging fly-type enemies on touch.

Notes

• A maximum of three Pretty Flies can orbit around Isaac.
  • It is possible to have more than three orbitals if one has access to co-op mode. If a co-op baby or multiple co-op babies temporarily hold all but two orbitals while Isaac picks up another, and then the co-op baby or co-op babies sign out or die, Isaac will receive their orbitals as well.
• Cube of Meat, Ball of Bandages, and Sacrificial Dagger take up a Pretty Fly slot.
  • For example, If Isaac has three Pretty Flies and picks up a Cube of Meat, the Cube of Meat will replace one of the flies.
  • Only first and second stage Cube of Meat and Ball of Bandages are orbitals. Therefore, upgrading from level 2 to level 3 will free up a Pretty Fly slot.
• Duplicated orbitals, such as Forever alone being copied with the Box of Friends or Diplopia, will fly directly opposite the original (having three copies will cause them to fly 120 degrees apart, four will fly at 90 degrees and so on).

Trivia

• Pretty Fly is a play on the phrase "pretty fly" as a descriptor.

Pickup Generation Familiars

Familiars that generate pickups when certain conditions are met.

Name	ID	Icon	Quote	Description	Quality
Bomb Bag	5.100.131		Gives bombs	Spawns a familiar that drops a Bomb every 3 rooms.	2
Bum Friend	5.100.144		He's greedy	Spawns a familiar that picks up coins for himself, giving random pickups in return. Can spawn Items from the Beggar Item Pool.	1
Dark Bum	5.100.278		He wants to take your life	Spawns a familiar that follows Isaac around and collects Red Hearts. For every 1½ Red Hearts collected, Dark Bum will give a reward.	3
Little C.H.A.D.	5.100.96		Gives kisses	Spawns a familiar who drops a Half Red Heart every 3 rooms.	2
Mystery Sack	5.100.271		?	Spawns a familiar that drops a Heart, coin, Bomb, or Key every 5-6 rooms.	2
Sack of Pennies	5.100.94		Gives money	Spawns a familiar that drops a coin every 2 rooms.	1
The Relic	5.100.98		Soul generator	Spawns a cross familiar that drops a Soul Heart after clearing enough rooms.	3
Bumbo	5.100.385		Bumbo want coin!	Spawns a beggar familiar which picks up any nearby coins, leveling up after collecting several coins. At level 2, Bumbo gains a body. At level 3, it begins to fire tears. At level 4, Bumbo follows enemies and gains contact damage.	1
Charged Baby	5.100.372		Bbbzzzzzt!	Spawns a familiar that occasionally drops a Lil' Battery, gives an active item charge, or petrifies all enemies in the room.	3
Key Bum	5.100.388		He wants your keys!	Spawns a familiar that follows Isaac and collects Keys for himself, giving random Chests in return.	0
Lil Chest	5.100.362		What's in the box?	Spawns a chest familiar that spawns a random pickup (25% chance) or trinket (10% chance) upon clearing a room.	2
Rune Bag	5.100.389		Rune generator	Spawns a familiar that drops a random rune after clearing enough rooms.	3
Spider Mod	5.100.403		Mod buddy!	Displays Isaac's tear damage and enemy health bars. Spawns a familiar that wanders around and inflicts random status effects on enemies it touches. Can spawn a Lil' Battery/Blue spider upon clearing a room.	1
Sworn Protector	5.100.363		Protective friend	Spawns an orbital familiar which does 105 damage per second and attracts and blocks enemy shots. Upon blocking 10 shots in a room, it drops an Eternal Heart.	3
Acid Baby	5.100.491		Pills pills pills!	Spawns a familiar that drops a random pill every 3 rooms. Upon using a pill, all enemies in the room are poisoned.	2
Sack of Sacks	5.100.500		Gives sacks	Spawns a familiar that drops a Grab Bag every 5-6 rooms cleared.	3
Blood Puppy	5.100.565		What a cute little thing!	Spawns a familiar that chases enemies. After killing enough enemies, it becomes more powerful but will also try to hurt Isaac, it will also generate Half Red Hearts on enemy kills. It can increase in power one more stage after killing even more enemies. Dealing enough damage to it returns it to normal.	1
Lost Soul	5.100.612		Protect him	Creates a ghostly familiar that closely follows behind Isaac. It dies in one hit, but respawns at the start of the next floor. Each time it survives until the next floor, it rewards Isaac with Soul Hearts, Eternal Hearts, or an Item.	2

Note: Only the second, third, and fourth stages of Bumbo generate pickups.

