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.

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. Isaac cannot have more than 64 Blue Flies/Spiders combined.

Name	ID	Icon	Quote	Description	Quality
Guppy's Head	5.100.145		Reusable fly hive	Spawns 2-4 friendly Blue Flies that damage enemies.	3
Jar of Flies	5.100.434		Gotta catch 'em all?	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.	2

Name	ID	Icon	Quote	Description	Quality
Infestation	5.100.148		Fly revenge	1-3 Blue Flies randomly spawn every time Isaac gets hit.	0
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 nine 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 Blue Spiders will generate twice as many.
Rotten Penny	5.350.126		Wealth of flies	Spawns a Blue Fly every time a coin is picked up.

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 transformation: Isaac will create Blue Flies whenever his tears or his familiars' tears hit enemies.
• Beelzebub transformation: All enemy flies become Blue Flies.
• Rune of Berkano: Spawns 3 Blue Flies and 3 Blue Spiders upon use.
• Friends Till The End! pill: Spawns three Blue Flies.
• As Keeper, all heart pickups turn into Blue Flies.
• Black Rune: Turns pickups into Blue Flies and Blue Spiders.
• Mom's Underwear: Spawns 3-6 Blue Flies on pickup.
• Rotten Heart: After clearing a room, two Blue Flies spawn for each Rotten Heart in Isaac's life bar.

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. 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 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
Locust of Conquest	5.350.117		I bring Conquest	Upon entering a room with enemies, spawns 2-5 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, 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.

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. Isaac cannot have more than 64 Blue Flies/Spiders combined.

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 2.5x damage to enemies. Spawns 4-8 Blue Spiders that deal 2x 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.	2

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 himself. For every 1½ Red Hearts collected, Dark Bum will give a Soul Heart, a hostile Spider, a friendly Blue Spider, or a random card, rune or pill.	4
Infestation 2	5.100.234		Infestation shot	Spawns allied Blue Spiders from killed enemies.	4
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.	3
Sissy Longlegs	5.100.280		She loves you	Spawns a familiar that wanders randomly, occasionally spawning Blue Spiders.	1
Spiderbaby	5.100.211		Spider revenge	When hit, spawns up to 2 Blue Spiders.	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
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.	1
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 props spawn 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 Keeper to fight enemies alongside Isaac. If Keeper dies, he spawns 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.
Fish Tail	5.350.94		It also stinks!	Items and trinkets that generate Blue Flies or Blue Spiders will generate twice as many.
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.

Other sources of Blue Spiders

• Rune of Berkano: Spawns 3 Blue Flies and 3 Blue Spiders upon use.
• 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.

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	Gives flight for the current room, while turning Isaac's body into a fast, high damage familiar.	3

Name	ID	Icon	Quote	Description	Quality
Ball of Bandages	5.100.207		Gotta lick 'em all!	Spawns an orbital familiar that blocks enemy shots, dealing 105 damage per second. Collecting additional copies gives it the ability to shoot charm tears, then chase enemies, then increases the damage.	2
Cube of Meat	5.100.73		Gotta meat 'em all!	Spawns an orbital familiar that blocks enemy shots, dealing 105 damage per second. Collecting additional copies grants it the ability to shoot, then chase enemies, then increases the 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 ~5 damage per second.	0
Gemini	5.100.318		Conjoined friend	Spawns a conjoined familiar which chases enemies close to Isaac, dealing ~8 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.	1
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.	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
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 and drops red hearts after killing enemies, but will also try to hurt Isaac. Attacking it returns it to normal.	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

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.

