Binding of Isaac: Rebirth Wiki
Advertisement

Items are an integral part of the gameplay of The Binding of Isaac: Rebirth. They modify Isaac's attributes, grant or modify tear effects, and much more.

Items are classified into several distinct types and groups. Some items are passive, which add an effect permanently to Isaac, while others only activate when used.

  • The original The Binding of Isaac had 196 items.
  • Rebirth has a total of 341 items.
  • (except in Rebirth) Afterbirth added 95 new items, for a total of 436 items.
  • (in Afterbirth † and Repentance) Afterbirth † added 111 new items, for a total of 547 items.
  • (in Repentance) Repentance added 169 new items, for a total of 716 items. An update for Repentance, V1.7.5, added 3 new items, for a total of 719 items.

In Afterbirth † and prior, 13 items are considered special and will be less likely to appear if the player has already come across other special items. The Repentance expansion removed the Special Item mechanic, replacing it with the item weight and item quality mechanics.

For a list of which items can potentially appear in a given special room or under certain conditions, see item pool and Item Tags.

For the grids of items that appear in the stats menu, see Collection Page.

Not to be confused with cards and runes, pills, and trinkets.

Activated Collectibles[ | ]

Unless the player has (in Afterbirth † and Repentance)Collectible Schoolbag iconSchoolbag, only one activated item can be held at a time, with the old collectible being placed on a pedestal if a new activated item is picked up. Most activated items need to recharge before use, with the recharge bar filling either by clearing rooms or recharging over time. Other activated items do not have a charge bar, and, with a few exceptions (such as Collectible How to Jump iconHow to Jump), will instead either disappear after a single use or require resources such as coins or health. Some activated items will also grant passive effects as long as they are equipped.

(in Repentance) In some special circumstances, activated items can be placed in the consumable slot instead of the standard activated item slot. This counts as both an extra activated item slot and an extra consumable slot, meaning that other activated items and consumables can be picked up as normal. Items in this slot are used with the consumable key, and can't be lost through any means (unless they're consumed like items from (in Repentance)Dice BagDice Bag). Otherwise, they function the same as other activated items.

Notes[ | ]

  • Battery Bums and most Batteries charge the item(s) in the activated item slot first, then the item in the consumable slot. The exception to this is the (in Repentance) Mega BatteryMega Battery, which recharges the items in both slots.
  • Most trinkets that work with activated items (e.g. (in Afterbirth † and Repentance)Vibrant BulbVibrant Bulb, (in Repentance)Panic ButtonPanic Button, etc.) ignore the items in the consumable slot.
  • There is a total of 171 activated items.


Name ID Icon Quote Description (in Repentance) Quality
A Pony 5.100.130
A Pony
2 rooms
Flight + dash attack Passively grants flight and increases speed to 1.5. Upon use, Isaac charges in the direction the pony is facing, giving invulnerability during the charge and dealing damage to enemies hit. 2
Anarchist Cookbook 5.100.65
Anarchist Cookbook
3 rooms
Summon bombs Spawns six Troll BombTroll Bombs around the room. 1
Best Friend 5.100.136
Best Friend
3 rooms
Friends 'till the end Spawns a decoy Isaac that explodes after 5 seconds. Enemies will always target the decoy and ignore Isaac. 1
Blank Card 5.100.286
Blank Card
Variable
Card mimic (except in Repentance) Copies the effect of the card or rune currently held by Isaac.
(in Repentance) Copies the effect of the card currently held by Isaac. The charge time is based on the power of the card.
2
Blood Rights 5.100.186
Blood Rights
Unlimited
Mass enemy damage at a cost Upon use, takes a full heart of health and deals 40 damage to all enemies in the room. (in Repentance) Repeated uses in the same room only take half a heart. 0
Bob's Rotten Head 5.100.42
Bob's Rotten Head
2 rooms
Reusable ranged bomb Upon use, Isaac holds a poison BombBomb which can be thrown in the cardinal directions and explodes on impact. 1
Book of Revelations 5.100.78
Book of Revelations
6 rooms
Reusable soul protection Increases the chance of a Devil RoomDevil Room / Angel RoomAngel Room appearing while held. On use, gives one Soul HeartSoul Heart, and replaces the boss of the current floor with a Harbinger if possible. 3
Book of Secrets 5.100.287
Book of Secrets
6 rooms
Tome of knowledge Gives the effect of Collectible Treasure Map iconTreasure Map, Collectible The Compass iconThe Compass, or Collectible Blue Map iconBlue Map for the duration of the current floor. (in Repentance) If all effects are active, Collectible X-Ray Vision iconX-Ray Vision is provided for the floor instead. Highlights any Tinted Rocks and rocks with Crawl SpaceCrawl Space in the room. 1
Book of Shadows 5.100.58
Book of Shadows
3 rooms
Temporary invincibility Creates a protective shield, nullifying all types of damage in the current room for 10 seconds. 3
Box of Spiders 5.100.288
Box of Spiders
2 rooms
It's a box of spiders (except in Repentance) Spawns 1-4 Blue Spiders that deal 2.5x Isaac's damage to enemies.
(in Repentance) Spawns 4-8 Blue Spiders that deal 2x Isaac's damage to enemies.
1
Breath of Life 5.100.326
Breath of Life
3 seconds
Invincibility at a cost Grants a brief moment of invincibility when the charge bar hits zero. Isaac begins taking damage if the item is held any longer. (in Repentance) Isaac creates beams of light when touching enemies while invulnerable, and creates a powerful 4-way beam if blocking damage exactly as the invincibility starts. 1
Butter Bean 5.100.294
Butter Bean
3 seconds
Reusable knock-back Upon use, Isaac farts and knocks back nearby enemies (except in Rebirth) and projectiles. (in Repentance) Enemies pushed into walls or obstacles take 12 damage. 1
Converter 5.100.296
Converter
3 rooms
Convert your soul (except in Repentance) Converts two Soul HeartSoul Hearts or Black HeartBlack Hearts into one filled Red HeartRed Heart Container.
(in Repentance) Converts one Soul HeartSoul Heart or Black HeartBlack Heart into one filled Red HeartRed Heart Container.
2
Crack the Sky 5.100.160
Crack the Sky
4 rooms
Holy white death Summons 5 beams of light in random locations on the ground, dealing large amounts of damage to any enemies that touch them. 2
Crystal Ball 5.100.158
Crystal Ball
6 rooms
I see my future Upon use, reveals the map (except the Super Secret RoomSuper Secret Room and Ultra Secret RoomUltra Secret Room) and drops a Soul HeartSoul Heart or random card/rune. 3
D10 5.100.285
D10
2 rooms
Reroll enemies (except in Repentance) Re-rolls all monsters in the room.
(in Repentance) Replaces all monsters in the room with weaker monsters.
1
D100 5.100.283
D100
6 rooms
REEROLLLLL! (except in Repentance) Combines the effects of Collectible D4 iconD4, Collectible The D6 iconThe D6, and Collectible D20 iconD20.
(in Repentance) Combines the effects of Collectible D1 iconD1, Collectible D4 iconD4, Collectible The D6 iconThe D6, Collectible D7 iconD7, Collectible D8 iconD8, Collectible D10 iconD10, Collectible D12 iconD12, and Collectible D20 iconD20.
3
D20 5.100.166
D20
6 rooms
Reroll the basics Rerolls all pickups in the current room. 2
D4 5.100.284
D4
6 rooms
Reroll into something else Rerolls all of Isaac's passive items. 2
Dad's Key 5.100.175
Dad's Key
2 rooms
Opens all doors... Upon activation, opens all doors in the current room in almost all circumstances, including doors which require a KeyKey to open, entrances to Secret RoomSecret Rooms, and the door to Mega Satan Head ingameMega Satan. 2
Dead Sea Scrolls 5.100.124
Dead Sea Scrolls
2 rooms
It's a mystery Triggers the effect of a random activated item from a list of possible options (not every activated item is included). 1
Deck of Cards 5.100.85
Deck of Cards
6 rooms
Reusable card generator Gives Isaac a random card. 2
Doctor's Remote 5.100.47
Doctor's Remote
2 rooms
Reusable air strike Creates a crosshair on the ground that can be aimed with tear controls. A missile strikes the spot after 2 seconds, creating a heavy damage explosion. 1
Flush! 5.100.291
Flush!
4 rooms
... Turns all non-boss monsters in the room into PoopPoop. Instantly kills poop-themed bosses.(except in Rebirth) Floods the current room. 1
Forget Me Now 5.100.127
Forget Me Now
One time use
I don't remember... On use, re-generates the current floor with a new layout. Isaac loses Forget Me Now, but keeps other items and consumables picked up on the original floor. 3
Guppy's Head 5.100.145
Guppy's Head
1 room
Reusable fly hive Spawns 2-4 friendly Blue Flies that damage enemies. 2
Guppy's Paw 5.100.133
Guppy's Paw
Unlimited
Soul converter Upon use, converts one Red Heart Container into three Soul HeartSoul Hearts. 3
Head of Krampus 5.100.293
Head of Krampus
3 rooms
Krampus rage (except in Afterbirth) Fires a powerful Collectible Brimstone iconBrimstone beam in four cardinal directions, much like Boss Krampus ingameKrampus shoots.

(in Afterbirth) Fires a powerful Collectible Brimstone iconBrimstone beam in four cardinal directions, much like Boss Krampus ingameKrampus shoots with a 50% chance to rotate all beams around Isaac 90 degrees.