Note: Only the second and third stages of Blood Puppy generate pickups.

Shooting Familiars

Familiars that attack with their own tears or other ranged effects. Most shooting familiars only shoot as long as Isaac is attacking or charging a shot, though there are others that target and fire automatically.

Name	ID	Icon	Quote	Description	Quality
Scissors	5.100.325		Lose your head	Turns Isaac's head into a stationary familiar for the current room which fires tears automatically. Isaac's body also shoots a controllable fountain of blood shots for the room.	1
Brown Nugget	5.100.504		Friendly fly	Spawns a stationary fly turret that lasts for the current room and fires tears at nearby enemies.	0
Gello	5.100.728		Demonic gestation	Spawns a demon familiar for the current room that's attached to Isaac and moves and fires in the direction Isaac shoots, using Isaac's damage, tears, range, shot speed, and special tear effects.	3
Sumptorium	5.100.713		Blood to blood	Removes half a heart and creates a Clot familiar that mimics Isaac's movements and tear effects. As Tainted Eve, passively converts health into Clots while firing. Activating returns all Clots to health.	3

Name	ID	Icon	Quote	Description	Quality
Abel	5.100.188		Mirrored buddy	Spawns a familiar that mirrors Isaac's movements and shoots in the opposite direction. Spawns a familiar that mirrors Isaac's movements and shoots towards him.	0
Ball of Bandages	5.100.207		Gotta lick 'em all!	Creates an orbital familiar. Collecting additional copies gives it the ability to shoot Charm tears, then chase enemies to deal contact damage, then deal even more contact damage.	2
Brother Bobby	5.100.8		Friends 'till the end	Spawns a familiar that follows Isaac around shooting tears that deal 3.5 damage. He shoots more frequently than most familiars.	1
Cain's Other Eye	5.100.319		Near-sighted friend	Spawns a familiar that slowly floats around the room on a zig-zag pattern and shoots normal tears in the same direction as Isaac. Spawns a familiar that follows Isaac and fires tears in random cardinal directions that copy Isaac's tears and tear effects and scale with damage.	2
Cube of Meat	5.100.73		Gotta meat 'em all!	Creates an orbital familiar. Collecting additional copies gives it the ability to shoot tears, then chase enemies to deal contact damage, then deal even more contact damage.	2
Demon Baby	5.100.113		Auto-turret friend	Spawns a familiar that follows Isaac and automatically fires at enemies in its reach.	2
Ghost Baby	5.100.163		Spectral buddy	Spawns a familiar that follows Isaac around and fires spectral tears.	1
Harlequin Baby	5.100.167		Double shot buddy	Spawns a familiar that follows Isaac around and fires two tears at once in a V-pattern.	1
Isaac's Heart	5.100.276		Protect it	Isaac himself is now immune to all damage, and a heart familiar follows him. If the heart is hurt, Isaac is hurt. The heart charges up as Isaac shoots, firing 8 blood shots, knocking back enemies, and leaving a puddle of creep when released.	0
Lil Brimstone	5.100.275		Evil friend	Grants a familiar that charges a thin Brimstone laser while Isaac is shooting.	2
Little Gish	5.100.99		Sticky friend	Spawns a familiar that follows Isaac around and fires slowing tears, impeding enemies' speed.	2
Little Steven	5.100.100		Psychic friend	Spawns a familiar who follows Isaac around and fires homing tears.	2
Mongo Baby	5.100.322		Mongo friend	Spawns a familiar that copies the tears of Isaac's other familiars.	2
Rainbow Baby	5.100.174		Random buddy	Spawns a familiar that follows Isaac around and fires tears with random effects.	1
Robo-Baby	5.100.95		Friends 'till the bbbbzzzt	Spawns a familiar that shoots Technology lasers.	1
