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Hard mode changes the gameplay compared to Normal in some ways to make it more difficult. When playing in Hard mode, a small red pentagram (Hard mode only) appears on the HUD, below the pickups.

Differences[ | ]

  • 2-3 more rooms generate each floor.
  • (except in Repentance) Standard rooms with a difficulty of "1" cannot generate.
    • (in Repentance) Standard rooms with a difficulty of "1" have a reduced chance of appearing.
    • Most rooms with this difficulty are very easy, making difficult rooms more common.
  • (in Afterbirth † and Repentance) Rooms with a difficulty of "15" are able to generate on the second floor of chapters 1-4.
    • (in Repentance) Additionally, they can always spawn on single floor chapters.
  • (except in Repentance) Enemies have a base 20% chance to become Champions instead of only 5%.
  • Champion enemies only award pickups 33% of the time instead of 100%.
  • (except in Repentance) Hearts are 66% less likely to drop after completing a room.
    • (in Repentance) Hearts are 33% less likely to drop after completing a room.
  • (except in Repentance) Only champion bosses will drop hearts; normal bosses will not.
  • Floors are more likely to have curses.
  • Slot Machines are half as likely to pay out.
  • Blood Donation Machines only give out one coin per use.
    • (in Repentance) Also applies to IV Bag.
  • Beggars require a minimum of 6 donations before paying out.
    • (in Repentance) This doesn't apply to Bomb Bums or Key Masters.
  • (in Repentance) The ShopShop has a 50% chance of becoming a lower level, regardless of having store upgrades unlocked.
  • (in Repentance) The drop rate of soul hearts from blue fires is decreased to 10%, instead of 25%.
  • (in Repentance) Tinted rocks have a lower chance of appearing.
  • (in Repentance) Certain enemies and bosses have increased shot and movement speed.
  • (in Repentance)Collectible Dogma iconDogma does not provide the effect ofCollectible The Wafer iconThe Wafer.

Unlocks for Hard Mode[ | ]

Character Mom's Heart (except in Rebirth) All completion marks
Character Isaac iconIsaac Lost Baby Buddy Baby
Character Magdalene iconMagdalene Cute Baby Colorful Baby
Character Cain iconCain Glass Baby Picky Baby
Character Judas iconJudas Shadow Baby Belial Baby
Character ??? (Character) icon??? Dead Baby Hive Baby
Character Eve iconEve Crow Baby Whore Baby
Character Samson iconSamson Fighting Baby Revenge Baby
Character Azazel iconAzazel Begotten Baby Sucky Baby
Character Lazarus iconLazarus Wrapped Baby Bethany Dripping Baby
Character Eden iconEden Glitch Baby Cracked Baby
Character The Lost iconThe Lost -0- Baby Godhead
(except in Rebirth) Character Lilith iconLilith Goat Head Baby Dark Baby
(except in Rebirth) Character Keeper iconKeeper Super Greed Baby Sale Baby
(in Afterbirth † and Repentance) Character Apollyon iconApollyon Smelter Apollyon Baby
(in Afterbirth † and Repentance) Character The Forgotten iconThe Forgotten Marrow Bone Baby
(in Repentance) Character Bethany iconBethany Wisp Baby Hope Baby
(in Repentance) Character Jacob and Esau iconJacob and Esau Double Baby Solomon's Baby
(in Repentance) All non-Tainted characters Mega Mush
(in Repentance) All characters Death Certificate

Trivia[ | ]

  • Before update 1.03, the reduced drop-rate affected all pickups (not just Red Hearts).
  • Most Hard mode unlocks are co-op babies, with the notable exceptions of Collectible Godhead iconGodhead, (in Afterbirth † and Repentance)Collectible Smelter iconSmelter, (in Afterbirth † and Repentance)Collectible Marrow iconMarrow, (in Repentance)Collectible Mega Mush iconMega Mush, (in Repentance)Collectible Death Certificate iconDeath Certificate and the character (in Repentance) Character Bethany iconBethany.
  • Collectible Godhead iconGodhead's unlock requirements were extended in later DLCs due to the addition of more completion marks, but it can still be unlocked in the base game using the same method.
  • (in Repentance) The Repentance chances for max level shops and tinted rocks were initially much more sparse. These chances were increased in update 1.7.1 a few days later.
  • (in Repentance) None of the tainted characters have unlocks tied to getting all completion marks, apart from Collectible Death Certificate iconDeath Certificate.


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