2
How to Jump 5.100.282
How to Jump
Unlimited
It's time you learned how Upon use, Isaac jumps in the direction he is currently moving, allowing travel over obstacles and enemies. 1
Isaac's Tears 5.100.323
Isaac's Tears
6 rooms
Collected tears Fires 8 tears around Isaac, which retain the damage, range, shot speed, and special tear effects of his tears. Each tear shot by Isaac increases item charge by one. (in Repentance) Tears from this item have a +5 flat damage bonus. 1
IV Bag 5.100.135
IV Bag
Unlimited
Portable blood bank Upon use, Isaac loses half a heart of health (or a full heart in Chapter 4 onward) for a random amount of coins, similar to a Blood Donation MachineBlood Donation Machine. 1
Kamikaze! 5.100.40
Kamikaze!
Unlimited
Become the bomb! Creates an explosion around Isaac, damaging him and nearby enemies as well as destroying obstacles. 0
Lemon Mishap 5.100.56
Lemon Mishap
2 rooms
Oops... Creates a tiny pool of yellow creep, damaging enemies that cross it. 0
Magic Fingers 5.100.295
Magic Fingers
Unlimited
Pay to win Uses 1 PennyPenny to deal damage to all enemies in the room. 1
Mom's Bottle of Pills 5.100.102
Mom's Bottle of Pills
6 rooms
Reusable pill generator On use, gives Isaac a random pill. 1
Mom's Bra 5.100.39
Mom's Bra
3 rooms
Mass paralysis Petrifies all enemies in the current room for 4 seconds. 1
Mom's Pad 5.100.41
Mom's Pad
2 rooms
Mass fear Inflicts fear to all enemies in the room for 4 seconds. (in Repentance) Spawns a blue fly. 0
Monster Manual 5.100.123
Monster Manual
6 rooms
Temporary buddy generator (except in Repentance) Spawns a familiar from a specific selection for the current room.
(in Repentance) Spawns a familiar from a specific selection for the current floor.
1
Monstro's Tooth 5.100.86
Monstro's Tooth
3 rooms
Summon Monstro A friendly Boss Monstro ingameMonstro jumps on a random enemy, dealing 120 area damage. Targets Isaac if used in a room without enemies. 1
Mr. Boom 5.100.37
Mr
2 rooms
Reusable bomb buddy (except in Repentance) Places a Collectible Mr. Mega iconMr. Mega BombBomb that deals 110 damage.
(in Repentance) Places a Collectible Mr. Mega iconMr. Mega BombBomb that deals 185 damage.
1
My Little Unicorn 5.100.77
My Little Unicorn
4 rooms
Temporary badass Gives invulnerability and +0.28 speed for six seconds, removing the ability to shoot tears and replacing it with the ability to deal contact damage to enemies. 1
Notched Axe 5.100.147
Notched Axe
Unlimited
Rocks don't stand a chance (except in Repentance) Isaac destroys obstacles and opens Secret RoomSecret Rooms by walking into them, but cannot shoot or pick up items until it's cancelled.
(in Repentance) Toggles between tears and the pickaxe, which can be swung to attack and break obstacles. Using it depletes the charge, and it can't be used until next floor once the charge runs out.
1
Pandora's Box 5.100.297
Pandora's Box
One time use
? ? Upon use, spawns specific pickups or items depending on the floor it is used on. Disappears after use. 2
Portable Slot 5.100.177
Portable Slot
Unlimited
Gamble 24/7 Upon use, consumes 1 PennyPenny and has a chance to drop a random pickup, like a Slot MachineSlot Machine. 0
Prayer Card 5.100.146
Prayer Card
6 rooms
Reusable eternity Gives an Eternal HeartEternal Heart per use. 3
Razor Blade 5.100.126
Razor Blade
Unlimited
Feel my pain Takes one Red HeartHeart of health and grants +1.2 damage for the current room. (in Repentance) Repeated uses in the same room only take half a heart. 0
Red Candle 5.100.289
Red Candle
4 seconds
Flame on Throws out a flame that damages everything in its path, diminishing in size as it hits enemies or blocks shots. 2
Remote Detonator 5.100.137
Remote Detonator
Unlimited
Remote bomb detonation BombBombs placed by Isaac only explode when Remote Detonator is used. Gives 5 bombs. 1
Satanic Bible 5.100.292
Satanic Bible
6 rooms
Reusable evil... but at what cost? Gives one Black HeartBlack Heart. (in Repentance) Replaces the boss room item on the current floor with a Devil Deal. 4
Scissors 5.100.325
Scissors
4 rooms
Lose your head Turns Isaac's head into a stationary familiar for the current room which fires tears automatically. (in Repentance) Isaac's body also shoots a controllable fountain of blood shots for the room. 1
Shoop da Whoop! 5.100.49
Shoop da Whoop!
2 rooms
BLLLARRRRGGG! Fires a laser from Isaac's mouth. 2
Spider Butt 5.100.171
Spider Butt
2 rooms
Mass enemy slowdown + damage Deals 10 damage to all enemies in the room and slows them for 4 seconds. (in Repentance) Enemies killed by Spider Butt spawn Blue Spiders. 1
Tammy's Head 5.100.38
Tammy's Head
1 room
Reusable tear burst Shoots 10 tears in a circle around Isaac, which retain the damage, range, shot speed, and special effects (such as poison) of Isaac's tears. Tears from this item have a +25 flat damage bonus. 2
Telepathy For Dummies 5.100.192
Telepathy For Dummies
2 rooms
Temporary psychic shot Gives homing tears for the current room. (in Repentance) Also gives +3 range. 1
Teleport! 5.100.44
Teleport!
2 rooms
Teleport! Teleports Isaac to a random room on the current floor. 0
The Bean 5.100.111
The Bean
1 room
Toot on command Isaac farts, poisoning any enemy in close range. 0
The Bible 5.100.33
The Bible
4 rooms
Temporary flight On use, Isaac gains flight for the current room. Instantly kills Boss Mom ingameMom, Boss Mom's Heart ingameMom's Heart, and Boss It Lives ingameIt Lives when activated, but kills Isaac when used on Boss Satan ingameSatan. 1
The Book of Belial 5.100.34
The Book of Belial
3 rooms
Temporary DMG up (in Rebirth) +2 damage for the current room. Passively guarantees a Devil RoomDevil Room or Angel RoomAngel Room will appear while held.
(except in Rebirth) +2 damage for the current room. Passively increases the chance of finding a Devil RoomDevil Room or Angel RoomAngel Room while held.
2
The Book of Sin 5.100.97
The Book of Sin
4 rooms
Reusable item generator Generates a random pickup, pill, card, or rune. 2
The Boomerang 5.100.338
The Boomerang
2 seconds
It will never leave you Throws a boomerang which retrieves pickups, as well as damages and petrifies enemies hit for 2 seconds. 1
The Candle 5.100.164
The Candle
4 seconds
Reusable flames Throws out a flame that damages everything in its path, diminishing in size as it travels. 2
The D6 5.100.105
The D6
6 rooms
Reroll your destiny Re-rolls all items in the current room into other items, depending on the current room's Item Pool. 4
The Gamekid 5.100.93
The Gamekid
4 rooms
Temporary Man-Pac Turns Isaac into a Pac-Man-like creature for 6.5 seconds, granting invulnerability, inflicting fear on all enemies, and has a chance of replenishing a Half Red HeartHalf Red Heart every time an enemy is killed. 1
The Hourglass 5.100.66
The Hourglass
2 rooms
Temporary enemy slowdown All enemies in the room are slowed for 8 seconds. 1
The Jar 5.100.290
The Jar
Unlimited
Save your life When at full health, up to 4 extra Red HeartRed Hearts can be stored in The Jar. Activating drops the stored hearts on the ground. 0
The Nail 5.100.83
The Nail
6 rooms
Temporary demon form (except in Repentance) Gives one Soul HeartSoul Heart. For the current room; +0.7 damage, -0.18 speed, Isaac breaks rocks and deals contact damage.
(in Repentance) Gives half a Black HeartBlack Heart. For the current room; +2 damage, -0.18 speed, Isaac breaks rocks and deals contact damage.
2
The Necronomicon 5.100.35
The Necronomicon
4 rooms
Mass room damage Deals 40 damage to every enemy in the room. 1
The Pinking Shears 5.100.107
The Pinking Shears
4 rooms
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
The Poop 5.100.36
The Poop
1 room
Plop! Spawns a pile of PoopPoop where Isaac is standing and knocks back nearby enemies. May yield pickups like regular poop. 0
Undefined 5.100.324
Undefined
6 rooms
Undefined Teleports Isaac to the Secret RoomSecret Room, Super Secret RoomSuper Secret Room, Treasure RoomTreasure Room, or I AM ERRORI AM ERROR. 2
Unicorn Stump 5.100.298
Unicorn Stump
1 room
You feel stumped Gives invulnerability and increased speed for six seconds, but removes the ability to shoot tears. 1
We Need To Go Deeper! 5.100.84
We Need To Go Deeper!
6 rooms
Reusable level skip Creates a trapdoor to go to the next floor. (in Repentance) Once per floor, using it on tiles with special graphics will instead create a Crawl SpaceCrawl Space. 2
White Pony 5.100.181
White Pony
2 rooms
Flight + holy death Passively grants flight and increases speed to 1.5. Upon use, Isaac charges in the direction the pony is facing, giving invulnerability during the charge while also creating damaging beams of light. 2
Yum Heart 5.100.45
Yum Heart
4 rooms
Reusable regeneration Restores one full Red HeartRed Heart. 1
(except in Rebirth) Box of Friends 5.100.357
Box of Friends
3 rooms
Double your friends Duplicates all of Isaac's familiars for the current room. If Isaac has no familiars, spawns a Collectible Demon Baby iconDemon Baby for the room instead. 1
(except in Rebirth) D12 5.100.386
D12
3 rooms
Rerolls rocks (except in Repentance) Re-rolls all Rocks and Metal Blocks in the current room into other random obstacles.
(in Repentance) Re-rolls most types of Obstacles in the current room into other random obstacles.
1
(except in Rebirth) D7 5.100.437
D7
3 rooms
Roll again Restarts the current room and brings back all enemies, allowing more rewards to be acquired by completing the room. 1
(except in Rebirth) D8 5.100.406
D8
4 rooms
Reroll stats Re-rolls Isaac's damage, tears, range, and speed. 2
(except in Rebirth) Diplopia 5.100.347
Diplopia
One time use
Double item vision Duplicates all pickups and item pedestals in the room. 3
(except in Rebirth) Friendly Ball 5.100.382
Friendly Ball
2 rooms
Gotta fetch 'em all! Throwing the ball at a monster instantly kills and captures it. The captured enemy can later be released and will be friendly, fighting for Isaac and persisting between rooms. 1
(except in Rebirth) Glass Cannon 5.100.352
Glass Cannon
4 seconds
Be gentle... (except in Repentance) Fires a high-damage piercing spectral tear, but lowers Isaac's health to half a heart.
(in Repentance) Fires a high-damage piercing spectral tear. If Isaac takes damage while holding this, he takes extra damage and it becomes Collectible Broken Glass Cannon iconBroken Glass Cannon.
1
(except in Rebirth) Glowing Hourglass 5.100.422
Glowing Hourglass
Unlimited
Turn back time Rewinds time, putting Isaac back in the previous room and undoing anything that happened in the current room. (in Repentance) Can only be used three times per floor, after which it functions like Collectible The Hourglass iconThe Hourglass until the next floor. 3
(except in Rebirth) Jar of Flies 5.100.434
Jar of Flies
Unlimited
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
(except in Rebirth) Kidney Bean 5.100.421
Kidney Bean
1 room
Love toots! Isaac farts, charming all nearby enemies. 1
(except in Rebirth) Mega Bean 5.100.351
Mega Bean
3 rooms
Giga fart! Petrifies all enemies in the current room for about 1.5 seconds, poisons any enemies near Isaac, and sends a rock wave across the room in the direction Isaac is facing. 1
(except in Rebirth) Mega Blast 5.100.441
Mega Blast
12 rooms
Laser breath Upon use, Isaac fires a laser similar to the one used by Mega Satan Head ingameMega Satan. This laser deals massive damage, lasts for approximately 15 seconds, and persists between rooms. Isaac is pushed backwards by the force of the laser while it is active. 4
(except in Rebirth) Mine Crafter 5.100.427
Mine Crafter
1 room
Booom! Places a Movable TNTMovable TNT barrel that can be pushed and used to destroy rocks or damage enemies. If used again in the same room while the previous TNT barrel is still intact, remotely detonates the TNT. 1
(except in Rebirth) Mom's Box 5.100.439
Mom's Box
4 rooms
What's inside? Increases luck by 1 and doubles the effects of trinkets while held. When used, drops a random trinket on the ground. 2
(except in Rebirth) Placebo 5.100.348
Placebo
Variable
Pill mimic Has the same effect as the Pill currently held by Isaac. (in Repentance) The charge time is based on the power of the pill. 2
(except in Rebirth) Tear Detonator 5.100.383
Tear Detonator
15 seconds
Remote tear detonation! Splits all of Isaac's tears that are currently in the air into 6 tears that fire in all directions, which retain their damage and shot speed. 1
(except in Rebirth) Teleport 2.0 5.100.419
Teleport 2
4 rooms
I-Teleport! Teleports Isaac to a room that has not been explored yet. Normal rooms are prioritized over special rooms, and common special rooms take priority over rarer ones. 3
(except in Rebirth) Ventricle Razor 5.100.396
Ventricle Razor
Unlimited
Short cutter Creates up to two portals that remain even if Isaac leaves the room. Upon entering a portal, Isaac is teleported to the other portal. 1
(except in Rebirth) Wooden Nickel 5.100.349
Wooden Nickel
1 room
Flip a coin When used, has a roughly 50% chance to drop a penny, nickel or dime. 1
(in Afterbirth † and Repentance) Black Hole 5.100.512
Black Hole
4 rooms
Nothing can escape Throws a black hole on the ground which sucks in and damages enemies and destroys nearby obstacles. 1
(in Afterbirth † and Repentance) Book of the Dead 5.100.545
Book of the Dead
6 rooms
Rise from the grave (except in Repentance) Creates a friendly BonyBony, Black BonyBlack Bony, or an orbital bone for each enemy killed in the current room.
(in Repentance)Creates a friendly BonyBony, Black BonyBlack Bony, Bone FlyBone Fly, RevenantRevenant, or an orbital bone for each enemy killed in the current room.
3
(in Afterbirth † and Repentance) Broken Shovel 5.100.550
Broken Shovel
4 rooms
It feels cursed While held, causes Mom to continuously attempt to stomp on Isaac. Activating makes her stop for the current room or wave. One of two parts necessary to create Collectible Mom's Shovel iconMom's Shovel. 4
(in Afterbirth † and Repentance) Brown Nugget 5.100.504
Brown Nugget
8 seconds
Friendly fly Spawns a stationary fly turret that lasts for the current room and fires tears at nearby enemies. 0
(in Afterbirth † and Repentance) Clicker 5.100.482
Clicker
6 rooms
Change Transforms Isaac into a random character and removes the last item collected. 0
(in Afterbirth † and Repentance) Compost 5.100.480
Compost
2 rooms
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
(in Afterbirth † and Repentance) Coupon 5.100.521
Coupon
6 rooms
Allow 6 weeks for delivery While held, guarantees one item in every ShopShop will be on sale. On use, makes a random item in the current room free. 2