Robo-Baby 2.0	5.100.267		We worked out all the kinks	Spawns a familiar that fires lasers at any enemy in its line of sight and moves based on the direction Isaac is firing tears.	1
Rotten Baby	5.100.268		Infested friend	Spawns a familiar that spawns a Blue Fly when Isaac shoots. It can only have one Fly at a time.	3
Sister Maggy	5.100.67		Friends 'till the end	Spawns a familiar that follows Isaac around shooting tears that deal 3.5 damage. Spawns a familiar that follows Isaac around shooting tears that deal 6 damage.	1
Bumbo	5.100.385		Bumbo want coin!	Spawns a beggar familiar which picks up any nearby coins, leveling up after collecting several coins. At level 2, Bumbo gains a body. At level 3, it begins to fire tears. At level 4, Bumbo follows enemies and gains contact damage.	1
Fate's Reward	5.100.361		Your fate beside you	A blue head familiar that will follow Isaac and fire tears copying his tear effects and damage.	2
Incubus	5.100.360		Dark friend	Spawns a demonic familiar that shoots tears identical to Isaac's in terms of damage, tears, and tear effects.	4
Lil Loki	5.100.435		4-way buddy!	Spawns a Loki familiar that follows Isaac and fires 4 tears in a cross pattern.	1
Papa Fly	5.100.430		Turret follower	Spawns a familiar that follows Isaac's movements on a 3 second delay, firing tears at nearby enemies.	1
Seraphim	5.100.390		Sworn friend	Spawns an angel familiar who follows Isaac and fires homing tears which deal 10 damage and have 75% shot speed.	3
Buddy in a Box	5.100.518		What could it be?!	Spawns a familiar with a random tear effect. The familiar is randomized at the start of each floor.	2
Lil Monstro	5.100.471		Ain't he cute?	Spawns a familiar that fires clusters of tears. Must be charged before shooting.	2
Lil Spewer	5.100.537		Puking buddy	Drops a random pill, and spawns a familiar that charges up and fires creep. Using pills changes the creep type.	1
Boiled Baby	5.100.607		Messy friend	Gives Isaac a familiar that fires chaotic bursts of tears in all directions.	1
Freezer Baby	5.100.608		Iced iced baby	Spawns a shooting familiar that has a chance to petrify enemies, and freezes monsters upon killing them.	2
Giant Cell	5.100.658		Micro friends	Causes Isaac to spawn Minisaac familiars when he takes damage, which chase and shoot at nearby enemies.	1
Lil Abaddon	5.100.679		Abyssal friend	Spawns a familiar that charges a miniature Maw Of The Void attack while Isaac shoots.	2
Quints	5.100.661		They lurk inside	The first five enemies killed in a room will spawn stationary shooting familiars where they died.	2
The Intruder	5.100.575		Invasive friend	A familiar burrows in Isaac's head, firing 4 slowing tears. Upon taking damage, there's a chance it will burst out of Isaac's head, spawning blue spiders and chasing enemies for the current room.	3
Twisted Pair	5.100.698		Double trouble!	Spawns two familiars that float on either side of Isaac and fire tears that use his tears, range, shot speed, and tear effects, and scale with damage.	4

Name	ID	Icon	Quote	Description
???'s Soul	5.350.57		Imaginary Friend	Spawns a familiar that floats slowly around the room on a zig-zag pattern similar to The Peeper and fires spectral and homing tears.
Isaac's Head	5.350.54		Dead friend	Spawns Isaac's severed head as a tear-firing familiar. Fires piercing tears.
Umbilical Cord	5.350.33		Fetal Protection	When brought down to only a Half Red Heart, spawns a Little Steven familiar for the current room. Adds a high chance to spawn a Gemini familiar for the current room after taking damage.
Found Soul	5.350.180		Finally!	Spawns a familiar that copies Isaac's movements and scales with damage and tears. If it takes damage, it will die and respawn on the next floor.
Lil Clot	5.350.176		Mini friend	Spawns a clot familiar that mimics Isaac's movements and tears. It dies for the current room after taking too much damage.

