Head of Krampus is an unlockable activated item.
- Fires a powerful Brimstone beam in the four cardinal directions, much like The Fallen and Krampus shoot.
- Has a 50% chance to rotate all beams around the player 90 degrees, similar to Krampus' second Brimstone attack.
- Each beam deals 22 damage per tick, and they tick a total of 20 times, dealing a total of 440 damage per use.
- Each beam deals 10 damage over 19 ticks, dealing a total of 190 damage per use.
- Damaging enemies with the effect of this item as Guppy will spawn multiple Blue Flies.
- By standing really close to large enemies such as bosses, it's possible to hit them with multiple beams at once, dealing significantly more damage than a single beam.
- Car Battery: Doubles the damage the brimstone beams deal (for a total of 880 damage/ 380 damage per use). Doesn't double the brimstone beams' duration.
- Book of Virtues: Spawns red wisps in the middle ring. The wisps fire small Brimstone lasers in the cardinal directions when destroyed. The lasers deal the wisps' tear damage per tick, and can hit up to 20 times. BFFS! will not increase this damage, despite it scaling with the wisps' tear damage.
- This item was originally planned to appear as a Halloween Update in the original The Binding of Isaac but was scrapped.
- A scrapped item in the original game called Pumpkin Mask was very similar in effect to Head of Krampus.
- v1.031: Head of Krampus' recharge was set from 6 charges, up from 3.
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