(in Afterbirth † and Repentance) Crooked Penny 5.100.485
Crooked Penny
4 rooms
50/50 Spawns a penny and has a 50% chance to double all items and pickups in the room. If the effect fails, the items and pickups disappear. 2
(in Afterbirth † and Repentance) D infinity 5.100.489
D infinity
Variable
Reroll forever (except in Repentance) Grants a random die item that changes each use.
(in Repentance) Acts as any die item, and can by cycled by pressing the drop key.
4
(in Afterbirth † and Repentance) D1 5.100.476
D1
4 rooms
What will it be? Duplicates a random pickup in the room. (in Repentance) The new pickup may be different than the original (i.e. a different card, etc). 2
(in Afterbirth † and Repentance) Dataminer 5.100.481
Dataminer
4 rooms
109 Displaces enemy sprites for the current room, randomly increases one stat and decreases another. 0
(in Afterbirth † and Repentance) Delirious 5.100.510
Delirious
12 rooms
Unleash the power! Spawns Boss Delirium ingameDelirium as a random friendly boss that fights for Isaac. 1
(in Afterbirth † and Repentance) Dull Razor 5.100.486
Dull Razor
2 rooms
I feel numb... Hurts Isaac without depleting health, activating any items that trigger upon taking damage. 1
(in Afterbirth † and Repentance) Eden's Soul 5.100.490
Eden's Soul
12 rooms
... Spawns two item pedestals then is consumed. Begins with no charges. 3
(in Afterbirth † and Repentance) Mama Mega! 5.100.483
Mama Mega!
One time use
BOOOOOOOOOM! Damages all enemies and destroys all obstacles. The effect occurs every time a new room is entered for the rest of the floor. Opens the doors to the floor's Secret RoomSecret Rooms and Super Secret RoomSuper Secret Rooms. 3
(in Afterbirth † and Repentance) Metronome 5.100.488
Metronome
2 rooms
Waggles a finger Grants a random item effect for the current room. 1
(in Afterbirth † and Repentance) Mom's Shovel 5.100.552
Mom's Shovel
4 rooms
Lost but not forgotten Creates a trapdoor that leads to the next floor upon activation. Unlocks Character The Forgotten iconThe Forgotten when used on a mound of dirt that appears in Dark RoomDark Room. 4
(in Afterbirth † and Repentance) Moving Box 5.100.523
Moving Box
4 rooms
Pack and unpack If the box is empty, picks up items and pickups in a room and stores them. If the box is not empty, places all stored items and pickups in the current room. (in Repentance) Can carry up to 10 items or pickups at once. 1
(in Afterbirth † and Repentance) Mr. ME! 5.100.527
Mr
4 rooms
Caaan do! Summons a controllable ghost that can perform various tasks depending on what it targets. 3
(in Afterbirth † and Repentance) Mystery Gift 5.100.515
Mystery Gift
One time use
Wrapped up nice for you! Upon use, spawns a random item from the current room's item pool, with a chance to spawn Collectible A Lump of Coal iconA Lump of Coal or Collectible The Poop iconThe Poop instead. 3
(in Afterbirth † and Repentance) Pause 5.100.478
Pause
2 rooms
Stop! Freezes all enemies until a fire button is pressed. 1
(in Afterbirth † and Repentance) Plan C 5.100.475
Plan C
One time use
My last resort Kills all enemies in the room, then kills Isaac three seconds later. 0
(in Afterbirth † and Repentance) Potato Peeler 5.100.487
Potato Peeler
Unlimited
A pound of flesh Removes a Heart Container, increases damage and range, and grants a Collectible Cube of Meat iconCube of Meat. 2
(in Afterbirth † and Repentance) Sacrificial Altar 5.100.536
Sacrificial Altar
One time use
He demands a sacrifice Sacrifices up to 2 familiars and spawns an item for each familiar sacrificed. Converts all friendly spiders and flies into coins. 2
(in Afterbirth † and Repentance) Sharp Straw 5.100.507
Sharp Straw
10 seconds
More blood! (except in Repentance) Damages all enemies in the room. Has a chance to drop a Half Red HeartHalf Red Heart or Half Soul HeartHalf Soul Heart if an enemy is hit.
(in Repentance) Damages all enemies in the room. Has a chance to drop a Half Red HeartHalf Red Heart if an enemy is hit.
2
(in Afterbirth † and Repentance) Smelter 5.100.479
Smelter
6 rooms
Trinket melter! Consumes Isaac's currently held trinket and applies its effect permanently. 2
(in Afterbirth † and Repentance) Sprinkler 5.100.516
Sprinkler
4 rooms
Sprinkles. Upon use, creates a stationary sprinkler that rotates and fires tears in 8 directions. The tears copy Isaac's stats and most tear effects. 2
(in Afterbirth † and Repentance) Telekinesis 5.100.522
Telekinesis
7 seconds
Power of the mind Upon use, for the next three seconds, any enemy shots that come near Isaac are held in place and then later reflected. 1
(in Afterbirth † and Repentance) Void 5.100.477
Void
6 rooms
Consume Consumes all pedestal items in the room. Active items will have their effects added to Void, and passive items will grant random stat upgrades. 4
(in Afterbirth † and Repentance) Wait What? 5.100.484
Wait What?
10 seconds
I can't believe it's not butter bean! Isaac farts, sending out rock waves. 1
(in Repentance) Abyss 5.100.706
Abyss
4 rooms
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
(in Repentance) Alabaster Box 5.100.585
Alabaster Box
12 rooms
A sacred offering Spawns three Soul HeartSoul Hearts and two Angel RoomAngel Room items and is consumed. Starts with no charges, and can only be charged by picking up 6 Soul Hearts. 2
(in Repentance) Anima Sola 5.100.722
Anima Sola
15 seconds
Repent Chains down the nearest enemy for 5 seconds, preventing them from acting. 3
(in Repentance) Bag of Crafting 5.100.710
Bag of Crafting
Unlimited
Make your destiny Collects and holds up to 8 pickups, which can then be used to craft an item. The power level of the item is based on the quality of pickups used. 3
(in Repentance) Berserk! 5.100.704
Berserk!
With damage dealt
Rip and tear Causes Isaac to go berserk for 5 seconds, greatly increasing his speed, tears, and damage, but restricting him to using a melee weapon instead of his tears. This item charges by dealing damage to enemies instead of clearing rooms. 2
(in Repentance) Book of Virtues 5.100.584
Book of Virtues
4 rooms
Spiritual companionship On use, 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
(in Repentance) Broken Glass Cannon 5.100.474
Broken Glass Cannon
4 rooms
You broke it! Begins with no charges and turns into Collectible Glass Cannon iconGlass Cannon when used. Only acquired by taking damage while holding Glass Cannon. 0
(in Repentance) Clear Rune 5.100.263
Clear Rune
Variable
Rune mimic Has the same effect as the rune or soul stone currently held by Isaac. The charge time is based on the power of the rune. 2
(in Repentance) Damocles 5.100.577
Damocles
One time use
A king's fortune... but at what cost? Spawns a sword above Isaac's head, which doubles all item pedestals. After Isaac takes damage, the sword can randomly fall at any point, instantly killing him. 2
(in Repentance) Dark Arts 5.100.705
Dark Arts
6 seconds
One with the shadows Briefly grants +1 speed and makes Isaac invulnerable and intangible. When the effect ends, destroys all projectiles and damages all enemies Isaac ran through. 2
(in Repentance) Death Certificate 5.100.628
Death Certificate
One time use
Where am I? Takes Isaac to an abandoned and expanded version of HomeHome, which has one copy of every item in the game. After taking an item, Isaac returns to the room he used Death Certificate in. 4
(in Repentance) Decap Attack 5.100.729
Decap Attack
4 seconds
Chuck away! Throws Isaac's head, which is still able to fire tears at the spot it lands. Reactivating the item or stepping on the head reattaches it. 2
(in Repentance) Eraser 5.100.638
Eraser
1 floor
Erase thy enemy Throws an eraser that instantly kills the first monster it hits, and prevents that monster from spawning for the rest of the run. Can only be used once per floor. 2
(in Repentance) Esau Jr. 5.100.703
Esau Jr.
1 room
Lost brother Swaps between the current character and Esau Jr., who has +2 flat damage and flight. Characters have independent items and health. Dying as either character ends the run. 2
(in Repentance) Eternal D6 5.100.609
Eternal D6
2 rooms
??? Rerolls all items in the room. Each item has a 25% chance to disappear instead. 3
(in Repentance) Everything Jar 5.100.720
Everything Jar
12 rooms
Anything is possible Spawns certain pickups based on how many charges it has. If fully charged, instead has one of many unique effects. 3
(in Repentance) Flip 5.100.711
Flip
6 rooms
Twist of fate Item pedestals have a second uninteractable "ghostly" item behind them. Activating will flip the real and ghostly items around. If playing as Character Tainted Lazarus iconTainted Lazarus, also flips between them and Character Dead Tainted Lazarus iconDead Tainted Lazarus. 4
(in Repentance) Fortune Cookie 5.100.557
Fortune Cookie
2 rooms
Reusable fortunes Gives Isaac a fortune, Soul HeartSoul Heart, Card, Rune, or trinket, similar to a Fortune Telling MachineFortune Telling Machine. Fortunes are much more likely to be given than anything else. 2
(in Repentance) Free Lemonade 5.100.578
Free Lemonade
4 rooms
Party time! Creates a large pool of yellow creep beneath Isaac. 1
(in Repentance) Friend Finder 5.100.687
Friend Finder
4 rooms
Best friends forever! Spawns a random friendly monster that mimics Isaac's movements and attacks. 3
(in Repentance) Gello 5.100.728
Gello
2 rooms
Demonic gestation Spawns a demon familiar 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
(in Repentance) Genesis 5.100.622
Genesis
One time use
In the beginning Removes all of Isaac's items and pickups and takes him to a unique Bedroom with some pickups and ChestChests and a trapdoor to the next floor. For every item Isaac lost, he gets to take an item from a set of three. 3
(in Repentance) Golden Razor 5.100.555
Golden Razor
Unlimited
Pain from gain Spends five PennyPennies to increase Isaac's damage by 1.2 for the current room. 1
(in Repentance) Hold 5.100.715
Hold
Unlimited
Saved for later Exclusive to Character Tainted ??? iconTainted ???. Allows him to save one poop bomb for later, allowing him to gather more over time. 0
(in Repentance) Jar of Wisps 5.100.685
Jar of Wisps
12 rooms
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
(in Repentance) Keeper's Box 5.100.719
Keeper's Box
4 rooms
Portable shop Spawns a random shop item or pickup which can be bought for its normal price. 2
(in Repentance) Larynx 5.100.611
Larynx
12 rooms
Hear my pain Isaac shouts, damaging and pushing away nearby enemies. The shout gets stronger the more charges the item has. Can also be charged by taking damage. 2
(in Repentance) Lemegeton 5.100.712
Lemegeton
6 rooms
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
(in Repentance) Magic Skin 5.100.642
Magic Skin
6 rooms
All your desires fulfilled Consumes one heart container or two Soul HeartSoul Hearts to spawn an item and give Isaac a broken heart container that can never be filled. If Magic Skin isn't being held after being used, it is very likely to replace any future items. 2
(in Repentance) Meat Cleaver 5.100.631
Meat Cleaver
2 rooms
Slice but no dice Splits all enemies in the room into two smaller versions of themselves with much less health. 1
(in Repentance) Mega Mush 5.100.625
Mega Mush
12 rooms
I'm a big boy now! Gigantifies Isaac for 30 seconds, increasing damage and range while lowering tears, granting invulnerability, and allowing Isaac to crush enemies and obstacles he walks on. The effect persists between rooms. 4
(in Repentance) Mom's Bracelet 5.100.604
Mom's Bracelet
1 second
Mother's strength Lets Isaac pick up and throw rocks, TNTTNT, PoopPoops, friendly Dips, BombBombs, and other obstacles. 1
(in Repentance) Plum Flute 5.100.650
Plum Flute
4 rooms
Play time! Summons the boss Boss Baby Plum ingameBaby Plum to fight for Isaac in the current room. 1
(in Repentance) R Key 5.100.636
R Key
One time use
Time to start over Brings Isaac back to the first floor of a new run, retaining all of his items. 4
(in Repentance) Recall 5.100.714
Recall
3 seconds
Come back Retrieves the Forgotten's body from any distance. Only available as the Collectible Birthright iconBirthright effect for Character Tainted Forgotten iconTainted Forgotten. 0
(in Repentance) Red Key 5.100.580
Red Key
4 rooms
Explore the other side Creates a Red RoomRed Room adjacent to a viable wall, indicated by the outline of a door. These rooms have a 10% chance to be a special room. 3
(in Repentance) Sharp Key 5.100.623
Sharp Key
Unlimited
Open your enemies Adds 5 KeyKeys on pickup. Allows Isaac to throw his keys to deal damage to enemies, destroy obstacles, and open doors. 1
(in Repentance) Spin to Win 5.100.655
Spin to Win
3 seconds
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
(in Repentance) Spindown Dice 5.100.723
Spindown Dice
6 rooms
-1 Reduces the internal ID number of all items in the room by one, turning them into the item with that number. 4
(in Repentance) Stitches 5.100.635
Stitches
3 seconds
Bait and switch Passively spawns a familiar that moves in the direction Isaac shoots. On use, Isaac swaps places with the familiar. 1
(in Repentance) Sulfur 5.100.556
Sulfur
3 rooms
Temporary demon form Grants Collectible Brimstone iconBrimstone for the current room. 3
(in Repentance) Sumptorium 5.100.713
Sumptorium
10 seconds
Blood to blood Removes half a heart and creates a Clot familiar that mimics Isaac's movements and tear effects. As Character Tainted Eve iconTainted Eve, passively converts health into Clots while firing. Activating returns all Clots to health. 3
(in Repentance) Suplex! 5.100.709
Suplex!
7 seconds
Angel breaker Isaac dashes forward and picks up the first enemy hit. After a moment, he slams them into the ground to deal damage and create a circular rock wave. 2
(in Repentance) The Scooper 5.100.605
The Scooper
3 rooms
Plop! Summons Collectible The Peeper iconThe Peeper for the current room, which leaves a trail of red creep. 1
(in Repentance) Urn of Souls 5.100.640
Urn of Souls
Unlimited
Unleash their sorrow Spews a stream of damaging flame. Gains Soul Charges each time an enemy dies, which are used to fuel the urn. 3
(in Repentance) Vade Retro 5.100.653
Vade Retro
Unlimited
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
(in Repentance) Wavy Cap 5.100.582
Wavy Cap
0
Tears up. A mind changing experience! Increases fire rate, decreases speed, and distorts the screen. All effects become more pronounced with repeated use, and wear off by clearing rooms. 1
(in Repentance) Yuck Heart 5.100.639
Yuck Heart
4 rooms
Gross! Gives Isaac a Rotten HeartRotten Heart. 1