Note: Only second stage Cube of Meat and Ball of Bandages shoot tears.
Note: Only third stage Bumbo fires tears.

Note: Most shooting familiars that follow Isaac take 5th priority along the familiar line. This is the second to last priority with the last being non-combat familiars. There are some exceptions such as Incubus which has 2nd priority, Lil Brimstone and Lil Monstro which have 3rd priority, and Boiled Baby which has 6th priority.
Note: Using five or more different copies of Esau Jr. will destroy the item and spawn a familiar that behaves the same way as Abel.

Wandering Familiars

Familiars that move around the room sporadically.

Name	ID	Icon	Quote	Description	Quality
Punching Bag	5.100.281		Scape goat	Spawns a Mulligan familiar that wanders randomly. Enemies will attack the Mulligan if it's closer.	1
Sissy Longlegs	5.100.280		She loves you	Spawns a familiar that wanders randomly, occasionally spawning Blue Spiders. Briefly charms enemies on contact.	1
Spider Mod	5.100.403		Mod buddy!	Displays Isaac's tear damage and enemy health bars. Spawns a familiar that wanders around and inflicts random status effects on enemies it touches. Can spawn a Lil' Battery/Blue spider upon clearing a room.	1
7 Seals	5.100.526		Lil harbingers!	Spawns a random Harbinger familiar that changes every 10 seconds. Harbingers have different behaviors and spawn themed Locusts.	2
YO LISTEN!	5.100.492		Yo listen!	+1 luck. Spawns a fairy familiar that points out Secret Rooms, Crawl Space entrances, and tinted rocks.	2

Note: The Spider Baby transformation grants a familiar nearly identical to Spider Mod with the only difference being the lack of ability to see enemy HP bars.

Note: Only Famine, Pestilence, and Conquest in 7 Seals wander randomly.

Bouncing Familiars

Familiars that bounce around the room in a zig-zag pattern, changing directions when hitting a wall.

Name	ID	Icon	Quote	Description	Quality
The Scooper	5.100.605		Plop!	Summons The Peeper for the current room, which leaves a trail of red creep.	1

Name	ID	Icon	Quote	Description	Quality
BBF	5.100.272		Big Beautiful Fly	Spawns a familiar that flies around the room in a zig-zag pattern and explodes on contact with an enemy. Respawns after ten seconds.	1
Cain's Other Eye	5.100.319		Near-sighted friend	Spawns a familiar that slowly floats around the room on a zig-zag pattern and shoots normal tears in the same direction as Isaac. Spawns a familiar that follows Isaac and fires tears in random cardinal directions that copy Isaac's tears and tear effects and scale with damage.	2
The Peeper	5.100.155		Plop!	Spawns a familiar that slowly floats around the room in a zig-zag pattern, damaging enemies it passes through. Increases the damage of tears from Isaac's left eye by 35%.	2
GB Bug	5.100.405		Double tap glitch	Spawns a familiar that bounces diagonally around the room, applying a random status effect to enemies it hits and has a chance to re-roll pickups it passes over. Spawns a familiar that follows Isaac. Double tapping the fire button launches it forward, causing it to reroll the first monster or pickup it hits.	1
Succubus	5.100.417		Damage booster	Spawns a flying familiar that bounces around the room with a black aura, dealing rapid damage to any enemies inside it. While standing in the aura, Isaac gains a 1.5× tear damage multiplier.	3
Hushy	5.100.470		Lil hush!	Spawns a Hush familiar that bounces diagonally around the room and deals contact damage. While firing tears, it stops moving.	0

Name	ID	Icon	Quote	Description
???'s Soul	5.350.57		Imaginary Friend	Spawns a familiar that floats slowly around the room on a zig-zag pattern similar to The Peeper and fires spectral and homing tears.

Mimicking Familiars

Familiars that copy Isaac's movements after a certain delay.