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 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 Virtues	5.100.584		Spiritual companionship	On use, spawns an orbital Wisp familiar that fires spectral tears but can be destroyed. Also becomes a passive item that causes other active items to spawn themed Wisps.	3
Lemegeton	5.100.712		Item summoner	Spawns the ghost of a random passive item, which orbits Isaac but can be destroyed. While the ghost is alive, Isaac gains that item's effects.	3
Spin to Win	5.100.655		Let it rip!	When used, gives Isaac +0.5 speed and greatly increases the rotation speed of Isaac's orbitals for 3 seconds. Gives Isaac a spinning top orbital that blocks enemy shots and deals contact damage to enemies while held.	1

Name	ID	Icon	Quote	Description	Quality
Ball of Bandages	5.100.207		Gotta lick 'em all!	Spawns an orbital familiar that blocks enemy shots, dealing 105 damage per second. Collecting additional copies gives it the ability to shoot charm tears, then chase enemies, then increases the 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 dealing 75 damage per second.	0
Big Fan	5.100.279		Fat protector	Spawns a large orbital familiar that blocks enemy shots and deals 30 damage per second to enemies.	2
Cube of Meat	5.100.73		Gotta meat 'em all!	Spawns an orbital familiar that blocks enemy shots, dealing 105 damage per second. Collecting additional copies grants it the ability to shoot, then chase enemies, then increases the 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 105 damage per second to enemies, and increases the speed of all orbital familiars.	2
Guillotine	5.100.206		An out-of-body experience	Isaac's head is removed from his body and floats around him as an orbital. Gives +1 damage and grants -1 tear delay.	3
Halo of Flies	5.100.10		Projectile protection	Spawns two Pretty Flies that block enemy shots and deal contact damage to flies.	3
Sacrificial Dagger	5.100.172		My fate protects me	Spawns a dagger orbital familiar, dealing 225 damage per second and blocking enemy shots.	3
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.	3
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 30 damage per second and fires a randomly angled tear every 2 seconds.	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.	1
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 chases and deflects enemy shots and converts them into homing tears.	3
The Swarm	5.100.693		Infest	Spawns nine 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
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.	2

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. Does not spawn collectibles.	0
Dark Bum	5.100.278		He wants to take your life	Spawns a familiar that follows Isaac around and collects Red Hearts for himself. For every 1½ Red Hearts collected, Dark Bum will give a Soul Heart, a hostile Spider, a friendly Blue Spider, or a random card, rune or pill.	4
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 every 5-6 rooms.	4
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 activate 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 every 5-6 rooms.	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 sack every 5-6 rooms cleared.	3

Shooting Familiars

Familiars that attack with their own tears or other effects as long as Isaac is attacking or charging a shot.

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. Turns Isaac's head into a stationary familiar for the current room which fires tears automatically, while causing Isaac to shoot a controllable fountain of blood shots.	0
Sumptorium	5.100.713		Return	Holding down the fire button converts hearts into familiars that fire tears but can be destroyed. Activating converts the familiars back into hearts.	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.	0
Ball of Bandages	5.100.207		Gotta lick 'em all!	Spawns an orbital familiar that blocks enemy shots, dealing 105 damage per second. Collecting additional copies gives it the ability to shoot charm tears, then chase enemies, then increases the damage.	2
Brother Bobby	5.100.8		Friends 'till the end	A familiar that follows Isaac around shooting normal tears.	0
Cain's Other Eye	5.100.319		Near-sighted friend	Spawns a familiar that floats slowly around the room on a zig-zag pattern similar to The Peeper and shoots normal tears in the same direction as Isaac.	0
Cube of Meat	5.100.73		Gotta meat 'em all!	Spawns an orbital familiar that blocks enemy shots, dealing 105 damage per second. Collecting additional copies grants it the ability to shoot, then chase enemies, then increases the 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
Lil Brimstone	5.100.275		Evil Friend	Grants a familiar that shoots a thin Brimstone beam. Must charge like Brimstone before shooting.	3
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.	1
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	Fires lasers at any enemy in its line of sight and moves based on the direction Isaac is firing tears.	0
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 normal tears.	0
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
Seraphim	5.100.390		Sworn friend	Spawns an angel familiar which 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
Lil Abaddon	5.100.679		Abyssal friend	Spawns a familiar that charges a miniature Maw of the Void attack while Isaac shoots.	3
Twisted Pair	5.100.698		Double trouble!	Gives Isaac two familiars that stand by Isaac's side and fire tears that use Isaac's tears, range, shot speed, and tear effects and scale with Isaac's 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 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.