Passive Collectibles[ | ]

Passive collectibles are vast and diverse, varying wildly in effect and strength. Some simply improve Isaac's stats, add health, or provide a familiar. Some completely change the way the run can play.

  • Other common effects include:
    • Isaac's tears gaining Tear effects or causing Status Effects on hitting enemies.
    • Isaac's tears being replaced with a completely different weapon, such as a knife.
    • Isaac's bombs gaining new effects, often with a bonus supply of extra bombs.
    • Triggering a special effect when Isaac takes damage, or kills an enemy.
    • Creating additional pickups, either when first collected, or over time.
    • Improving active item cooldowns.
    • Granting permanent flight.

An unlimited amount of passive collectibles can be held at a time, and the effects they grant usually last until the end of that run.

  • Removing a passive item is only possible in a few rare ways, and usually comes with severe drawbacks, such as Collectible D4 iconD4 and (in Repentance)Collectible Genesis iconGenesis rerolling all passive items, or (in Afterbirth † and Repentance)Collectible Clicker iconClicker removing the last passive item collected at the cost of changing the active character.
  • (in Repentance) Character Tainted Isaac iconTainted Isaac is limited to 8 passive items (12 with (in Repentance)Collectible Birthright iconBirthright) at a time, and can freely swap out old passive items once his inventory is full.

Nearly all passive collectibles alter Isaac's appearance when collected, with newer items replacing the cosmetic effects of older items.