Name	ID	Icon	Quote	Description	Quality
Multidimensional Baby	5.100.431		ydduB Buddy	Spawns a familiar that will follow Isaac's movements on a 2.5-second delay. Tears that pass through the baby will be doubled and increase in speed.	2
My Shadow	5.100.433		Me! And my shaaaadow!	Inflicts fear on all enemies in the room upon taking damage and spawns black friendly Chargers that attack enemies. Spawns a shadow familiar that closely follows behind Isaac. It spawns a black friendly Charger whenever an enemy touches it.	2
Obsessed Fan	5.100.426		Follows my every move...	Spawns a familiar that follows Isaac's movements on a delay and deals 30 contact damage per second to enemies.	0
Papa Fly	5.100.430		Turret follower	Spawns a familiar that follows Isaac's movements on a 3 second delay, firing tears at nearby enemies.	1
Shade	5.100.468		It follows	Spawns a shadow familiar that follows Isaac's movements on a 1 second delay and deals contact damage to enemies. After dealing enough damage, it is absorbed by Isaac and spawns friendly Chargers.	0

Throwable Familiars

Familiars that are thrown by Isaac by shooting and can return to him after awhile.

Name	ID	Icon	Quote	Description	Quality
Abyss	5.100.706		Come forth from the depths	Destroys all items in the room and gives Isaac a unique locust familiar for each item destroyed. Some items generate locusts with special effects.	4

Name	ID	Icon	Quote	Description	Quality
Bob's Brain	5.100.273		Explosive thoughts	Spawns a familiar that charges forward when shooting tears and explodes upon contact with an enemy, damaging and poisoning them. The familiar respawns after a few seconds.	1
Holy Water	5.100.178		Splash!	Spawns a bottle familiar that breaks when Isaac takes damage, leaving a puddle of blue creep. A bottle familiar that flies forward when Isaac shoots. It breaks upon hitting an enemy, leaving a puddle of blue creep that petrifies enemies.	3
Little Chubby	5.100.88		Attack buddy	Spawns a Charger familiar that charges forward and deals contact damage to any enemies in its path.	2
GB Bug	5.100.405		Double tap glitch	Spawns a familiar that bounces diagonally around the room, applying a random status effect to enemies it hits and has a chance to re-roll pickups it passes over. Spawns a familiar that follows Isaac. Double tapping the fire button launches it forward, causing it to reroll the first monster or pickup it hits.	1
Big Chubby	5.100.473		Chub chub	Spawns a familiar that follows Isaac and charges across the room when Isaac fires, blocking shots and dealing 40.5 damage per second on contact.	1
Jaw Bone	5.100.548		Fetch!	Spawns a familiar that flies through the room while firing, dealing a flat 7 contact damage to enemies and retrieving pickups.	1
Knife Piece 1	5.100.626		???	Combined with Knife Piece 2, creates a knife familiar that damages enemies and can open the door to the Corpse.	0
Knife Piece 2	5.100.627		???	Combined with Knife Piece 1, creates a knife familiar that damages enemies and can open the door to the Corpse.	0
Lil Portal	5.100.681		It hungers	A familiar that flies forward, consuming pickups in its path. Each one will increase its size and damage and spawn a Blue Fly. Every four pickups, it opens a portal that leads to an unexplored room.	1

Name	ID	Icon	Quote	Description
Apollyon's Best Friend	5.350.186		Attack buddy	Spawns an attack locust familiar which will fly forward while Isaac shoots.

Note: Knife Piece 1 and Knife Piece 2 are only throwable when combined.

Controlled Familiars

Familiars that move in the direction Isaac is shooting.

Name	ID	Icon	Quote	Description	Quality
Stitches	5.100.635		Bait and switch	Passively spawns a familiar that moves in the direction Isaac shoots. On use, Isaac swaps places with the familiar.	1

Name	ID	Icon	Quote	Description	Quality
???'s Only Friend	5.100.320		Controlled friend	Spawns a controllable familiar that deals 37.5 damage per second on touch. It can be moved using the shooting directional keys	1
Robo-Baby 2.0	5.100.267		We worked out all the kinks	Spawns a familiar that fires lasers at any enemy in its line of sight and moves based on the direction Isaac is firing tears.	1

Others

Familiars that don't fit into any of the above categories or that produce multiple effects.