Note: Only second stage Cube of Meat and Ball of Bandages shoot tears.
Note: Demon Baby and Robo-Baby 2.0 shoot even when Isaac is not attacking.
Note: Shooting familiars that follow Isaac take priority over other familiars, always appearing before non-combat familiars in line. Incubus and Lil Brimstone have extra priority and will appear at the front, with Incubus taking priority over Lil Brimstone.

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.	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

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
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 floats slowly around the room on a zig-zag pattern similar to The Peeper and shoots normal tears in the same direction as Isaac.	0
The Peeper	5.100.155		Plop!	Spawns a familiar that floats slowly around the room on a zig-zag pattern, damaging enemies it passes through.	0
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. It respawns after clearing a room.	0
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 1.5x 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
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

Name	ID	Icon	Quote	Description
???'s Soul	5.350.57		Imaginary Friend	Spawns a familiar that floats slowly around the room on a 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.	1
Obsessed Fan	5.100.426		Follows my every move...	Spawns a familiar that follows Isaac's movements on a 3 second delay and deals contact damage 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

Others

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

Name	ID	Icon	Quote	Description	Quality
Brown Nugget	5.100.504		Friendly fly	Spawns a stationary fly turret that fires tears at nearby enemies.	0
Sprinkler	5.100.516		Sprinkles.	Upon use, spawns a sprinkler that rotates and fires tears.	2
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	2
1up!	5.100.11		Extra life	Gives Isaac an extra life. Upon death, he will respawn in the previous room with full health and lose the 1up!.	2
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
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 Hair Ball	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. The bottle respawns upon entering a different room. A bottle familiar that flies forward when Isaac shoots. It breaks upon hitting an enemy, leaving a puddle of blue creep that petrifies enemies. The bottle respawns after a few seconds.	0
Isaac's Heart	5.100.276		Protect It	Isaac himself is now immune to all damage, and a heart familiar appears and follows Isaac. If the heart is hurt, Isaac is hurt.	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 The 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 The Chest and Dark Room to fight Mega Satan.	0
Little Chubby	5.100.88		Attack Buddy	Spawns a charger familiar that charges forward and deals contact damage to any enemies in its path.	1
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
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
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.	1
Lost Fly	5.100.365		Lost protector	Spawns fly familiar that moves in a straight line and circles around the first wall or obstacle it hits, dealing 105 damage per second on contact.	0
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.	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
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
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 points at enemies, dealing scaling 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 halves tear delay and can block enemy shots.	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 retrieving pickups.	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.	0
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 cracks into a random friendly monster when Isaac is hurt. The egg regenerates upon entering a different room.	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.	2
C Section	5.100.678		Fetus shots	Switches control to a fetus that is attached via umbilical cord. The fetus has flight as well as all of Isaac's tear effects and stats.	4
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
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	Gives Isaac a Dumpy familiar that, when it takes damage, pushes/stuns/poisons nearby enemies and flies in a random direction.	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
Lost Soul	5.100.612		Protect him	Gives Isaac a soul familiar that dies in one hit, respawning at the start of the next floor. If it survives an entire floor, it rewards Isaac with hearts or items.	2
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.	2
Vanishing Twin	5.100.697		He wants revenge	Spawns a familiar that becomes a clone of the floor's boss when entering the boss room. Defeating it drops an extra item.	3

Name	ID	Icon	Quote	Description
Tonsil	5.350.97		Sick...	When hit, there is a small chance a removed tonsil familiar starts following Isaac, blocking enemy shots.

Unlockable Achievements

• 

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

• 

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