Name ID Icon Quote Description (in Repentance) Quality
???'s Only Friend 5.100.320 ???'s Only Friend 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
<3 5.100.15 <3 HP up Grants Isaac one Red Heart container and fully restores Isaac's health. 2
1up! 5.100.11 1up! 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
20/20 5.100.245 20/20 Double shot Isaac fires two tears at once, one from each eye. (in Repentance) 0.8x damage multiplier. 4
3 Dollar Bill 5.100.191 3 Dollar Bill Rainbow tears (in Rebirth) Gives Isaac a random tear effect every room.
(except in Rebirth) Gives Isaac a random tear effect every few seconds.
2
9 Volt 5.100.116 9 Volt Quicker charge Reduces the charge of any activated item by 1. Any 1 charge items instead have timed recharges. 2
A Dollar 5.100.18 A Dollar $$$ Gives Isaac 100 PennyPennies. 3
A Lump of Coal 5.100.132 A Lump of Coal My Xmas present The more distance tears travel, the more damage they will do. 3
A Quarter 5.100.74 A Quarter +25 coins Gives Isaac 25 Pennycoins. 0
A Snack 5.100.346 A Snack HP up Grants one full Red Heart container. (in Repentance) Heals 1 additional Red HeartRed Heart. 1
Abaddon 5.100.230 Abaddon Evil + DMG up + fear shot (except in Repentance) +1.5 damage, +0.2 speed. Removes all Red Heart containers, grants six Black HeartBlack Hearts, and adds a chance to shoot fear tears.
(in Repentance) +1.5 damage, +0.2 speed. Grants two Black HeartBlack Hearts, converts all Red Heart Containers into Black Hearts, and adds a chance to shoot fear tears.
3
Abel 5.100.188 Abel Mirrored buddy (in Rebirth) Spawns a familiar that mirrors Isaac's movements and shoots in the opposite direction.
(except in Rebirth) Spawns a familiar that mirrors Isaac's movements and shoots towards him.
0
Anemic 5.100.214 Anemic Toxic blood After Isaac is damaged, a trail of red creep will be left behind him until he leaves the current room. (except in Repentance) +5 range. (in Repentance) +1.5 range. 1
Ankh 5.100.161 Ankh Eternal life? Upon death, Isaac will respawn as Character ??? (Character) icon??? in the previous room, with 3 Soul HeartSoul Hearts. 1
Anti-Gravity 5.100.222 Anti-Gravity Anti-gravity tears + tears up Tears float in position until firing ceases, after which they will fly off in the direction they were shot in. (except in Repentance) -2 Tear Delay. (in Repentance) +1 Fire Rate. 2
Aquarius 5.100.308 Aquarius Trail of tears A trail of blue creep is left behind Isaac, which damages enemies. (in Repentance) The creep inherits most of Isaac's tear effects, like homing, etc. 2
Aries 5.100.300 Aries Ramming speed +0.25 Speed. Running into enemies while at a high speed will deal damage. (in Repentance) Prevents Isaac from taking contact damage while moving at high speed. 2
Ball of Bandages 5.100.207 Ball of Bandages 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
Ball of Tar 5.100.231 Ball of Tar Sticky feet... Adds a chance to shoot slowing tears. Isaac leaves a trail of slowing creep behind as he moves, impeding enemies' speed. 2
BBF 5.100.272 BBF 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
Best Bud 5.100.274 Best Bud Sworn protector When hit, spawns a quickly orbiting attack fly similar to Collectible Forever Alone iconForever Alone for the current room that deals high damage. 0
BFFS! 5.100.247 BFFS! Your friends rule! Increases the size and effectiveness of most familiars. 2
Big Fan 5.100.279 Big Fan Fat protector Spawns a large orbital familiar that blocks enemy shots and deals 30 damage per second to enemies. 2
Black Candle 5.100.260 Black Candle Curse immunity + evil up Prevents curses. Grants one Black HeartBlack Heart. Increases the chance for a Devil RoomDevil Room or Angel RoomAngel Room to appear. 3
Black Lotus 5.100.226 Black Lotus HP up x3! Grants one Red Heart Container, one Soul HeartSoul Heart, and one Black HeartBlack Heart. 2
Blood Bag 5.100.119 Blood Bag HP up Grants one filled Red Heart container, restores 4 Red HeartRed Hearts, and increases speed by 0.3. 2
Blood Clot 5.100.254 Blood Clot DMG + range up (except in Repentance)Tears fired from the left eye have +1 flat damage, +5 range, and +0.5 tear falling speed.
(in Repentance)Tears fired from the left eye have +1 flat damage and +2.75 range.
2
Blood of the Martyr 5.100.7 Blood of the Martyr DMG up +1 damage. Isaac shoots blood tears. 3
Bloody Lust 5.100.157 Bloody Lust RAGE! Increases Isaac's damage whenever he takes damage, up to six times. The bonus resets when entering a new floor. 2
Blue Cap 5.100.342 Blue Cap HP + tears up + shot speed down Gives one full Red Heart container, +0.7 tears, and -0.16 shot speed. (in Repentance) Heals 1 additional Red HeartRed Heart. 3
Blue Map 5.100.246 Blue Map Secrets Reveals the locations of Secret RoomSecret Rooms and Super Secret RoomSuper Secret Rooms on the map. 2
Bob's Brain 5.100.273 Bob's Brain 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
Bob's Curse 5.100.140 Bob's Curse +5 poison bombs +5 BombBombs. Grants Isaac's bombs a poison effect. (in Repentance) They also leave a lingering poison cloud, and Isaac becomes immune to poison. 1
Bobby-Bomb 5.100.125 Bobby-Bomb Homing bombs! +5 BombBombs. Bombs gain a homing effect, slowly moving towards the nearest enemy. 2
BOGO Bombs 5.100.250 BOGO Bombs 1+1 BOOM! All normal BombBombs become Double BombDouble Bombs. 1
Bomb Bag 5.100.131 Bomb Bag Gives bombs Spawns a familiar that drops a BombBomb every 3 rooms. 2
Boom! 5.100.19 Boom! 10 bombs Grants 10 BombBombs. 0
Box 5.100.198 Box Stuff Spawns various pickups: 1 Pennycoin, 1 KeyKey, 1 BombBomb, 1 Red HeartHeart, 1 card/rune, 1 pill and 1 trinket. 0
Breakfast 5.100.25 Breakfast HP up Grants one full Red Heart container. (in Repentance) Heals 1 additional Red HeartRed Heart. 1
Brimstone 5.100.118 Brimstone Blood laser barrage Tears are replaced by a laser beam that pierces through all enemies and obstacles in its path and deals high damage. Can only be fired after a short charge-up period. 4
Broken Watch 5.100.337 Broken Watch I think it's broken Slows all enemies in every fourth newly-discovered room, with a small chance to speed them up instead. 1
Brother Bobby 5.100.8 Brother Bobby Friends 'till the end Spawns a familiar that follows Isaac around shooting tears that deal 3.5 damage. (in Repentance) He shoots more frequently than most familiars. 1
Bucket of Lard 5.100.129 Bucket of Lard HP up (except in Repentance) Grants two empty Red Heart containers, heals Isaac for a Half Red HeartHalf Red Heart, -0.2 speed.
(in Repentance) Grants two Red Heart containers, -0.2 speed.
1
Bum Friend 5.100.144 Bum Friend He's greedy Spawns a familiar that picks up Pennycoins for himself, giving random pickups in return. (in Repentance) Can spawn Items from the Beggar Item Pool. 1
Butt Bombs 5.100.209 Butt Bombs Toxic blast +5 bombs +5 BombBombs. Bombs now cloud up the screen, briefly damaging and confusing all enemies. 2
Caffeine Pill 5.100.340 Caffeine Pill Speed up + size down Grants +0.3 speed, reduces character size, and gives a random pill. 1
Cain's Other Eye 5.100.319 Cain's Other Eye Near-sighted friend (except in Repentance) Spawns a familiar that slowly floats around the room on a zig-zag pattern and shoots normal tears in the same direction as Isaac.
(in Repentance) 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
Cancer 5.100.301 Cancer HP up + you feel protected Adds 3 Soul HeartSoul Hearts. Grants Collectible The Wafer iconThe Wafer effect for the current room after taking damage. 3
Capricorn 5.100.307 Capricorn All stats up (except in Repentance) Adds 1 Red Heart Container, gives +0.5 Damage, +0.1 Speed, +1.5 Range, and -1.0 Tear Delay, and gives 1 BombBomb, PennyPenny, and KeyKey.
(in Repentance) Adds 1 Red Heart Container, gives +0.5 Damage, +0.1 Speed, +0.75 Range, and +0.5 Fire Rate, and gives 1 BombBomb, PennyPenny, and KeyKey.
3
Cat-o-nine-tails 5.100.165 Cat-o-nine-tails Shot speed + damage up +1 damage, +0.23 shot speed. 3
Celtic Cross 5.100.162 Celtic Cross Blessing of protection Grants a chance to trigger the Collectible Book of Shadows iconBook of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 7 seconds. 1
Ceremonial Robes 5.100.216 Ceremonial Robes DMG + evil up Grants 3 Black HeartBlack Hearts, and +1 damage. 3
Champion Belt 5.100.208 Champion Belt DMG + challenge up +1 damage. Increases the chance of champion enemies appearing by 15%. 3
Charm of the Vampire 5.100.62 Charm of the Vampire DMG up + kills heal Heals Isaac for a Half Red HeartHalf Red Heart for every 13 enemies killed. (in Repentance) +0.3 damage. 1
Chemical Peel 5.100.154 Chemical Peel DMG up Tears fired from the left eye have +2 flat damage. 2
Chocolate Milk 5.100.69 Chocolate Milk Charge shots Grants charged tears that deal greater damage when fully charged. 3
Contract From Below 5.100.241 Contract From Below Wealth... but at what cost? Doubles the number of most room clear awards, but reduces the overall chance of getting one by 1/3. 3
Cricket's Body 5.100.224 Cricket's Body Bursting shots + tears up When tears hit an object or deplete their range, they spawn 4 smaller tears, whose range and damage scale with Isaac's. (except in Repentance) Grants -1 tear delay and reduces range. (in Repentance) Grants +0.5 fire rate and reduces range. 3
Cricket's Head 5.100.4 Cricket's Head DMG up Increases Damage by 0.5, and increases damage multiplier by x1.5. 4
Cube of Meat 5.100.73 Cube of Meat 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
Cupid's Arrow 5.100.48 Cupid's Arrow Piercing shots Grants Isaac piercing tears that travel through enemies (but not obstacles) instead of breaking on impact with them. 3
Cursed Eye 5.100.316 Cursed Eye Cursed charge shot Grants charged tears that can be fired in a tight burst. Getting hit while charging will teleport Isaac to another room. 0
Daddy Longlegs 5.100.170 Daddy Longlegs Daddy's love Daddy Long Legs' shadow follows Isaac and occasionally stomps enemies for 40 damage total. 3
Dark Bum 5.100.278 Dark Bum He wants to take your life Spawns a familiar that follows Isaac around and collects Red HeartRed Hearts. For every 1½ Red Hearts collected, Dark Bum will give a reward. 3
Dark Matter 5.100.259 Dark Matter DMG up + fear shot +1 damage, adds a chance to shoot fear tears. 3
Dead Bird 5.100.117 Dead Bird Protective buddy After Isaac takes damage, spawns a flying familiar that chases enemies for the current room, dealing ~4 damage per second. 0
Dead Cat 5.100.81 Dead Cat 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
Dead Dove 5.100.185 Dead Dove Flight + spectral tears Grants spectral tears and flight. 3