Name	ID	Icon	Quote	Description	Quality
Monster Manual	5.100.123		Temporary buddy generator	Spawns a familiar from a specific selection for the current room. Spawns a familiar from a specific selection for the current floor.	1
Sprinkler	5.100.516		Sprinkles.	Creates a stationary sprinkler for the current room that rotates and fires tears in 8 directions. The tears copy Isaac's stats and most tear effects.	2

Name	ID	Icon	Quote	Description	Quality
1up!	5.100.11		Extra life	Gives Isaac an extra life. Upon death, he will respawn in the previous room with full health, after which 1up! will disappear.	2
Dead Cat	5.100.81		9 lives	Sets Isaac's Red Heart Containers to 1, but grants 9 extra lives. After dying, Isaac respawns with 1 Red Heart Container.	3
Dry Baby	5.100.265		Immortal friend	Spawns a familiar that follows Isaac around and blocks enemy projectiles. Upon blocking a shot, it has a chance of triggering The Necronomicon effect.	3
Guppy's Hairball	5.100.187		Swing it	Spawns a familiar that loosely follows behind Isaac, which blocks shots can be swung like a flail to damage enemies. Grows bigger by killing enemies.	1
Headless Baby	5.100.269		Bloody friend	Spawns a familiar that follows Isaac, leaving blood creep on the ground.	1
Holy Water	5.100.178		Splash!	Spawns a bottle familiar that breaks when Isaac takes damage, leaving a puddle of blue creep. A bottle familiar that flies forward when Isaac shoots. It breaks upon hitting an enemy, leaving a puddle of blue creep that petrifies enemies.	3
Isaac's Heart	5.100.276		Protect it	Isaac himself is now immune to all damage, and a heart familiar follows him. If the heart is hurt, Isaac is hurt. The heart charges up as Isaac shoots, firing 8 blood shots, knocking back enemies, and leaving a puddle of creep when released.	0
Juicy Sack	5.100.266		Sticky babies	Spawns a familiar that follows Isaac and drips a trail of slow creep, spawning 1-2 Blue Spiders after each room.	2
Key Piece 1	5.100.238		???	Combined with Key Piece 2, unlocks the golden gate in the starting room of Chest and Dark Room to fight Mega Satan.	0
Key Piece 2	5.100.239		???	Combined with Key Piece 1, unlocks the golden gate in the starting room of Chest and Dark Room to fight Mega Satan.	0
Samson's Chains	5.100.321		The ol' ball and chain	Attaches a ball and chain to Isaac that pulls behind him that damages enemies, blocks shots, and destroys most Obstacles.	1
Cambion Conception	5.100.412		Feed them hate	After taking damage a certain amount of times, a permanent demonic familiar spawns.	2
Censer	5.100.387		Peace be with you	Spawns a familiar which creates a circular aura that slows down enemies and enemy shots inside.	3
Farting Baby	5.100.404		He farts!	Spawns a familiar that follows Isaac and blocks enemy shots. If a shot hits Farting Baby, it has a chance to fart, which charms, poisons, or knocks back nearby enemies.	1
Immaculate Conception	5.100.413		Feed them love	Upon picking up a certain amount of health, spawn a permanent angelic familiar.	1
Lil Gurdy	5.100.384		A gurd of your own!	A Gurdy Jr. familiar that charges up while Isaac is firing, bouncing around the room when released and dealing contact damage based on its speed.	2
Lost Fly	5.100.365		Lost protector	Spawns a fly familiar that moves in a straight line and circles around the first wall or obstacle it hits. It deals 105 damage per second on contact. It deals 56 damage per second and forces nearby enemies to attack it.	2
Milk!	5.100.436		Don't cry over it...	Spawns a glass familiar that spills on the floor upon taking damage. After the milk spills, Isaac's tear delay is decreased by 2 for the current room. After the milk spills, Isaac's fire rate is increased by 1 for the current room.	1
Angry Fly	5.100.511		He's violent	Spawns a fly familiar that orbits around a random enemy and deals 30 damage per second to enemies it comes in contact with.	1
Depression	5.100.469		:(	Spawns a familiar that leaves a trail of creep that damages enemies at 6 damage per second. Has a chance to spawn damaging beams of light onto enemies that touch the cloud.	1
Finger!	5.100.467		Watch where you point that!	Spawns a finger familiar that faces in the same direction as Isaac, rapidly damaging enemies it points at for 10% of Isaac's damage.	1
Hallowed Ground	5.100.543		Portable sanctuary	Spawns a white poop familiar, which turns into a White Poop when Isaac is hurt. White poop has an aura that increases tear fire rate and can block enemy shots. The aura also increases damage by 20% and gives homing.	1
King Baby	5.100.472		Hail to the king baby	Spawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, other familiars stop moving.	1
Lil Delirium	5.100.519		Delirious friend	Grants a familiar that transforms into another random familiar every 10 seconds.	2
Mystery Egg	5.100.539		Sacrificial insemination	Spawns an egg familiar, which hatches a random friendly monster when Isaac is hurt once per room. The power of the monster improves for each consecutive room cleared without taking damage.	1
Pointy Rib	5.100.544		Stabbing time	Spawns a bone familiar that hovers back and forth in front of Isaac, dealing damage equal to Isaac's damage.	2
Blood Oath	5.100.569		Bleed me dry	Stabs Isaac at the beginning of each floor, draining his Red Hearts. Increases damage and speed for the floor based on the amount drained.	1
Cube Baby	5.100.652		Kick it!	Spawns an ice cube familiar that slides around when walked into. It slows and deals contact damage, freezing monsters it kills.	1
Fruity Plum	5.100.649		Bouncy friend	Gives Isaac a miniature Baby Plum familiar that propels itself diagonally around the room, firing tears behind itself as it travels.	1
Giant Cell	5.100.658		Micro friends	Causes Isaac to spawn Minisaac familiars when he takes damage, which chase and shoot at nearby enemies.	1
Knife Piece 1	5.100.626		???	Combined with Knife Piece 2, creates a knife familiar that damages enemies and can open the door to the Corpse.	0
Knife Piece 2	5.100.627		???	Combined with Knife Piece 1, creates a knife familiar that damages enemies and can open the door to the Corpse.	0
Lil Dumpy	5.100.615		Puffy buddy	Spawns a Dumpy familiar that pushes away nearby enemies and projectiles just before Isaac is about to be hit, then falls asleep. He can be awoken by walking to him.	3
Paschal Candle	5.100.567		Keep the flame burning	Gives Isaac a familiar that grants +0.4 Fire Rate for each consecutive room he's cleared without taking damage. The bonus stacks up to five times.	3
Star of Bethlehem	5.100.651		Follow the light	Spawns a star familiar that slowly travels towards the Boss Room, giving an aura that increases damage and tears and grants homing tears.	3
Vanishing Twin	5.100.697		He wants revenge	Spawns a familiar that becomes a weaker clone of the floor's boss when entering the Boss Room. Defeating it drops an extra item.	2
Worm Friend	5.100.682		Clingy buddy	Gives Isaac a Nerve Ending familiar that burrows out of the ground to grab and deal damage to enemies over time.	3

Name	ID	Icon	Quote	Description
Tonsil	5.350.97		Sick...	When hit, there is a small chance to spawn a permanent tonsil familiar that blocks enemy shots. This can happen twice, after which the trinket is destroyed.

Name	ID	Icon	Message	Description
Soul of Lilith	5.300.92		Motherhood	Adds one permanent familiar from the Baby Shop pool, except Stitches. Can give familiars that Isaac already has. Unique familiars can be received only once.

Unlockable Achievements

• 

  Buddy in a Box - Pick up 5 familiars in a single run.

• 

  Rotten Penny - Have 20 Blue Flies at the same time.

The Binding of Isaac: Rebirth
Achievements Challenges Completion Marks Items Trinkets Characters Chapters Rooms Transformations Attributes Bosses Monsters Pickups Modes Curses Objects Seeds Effects Endings
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