Dead Onion 5.100.336 Dead Onion Toxic aura tears Grants piercing and spectral tears. Increases tear size (without increasing damage) while greatly reducing range and shot speed. 3
Death's Touch 5.100.237 Death's Touch Piercing shots + DMG up +1.5 damage, -0.3 tears. Tears are replaced with large piercing scythes. 3
Demon Baby 5.100.113 Demon Baby Auto-turret friend Spawns a familiar that follows Isaac and automatically fires at enemies in its reach. 2
Dessert 5.100.24 Dessert HP up Grants one full Red Heart container. (in Repentance) Heals 1 additional Red HeartRed Heart. 1
Dinner 5.100.23 Dinner HP up Grants one full Red Heart container. (in Repentance) Heals 1 additional Red HeartRed Heart. 1
Distant Admiration 5.100.57 Distant Admiration Attack fly Spawns an attack fly that circles further out than Collectible Halo of Flies iconHalo of Flies, but closer than Collectible Forever Alone iconForever Alone, dealing 75 damage per second. 2
Dr. Fetus 5.100.52 Dr ??? Tears are replaced by BombBombs that benefit from bomb-enhancing effects and slide for a fixed time after being fired. 4
Dry Baby 5.100.265 Dry Baby Immortal friend Spawns a familiar that follows Isaac around and blocks enemy projectiles. Upon blocking a shot, it has a chance of triggering Collectible The Necronomicon iconThe Necronomicon effect. 3
E. Coli 5.100.236 E Turdy touch Enemies that touch Isaac are transformed into PoopPoop. 1
Epic Fetus 5.100.168 Epic Fetus On-demand air strike Isaac's tears are replaced with guided missiles, like those used by the Collectible Doctor's Remote iconDoctor's Remote. 4
Eve's Mascara 5.100.310 Eve's Mascara DMG up, tears + shot speed down (except in Repentance) Doubles damage, halves tears stat, and greatly reduces shot speed.
(in Repentance) Doubles damage, 0.66x tears multiplier, and greatly reduces shot speed.
3
Experimental Treatment 5.100.240 Experimental Treatment Some stats up, some stats down (in Rebirth and Afterbirth) Randomly increases and decreases some of Isaac's stats.
(in Afterbirth † and Repentance) Increases four random stats and decreases the other two.
1
Fanny Pack 5.100.204 Fanny Pack Filled with goodies Has a chance to drop a random pickup when Isaac takes damage. 1
Fate 5.100.179 Fate Flight eternal Grants flight and one Eternal HeartEternal Heart. 3
Fire Mind 5.100.257 Fire Mind Flaming tears Grants flaming tears that deal burning damage over time. Tears have a chance to explode on impact with an enemy, which creates a fire at the location of the explosion. 2
Forever alone 5.100.128 Forever alone Attack fly Spawns an attack fly that orbits a long distance from Isaac, dealing 30 damage per second. 1
Gemini 5.100.318 Gemini Conjoined friend Spawns a conjoined familiar which chases enemies close to Isaac, dealing ~6.43 damage per second. 1
Ghost Baby 5.100.163 Ghost Baby Spectral buddy Spawns a familiar that follows Isaac around and fires spectral tears. 1
Gimpy 5.100.225 Gimpy Sweet suffering Gives chance of spawning a Soul HeartSoul Heart when taking damage. Enemies have a chance to drop a Half Red HeartHalf Red Heart after being killed. 2
Gnawed Leaf 5.100.210 Gnawed Leaf Unbreakable After standing still and not shooting for a short time, Isaac turns invincible until he moves or shoots. 1
Goat Head 5.100.215 Goat Head He accepts your offering A Devil RoomDevil Room / Angel RoomAngel Room will always spawn after every boss fight, excluding the first floor and floors after Chapter 4. 3
Godhead 5.100.331 Godhead God tears (except in Repentance) Grants homing tears with a damaging halo. +0.5 Damage, -0.3 Tears -0.3 Shot Speed, +0.8 Tear Falling Speed, and +1.2 Range.
(in Repentance) Grants homing tears with a damaging halo. +0.5 Damage, -0.3 Tears, and -0.3 Shot Speed.
4
Growth Hormones 5.100.70 Growth Hormones Speed + DMG up (except in Repentance) +1 damage, +0.4 speed.
(in Repentance) +1 damage, +0.2 speed.
3
Guardian Angel 5.100.112 Guardian Angel Extra protection Spawns an orbital familiar that blocks enemy shots, deals (except in Repentance) 105 /(in Repentance) 52.5 damage per second to enemies, and increases the speed of all orbital familiars. 2
Guillotine 5.100.206 Guillotine DMG + tears up. An out-of-body experience! Isaac's head is removed from his body and floats around him as an orbital. (except in Repentance) Gives +1 damage and grants -1 tear delay. (in Repentance) Gives +1 damage and grants +0.5 fire rate. 2
Guppy's Collar 5.100.212 Guppy's Collar Eternal life? Grants a permanent 50% chance to respawn with 1/2 of a Red HeartRed Heart after death. 1
Guppy's Hairball 5.100.187 Guppy's Hairball 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
Guppy's Tail 5.100.134 Guppy's Tail Cursed? Room Clear Awards have a 1/3 chance of being replaced with a ChestChest and a 2/9 chance being replaced with nothing. 2
Habit 5.100.156 Habit Item martyr When Isaac is hit, his active item gains 1 room's worth of charge. 2
Halo of Flies 5.100.10 Halo of Flies Projectile protection Spawns two Pretty Flies that block enemy shots and deal contact damage to flies. 2
Harlequin Baby 5.100.167 Harlequin Baby Double shot buddy Spawns a familiar that follows Isaac around and fires two tears at once in a V-pattern. 1
Headless Baby 5.100.269 Headless Baby Bloody friend Spawns a familiar that follows Isaac, leaving blood creep on the ground. 1
Hive Mind 5.100.248 Hive Mind Giant spiders and flies Increases the size of Blue Spiders and Blue Flies and doubles the amount of damage they deal. (in Repentance) Also increases the effectiveness of fly and spider familiars. 2
Holy Grail 5.100.184 Holy Grail Flight + HP up Grants flight and one Red Heart container. (in Repentance) Heals 1 additional Red HeartRed Heart. 3
Holy Mantle 5.100.313 Holy Mantle Holy shield Grants a shield that negates the first instance of damage taken, once per room. Does not apply to or negate self-damage (Blood Donation MachineBlood Donation Machines, etc). 4
Holy Water 5.100.178 Holy Water Splash! (except in Repentance) Spawns a bottle familiar that breaks when Isaac takes damage, leaving a puddle of blue creep.
(in Repentance) 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
Hot Bombs 5.100.256 Hot Bombs Burning blast +5 bombs +5 BombBombs. Isaac's bombs leave behind fire that damages enemies upon contact. 1
Humbleing Bundle 5.100.203 Humbleing Bundle 1+1 free 4Evar Transforms BombBombs, KeyKeys, PennyPennies, and Red HeartRed Hearts into their respective Double versions. (in Repentance) This will occur 50% of the time. 3
Infamy 5.100.242 Infamy Blocks damage... sometimes Gives Isaac a 50% chance to block projectiles coming from any direction. 2
Infestation 5.100.148 Infestation Fly revenge (except in Repentance) 1-3 Blue Flies randomly spawn every time Isaac gets hit.
(in Repentance) 2-6 Blue Flies
0
Infestation 2 5.100.234 Infestation 2 Infestation shot Spawns allied Blue Spiders from killed enemies. 3
Ipecac 5.100.149 Ipecac Explosive shots Replaces tears with explosive and poisoning projectiles fired in an arc from the mouth. 4
Iron Bar 5.100.201 Iron Bar DMG up + concussive tears +0.3 damage. Adds a chance to shoot concussive tears, causing enemies to walk around randomly. 2
Isaac's Heart 5.100.276 Isaac's Heart Protect it Isaac himself is now immune to all damage, and a heart familiar follows him. If the heart is hurt, Isaac is hurt. (in Repentance) The heart charges up as Isaac shoots, firing 8 blood shots, knocking back enemies, and leaving a puddle of creep when released. 0
Jesus Juice 5.100.197 Jesus Juice Damage + range up (except in Repentance) +0.5 damage, +0.25 range, +0.5 tear falling speed.
(in Repentance) +0.5 damage, +1.5 range.
2
Judas' Shadow 5.100.311 Judas' Shadow Sweet revenge Upon death, respawns Isaac as Character Dark Judas iconDark Judas with two Black HeartBlack Hearts in the previous room. 3
Juicy Sack 5.100.266 Juicy Sack 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 Key Piece 1 ??? Combined with Collectible Key Piece 2 iconKey Piece 2, unlocks the golden gate in the starting room of ChestChest and Dark RoomDark Room to fight Mega Satan Head ingameMega Satan. 0
Key Piece 2 5.100.239 Key Piece 2 ??? Combined with Collectible Key Piece 1 iconKey Piece 1, unlocks the golden gate in the starting room of ChestChest and Dark RoomDark Room to fight Mega Satan Head ingameMega Satan. 0
Latch Key 5.100.343 Latch Key Luck up Grants 1 Soul HeartSoul Heart and +1 luck. Spawns 2 KeyKeys. 1
Lazarus' Rags 5.100.332 Lazarus' Rags Eternal life? (except in Repentance) Upon dying, resurrect as Character Lazarus Risen iconLazarus Risen in the current room with one Red Heart container and Collectible Anemic iconAnemic.
(in Repentance) Upon dying, resurrect as Character Lazarus Risen iconLazarus Risen in the current room with one less Red Heart container, Collectible Anemic iconAnemic, and +0.5 Damage. Transform into Character Lazarus iconLazarus when reaching the next floor.
1
Leech 5.100.270 Leech Blood sucker Spawns a leech familiar that chases enemies, dealing ~3 damage per second. Heals a Half Red HeartHalf Red Heart whenever Leech kills an enemy. 2
Leo 5.100.302 Leo Stompy Isaac can destroy rocks by walking into them. 1
Libra 5.100.304 Libra You feel balanced Gives 6 PennyCoins, 6 BombBombs, and 6 KeyKeys and balances out all attributes. 1
Lil Brimstone 5.100.275 Lil Brimstone Evil friend Grants a familiar that charges a thin Collectible Brimstone iconBrimstone laser while Isaac is shooting. 2
Lil Haunt 5.100.277 Lil Haunt Fear him Spawns a familiar that chases down enemies, dealing 4 damage per second and inflicting fear. 1
Little Baggy 5.100.252 Little Baggy Extra pill room Isaac can hold 2 pills at once and all cards and runes are replaced by pills. 0
Little C.H.A.D. 5.100.96 Little C.H.A.D. Gives kisses Spawns a familiar who drops a Half Red HeartHalf Red Heart every 3 rooms. 2
Little Chubby 5.100.88 Little Chubby Attack buddy Spawns a ChargerCharger familiar that charges forward and deals contact damage to any enemies in its path. 2
Little Gish 5.100.99 Little Gish Sticky friend Spawns a familiar that follows Isaac around and fires slowing tears, impeding enemies' speed. 2
Little Steven 5.100.100 Little Steven Psychic friend Spawns a familiar who follows Isaac around and fires homing tears. 2
Loki's Horns 5.100.87 Loki's Horns Cross tears Gives a random chance for projectiles to fire in all 4 cardinal directions. 1
Lord of the Pit 5.100.82 Lord of the Pit Demon wings Grants flight and +0.3 speed. 3
Lost Contact 5.100.213 Lost Contact Shielded tears Isaac's tears can hit and destroy enemy projectiles. -0.15 shot speed. 2
Lucky Foot 5.100.46 Lucky Foot Luck up +1 luck. Improves Isaac's chances at various random events (independent from the luck stat). (in Repentance) Converts all bad pills into good pills, without identifying them. 2
Lunch 5.100.22 Lunch HP up Grants one full Red Heart container. (in Repentance) Heals 1 additional Red HeartRed Heart. 1
Maggy's Bow 5.100.312 Maggy's Bow HP up + you feel healthy Gives one Red Heart Container and doubles the healing provided by Red HeartRed Hearts. (in Repentance) Also heals 1 Red Heart when obtained. 2
Magic 8 Ball 5.100.194 Magic 8 Ball Shot speed up +0.16 shot speed, spawns a random tarot card. (in Repentance) Increases the chance of finding a PlanetariumPlanetarium. 1
Magic Mushroom 5.100.12 Magic Mushroom All stats up! (except in Repentance) Makes Isaac bigger. Adds one Red Heart Container, +0.3 Damage, x1.5 damage multiplier, +5.25 Range, +0.3 Speed, and restores all Health.
(in Repentance) Makes Isaac bigger. Adds one Red Heart Container, +0.3 Damage, x1.5 damage multiplier, +2.5 Range, +0.3 Speed, and restores all Health.
4
Magic Scab 5.100.253 Magic Scab HP + luck up Grants one full Red Heart container, +1 luck. (in Repentance) Heals 1 additional Red HeartRed Heart. 2
Magneto 5.100.53 Magneto Item snatcher Pulls pickups towards Isaac. 1
Match Book 5.100.344 Match Book Evil up Grants Isaac one Black HeartBlack Heart, spawns two or three BombBombs. (in Repentance) Also spawns Match StickMatch Stick if it hasn't been encountered yet. 1
MEAT! 5.100.193 MEAT! DMG + HP up Grants one full Red Heart container, +0.3 damage. (in Repentance) Heals 1 additional Red HeartRed Heart 2
Midas' Touch 5.100.202 Midas' Touch Golden touch Enemies that touch Isaac are temporarily petrified and turn to gold. Any enemy killed while in this state will drop PennyPennies. 2
Mini Mush 5.100.71 Mini Mush Speed + range up Decreases Isaac's size, making him less likely to be hit. (except in Repentance)+0.3 speed, +1.5 tear falling speed, -4.25 range (effective range is increased). (in Repentance) +0.3 speed, +2.5 range. 2
Missing No. 5.100.258 Missing No. Syntax error Randomizes all passive items and stats upon pickup and at the start of each succeeding floor. 0
Missing Page 2 5.100.262 Missing Page 2 Evil up. Your enemies will pay! Grants one Black HeartBlack Heart. Upon taking damage that reduces Isaac's health to one heart or less, deals damage to all enemies in the room. (in Repentance) Increases the damage of Black HeartBlack Hearts and Collectible The Necronomicon iconThe Necronomicon-like effects by 40. 0
Mitre 5.100.173 Mitre Blessing of purity Grants a chance of converting any Red HeartRed Heart pickups into Soul HeartSoul Hearts instead. 3
Mom's Coin Purse 5.100.195 Mom's Coin Purse What's all this...? Spawns 4 random pills near Isaac. 1
Mom's Contacts 5.100.110 Mom's Contacts Freeze effect Adds a chance to shoot petrifying tears, which stop enemies in place and prevent them from moving or attacking. (except in Repentance) +0.25 range. (in Repentance) +1.5 range. 3
Mom's Eye 5.100.55 Mom's Eye Eye in the back of your head Gives Isaac a chance to fire tears from the back of his head. 1
Mom's Eyeshadow 5.100.200 Mom's Eyeshadow Charm tears Tears have a chance to charm enemies. 1
Mom's Heels 5.100.30 Mom's Heels Range up (except in Repentance) +5.25 range, +0.5 tear falling speed.
(in Repentance) +2.5 range, enemies that touch Isaac take 12 damage.
1
Mom's Key 5.100.199 Mom's Key Better chest loot +2 keys Adds 2 keys. ChestChests will drop additional pickups. 3
Mom's Knife 5.100.114 Mom's Knife Stab stab stab Isaac's tears are replaced by a knife that pierces enemies, can travel through obstacles, and can hurt enemies while Isaac is holding it. Holding down the fire button before firing increases its range and power. 4
Mom's Lipstick 5.100.31 Mom's Lipstick Range up (except in Repentance)+5.25 range, +0.5 tear falling speed.
(in Repentance) +3.75 range. Spawns a Red HeartHeart on pickup.
1
Mom's Perfume 5.100.228 Mom's Perfume Fear shot + tears up Adds a chance to shoot fear tears. (except in Repentance) Decreases tear delay by 1. (in Repentance) +0.5 fire rate. 2
Mom's Purse 5.100.139 Mom's Purse More trinket room Allows Isaac to hold one additional trinket. (in Repentance) Drops a random trinket. 2
Mom's Underwear 5.100.29 Mom's Underwear Range up (except in Repentance) +5.25 range, +0.5 tear falling speed.
(in Repentance) +2.5 range. Spawns 3-6 Blue Flies on pickup.
1
Mom's Wig 5.100.217 Mom's Wig You feel itchy... Adds a chance to spawn Blue Spiders when firing tears. Restores 1 Red HeartRed Heart. 2
Money = Power 5.100.109 Money = Power $$$ = DMG Increases damage by 0.04 for every Pennycoin Isaac has, up to +3.96 damage at 99 coins. 3
Mongo Baby 5.100.322 Mongo Baby Mongo friend Spawns a familiar that copies the tears of Isaac's other familiars. 2
Monstro's Lung 5.100.229 Monstro's Lung Charged burst attack Replaces normal tears with a charged shot that fires 14 tears in the same fashion as Boss Monstro ingameMonstro. 2
Mr. Mega 5.100.106 Mr Bigger boom +5 BombBombs. Increases the size, blast radius, and damage of Isaac's bombs. 2
Mutant Spider 5.100.153 Mutant Spider Quad shot Grants quadruple shot but decreases Tears. 3
My Reflection 5.100.5 My Reflection Boomerang tears + DMG up + luck down Gives Isaac's tears a boomerang effect. (except in Repentance) +1.5 range, +1 tear falling speed, x1.6 shot speed multiplier. (in Repentance) 2x + 1.5 range, +1.5 damage, -1 luck, 1.6x shot speed multiplier. 2
Mysterious Liquid 5.100.317 Mysterious Liquid Toxic splash damage Tears leave a small, short lasting pool of creep on impact or when their range is depleted. 3
Mystery Sack 5.100.271 Mystery Sack ? Spawns a familiar that drops a Heart, coin, BombBomb, or KeyKey every 5-6 rooms. 2
Number One 5.100.6 Number One Tears up + range down Grants +1.5 tears, but severely reduces range. 2
Odd Mushroom 5.100.121 Odd Mushroom HP + DMG up, speed down (except in Repentance) Grants one empty Heart container, +0.3 damage, +0.25 range, +0.5 tear falling speed, and -0.1 speed.
(in Repentance) Grants one full Heart container, +1 damage, +1.5 range, and -0.2 speed
2
Odd Mushroom 5.100.120 Odd Mushroom Tears + speed up, DMG down +1.7 tears, +0.3 speed, slightly reduces damage. 2
Old Bandage 5.100.219 Old Bandage HP up Grants an empty Red Heart container. Adds a chance of dropping a Red HeartRed Heart after taking damage. 2
Ouija Board 5.100.115 Ouija Board Spectral tears + tears up Grants spectral tears that travel through obstacles (but not enemies). (in Repentance) +0.5 tears. 2
Pageant Boy 5.100.141 Pageant Boy Ultimate grand supreme Spawns seven random coins around Isaac. 0
Pentagram 5.100.51 Pentagram DMG up +1 damage, increases Devil RoomDevil Room / Angel RoomAngel Room chance by 10%. 3
PHD 5.100.75 PHD Better pills Converts all bad pills into good pills, spawns one pill pickup, and identifies all pills. Restores two Red HeartRed Hearts and increases the payout of Blood Donation MachineBlood Donation Machines. 2
Piggy Bank 5.100.227 Piggy Bank My life savings Gives 3 PennyPennies on pick-up. Every time Isaac is damaged, he will drop one or two additional pennies. 1
Pisces 5.100.309 Pisces Tears up + knock-back shots (except in Repentance) -1 Tear Delay, adds knock-back shots and increases tear size.
(in Repentance) +0.5 Fire Rate, adds knock-back shots and increases tear size.
2
Placenta 5.100.218 Placenta Regeneration + HP up Grants one full Red Heart container, and a chance to regenerate a Half Red HeartHalf Red Heart of health every minute of gameplay. 2
Polyphemus 5.100.169 Polyphemus Mega tears Isaac fires huge tears that deal massive damage, but fire rate is greatly decreased. If a tear kills an enemy, it travels on with any leftover damage. 4
Proptosis 5.100.261 Proptosis Short range mega tears Tears start out massive with high damage, and then shrink down and become weaker over a short range. 3
Punching Bag 5.100.281 Punching Bag Scape goat Spawns a MulliganMulligan familiar that wanders randomly. Enemies will attack the Mulligan if it's closer. 1
Pyro 5.100.190 Pyro 99 bombs Grants 99 BombBombs. 3
Pyromaniac 5.100.223 Pyromaniac It hurts so good +5 bombs +5 bombs. Grants immunity to explosion damage and causes explosions to heal Isaac. (in Repentance) Also grants immunity to fire. 4
Rainbow Baby 5.100.174 Rainbow Baby Random buddy Spawns a familiar that follows Isaac around and fires tears with random effects. 1
Raw Liver 5.100.16 Raw Liver HP up Grants 2 Red Heart containers and completely restores health. 2
Robo-Baby 5.100.95 Robo-Baby Friends 'till the bbbbzzzt Spawns a familiar that shoots Collectible Technology iconTechnology lasers. 1
Robo-Baby 2.0 5.100.267 Robo-Baby 2 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
Roid Rage 5.100.14 Roid Rage Speed and range up (except in Repentance) +0.6 speed, +5.25 range, +0.5 tear falling speed.
(in Repentance) +0.3 speed, +2.5 range
2
Rosary 5.100.72 Rosary Tears + faith up Grants 3 Soul HeartSoul Hearts. Causes Collectible The Bible iconThe Bible to appear in any item pool. (in Repentance) +0.5 tears. 2
Rotten Baby 5.100.268 Rotten Baby Infested friend Spawns a familiar that spawns a Blue Fly when Isaac shoots. It can only have one Fly at a time. 3
Rotten Meat 5.100.26 Rotten Meat HP up Grants one full Red Heart container. (in Repentance) Heals 1 additional Red HeartRed Heart. 1
Rubber Cement 5.100.221 Rubber Cement Bouncing tears Tears bounce off walls, enemies, and environmental objects. 3
Sack of Pennies 5.100.94 Sack of Pennies Gives money Spawns a familiar that drops a Pennycoin every 2 rooms. 1
Sacred Heart 5.100.182 Sacred Heart Homing shots + DMG up (except in Repentance) Adds a Red Heart Container. Grants homing tears, a x2.3 Damage multiplier, +1 flat Damage, -0.4 Tears, -0.25 Shot Speed, and +4.125 Range.
(in Repentance) Adds a Red Heart Container. Grants homing tears, a x2.3 Damage multiplier, +1 flat Damage, -0.4 Tears, and -0.25 Shot Speed.
4
Sacrificial Dagger 5.100.172 Sacrificial Dagger My fate protects me Spawns a dagger orbital familiar, blocking enemy shots and dealing a high amount of damage to enemies in contact. 2
Sad Bombs 5.100.220 Sad Bombs Tear blasts +5 bombs +5 BombBombs. Upon exploding, bombs shoot 10 tears around them, affected by tear modifiers. 2
Safety Pin 5.100.339 Safety Pin Evil + range + shot speed up (except in Repentance) Grants one Black HeartBlack Heart, +5.25 range, +0.5 tear falling speed, +0.16 shot speed.
(in Repentance) Grants one Black HeartBlack Heart, +2.5 range, +0.16 shot speed.
1
Sagittarius 5.100.306 Sagittarius Piercing shots + speed up Increases speed by +0.2 and grants piercing tears. 3
Samson's Chains 5.100.321 Samson's Chains 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
Scapular 5.100.142 Scapular Pray for a miracle Once per room, when Isaac is reduced to his last half heart, he is granted one Soul HeartSoul Heart. 2
Scorpio 5.100.305 Scorpio Poison tears Grants poison tears, which deal damage over time when inflicted. 3
Screw 5.100.255 Screw Tears + shot speed up +0.5 tears, +0.2 shot speed. 3
Sharp Plug 5.100.205 Sharp Plug Infinite charge... at a cost Damages Isaac in exchange for fully recharging Isaac's current activated item. 2
Sissy Longlegs 5.100.280 Sissy Longlegs She loves you Spawns a familiar that wanders randomly, occasionally spawning Blue Spiders. (in Repentance) Briefly charms enemies on contact. 1
Sister Maggy 5.100.67 Sister Maggy Friends 'till the end (except in Repentance) Spawns a familiar that follows Isaac around shooting tears that deal 3.5 damage.
(in Repentance) Spawns a familiar that follows Isaac around shooting tears that deal 6 damage.
1
Skatole 5.100.9 Skatole Fly love Flies become harmless or less dangerous depending on the type. 0
Skeleton Key 5.100.17 Skeleton Key 99 keys Gives Isaac 99 KeyKeys. 3
Smart Fly 5.100.264 Smart Fly 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
SMB Super Fan 5.100.189 SMB Super Fan All stats up (except in Repentance) +1 Red Heart container, +0.3 damage, +0.2 tears, +0.2 speed, +0.5 range, +1 tear falling speed. Fully restores all red hearts.
(in Repentance) +1 Red Heart container, +0.3 damage, +0.2 tears, +0.2 speed, +2.5 range. Fully restores all red hearts.
3
Soy Milk 5.100.330 Soy Milk DMG down + tears way up Tears are smaller and do much less damage, but fire in very rapid succession. 2
Speed Ball 5.100.143 Speed Ball Speed + shot speed up +0.3 speed, +0.2 shot speed. 2
Spelunker Hat 5.100.91 Spelunker Hat See-through doors Reveals type of adjacent rooms, including location for Secret RoomSecret Rooms and Super Secret RoomSuper Secret Rooms. (in Repentance) Reveals rooms up to 2 rooms away and blocks projectiles falling from above. 2
Spider Bite 5.100.89 Spider Bite Slow effect Adds a chance to shoot slowing tears, reducing speed of enemy movement and any projectile fired by them. 2
Spiderbaby 5.100.211 Spiderbaby Spider revenge (except in Repentance) Spawns 1-2 Blue Spiders when Isaac takes damage.
(in Repentance) Spawns 3-5 Blue Spiders when Isaac takes damage.
0
Spirit of the Night 5.100.159 Spirit of the Night Scary Grants spectral tears and flight. 3
Spoon Bender 5.100.3 Spoon Bender Homing shots Grants Isaac homing tears. 3
Squeezy 5.100.196 Squeezy Tears up +0.4 tears, spawns 2 Soul HeartSoul Hearts. 3
Starter Deck 5.100.251 Starter Deck Extra card room Isaac can hold 2 cards at once and all pills are replaced by cards. 2
Steam Sale 5.100.64 Steam Sale 50% off Reduces all Shop prices by 50%, rounded down to 7 coins for an item, rounded up to 2-3 coins for a pickup. 2
Stem Cells 5.100.176 Stem Cells HP + shot speed up Grants one full Red Heart container and +0.16 shot speed. (in Repentance) Heals 1 additional Red HeartRed Heart 1
Steven 5.100.50 Steven DMG up +1 damage. 3
Stigmata 5.100.138 Stigmata DMG + HP up +0.3 damage, grants one full Red Heart container. (in Repentance) Heals 1 additional Red HeartRed Heart. 2
Stop Watch 5.100.232 Stop Watch Let's slow this down a bit... (in Rebirth)+0.3 speed. Automatically inflicts slow to all enemies in every room.
(in Afterbirth and Afterbirth †)+0.3 speed. Upon taking damage, inflicts slow to all enemies for the current room.
(in Repentance)+0.3 speed. Slows all enemies in every room to 80% speed.
4
Strange Attractor 5.100.315 Strange Attractor Magnetic tears Pickups, trinkets, and monsters are magnetically attracted to Isaac's tears. 0
Super Bandage 5.100.92 Super Bandage +2 hearts Grants one full Red Heart container and 2 Soul HeartSoul Hearts. 2
Synthoil 5.100.345 Synthoil DMG + range up (except in Repentance) +1 damage, +5.25 range, +0.5 tear falling speed.
(in Repentance) +1 damage, +2.5 range.
3
Taurus 5.100.299 Taurus Speed down + rage is building -0.3 Speed. Isaac builds speed while in a room with enemies. At max speed, he gains the Collectible My Little Unicorn iconMy Little Unicorn effect for 5 seconds. 1
Tech.5 5.100.244 Tech It's still being tested... Isaac occasionally fires an unlimited range piercing laser alongside his normal tears. The laser can glitch, mimicking the effects of certain items and trinkets. 3
Technology 5.100.68 Technology Laser tears Replaces tears with a piercing laser with unlimited range. 3
Technology 2 5.100.152 Technology 2 Extra laser Replaces the tears fired from Isaac's right eye with a rapid-firing low damage piercing laser. (except in Repentance) Damage down. 2
The Battery 5.100.63 The Battery Stores energy Activated collectibles can store an extra level of charge, allowing them to be used twice in one room. 2
The Belt 5.100.28 The Belt Speed up +0.3 speed. 1
The Black Bean 5.100.180 The Black Bean Toot on touch (except in Repentance) When taking damage, Isaac farts, poisoning enemies in range.
(in Repentance) When taking damage, Isaac farts five times, poisoning and knocking back nearby enemies and leaving lingering poison clouds.
0
The Body 5.100.334 The Body I feel all Adds 3 Red Heart Containers. 3
The Common Cold 5.100.103 The Common Cold Poison damage Adds a chance to shoot poison tears, dealing damage over time when inflicted. 1
The Compass 5.100.21 The Compass The end is near Reveals the locations and types of all special rooms on the map, except Secret RoomSecret Rooms and Super Secret RoomSuper Secret Rooms. 2
The Halo 5.100.101 The Halo All stats up (except in Repentance) Grants one full Red Heart container, +0.3 damage, +0.2 tears, +0.25 range, +0.3 speed, and +0.5 tear falling speed.
(in Repentance) Grants one full Red Heart container, +0.3 damage, +0.2 tears, +1.5 range, and +0.3 speed. Heals 1 additional Red HeartRed Heart.
2
The Inner Eye 5.100.2 The Inner Eye Triple shot Grants triple shot but decreases tears. 2
The Ladder 5.100.60 The Ladder Building bridges Allows Isaac to walk across gaps one square across by automatically placing a ladder between the two walkable sections. 1
The Ludovico Technique 5.100.329 The Ludovico Technique Controlled tears Instead of firing tears, Isaac controls one floating tear that hover over obstacles. This tear deals constant damage when held in place over an enemy. 2
The Mark 5.100.79 The Mark DMG + speed up (except in Repentance) Grants one Soul HeartSoul Heart, +1 damage, and +0.2 speed.
(in Repentance) Grants one Black HeartBlack Heart, +1 damage, and +0.2 speed.
3
The Mind 5.100.333 The Mind I know all Reveals the entire map, including all special rooms and Secret RoomSecret Rooms. 3
The Mulligan 5.100.151 The Mulligan They grow inside Tears have a 1/6 chance of spawning allied Blue Flies when they hit an enemy. 3
The Negative 5.100.328 The Negative Fate chosen If Isaac has half a red heart or no red hearts after taking damage, all enemies in the room take significant damage. Allows entrance into the Dark RoomDark Room. (in Repentance) +1 Damage and also allows access to HomeHome. 2
The Pact 5.100.80 The Pact DMG + tears up (except in Repentance) Grants two Soul HeartSoul Hearts, +0.5 damage, and +0.7 tears.
(in Repentance) Grants two Black HeartBlack Hearts, +0.5 damage, and +0.7 tears.
3
The Parasite 5.100.104 The Parasite Split shot Isaac's tears split in two when they hit something. 3
The Peeper 5.100.155 The Peeper Plop! Spawns a familiar that slowly floats around the room in a zig-zag pattern, damaging enemies it passes through. (in Repentance) Increases the damage of tears from Isaac's left eye by 35%. 2
The Polaroid 5.100.327 The Polaroid Fate chosen If Isaac has half a red heart or no red hearts after taking damage, he gains a shield that nullifies all types of damage for 5 seconds. Allows entrance into ChestChest. (in Repentance) Also allows access to HomeHome. 2
The Relic 5.100.98 The Relic Soul generator Spawns a cross familiar that drops a Soul HeartSoul Heart after clearing enough rooms. 3
The Sad Onion 5.100.1 The Sad Onion Tears up +0.7 tears. 3
The Small Rock 5.100.90 The Small Rock DMG up + speed down +1 damage, +0.2 tears, -0.2 speed. 3
The Soul 5.100.335 The Soul I am all Grants two Soul HeartSoul Hearts. Isaac gains a pulsing aura that repels enemies and projectiles. 3
The Virus 5.100.13 The Virus Poison touch + speed up Isaac poisons enemies on contact. (except in Repentance) -0.1 speed. (in Repentance) +0.2 speed. (in Afterbirth and Afterbirth †) Poisoned enemies have a chance to drop a black heart when killed. 2
The Wafer 5.100.108 The Wafer Damage resistance Most sources of damage that would cause more than one-half heart of damage are reduced to one-half heart instead. 4
There's Options 5.100.249 There's Options More options Two items appear after defeating a Boss. Only one can be taken; the other will disappear. 3
Thunder Thighs 5.100.314 Thunder Thighs HP up + speed down + you feel stompy Destroys rocks upon contact with Isaac. Adds one Red Heart container and lowers Speed. 1
Tiny Planet 5.100.233 Tiny Planet Orbiting tears + range up Massively increases Range and grants spectral tears. Tears orbit around Isaac at a fixed distance until they hit the ground. 0
Tooth Picks 5.100.183 Tooth Picks Tears + shot speed up +0.7 tears, +0.16 shot speed. 3
Torn Photo 5.100.341 Torn Photo Tears + shot speed up +0.7 tears, +0.16 shot speed. 3
Tough Love 5.100.150 Tough Love Tooth shot Adds a chance to shoot a tooth instead of a tear, which deals x3.2 Isaac's damage. 3
Transcendence 5.100.20 Transcendence We all float down here... Grants flight. 3
Treasure Map 5.100.54 Treasure Map Full visible map Reveals the map of each floor. It does not identify special rooms and does not reveal the locations of Secret RoomSecret Rooms / Super Secret RoomSuper Secret Rooms. 2
Trinity Shield 5.100.243 Trinity Shield You feel guarded Isaac gains a shield that protects him from enemy shots. It aims in the direction Isaac fires from. 2
Virgo 5.100.303 Virgo You feel refreshed and protected Adds a chance to give a shield that nullifies all incoming damage for 10 seconds upon taking damage. Also converts bad pills into good pills. 2
Whore of Babylon 5.100.122 Whore of Babylon Curse up Grants +1.5 Damage and +0.3 Speed whenever Isaac has a Half Red HeartHalf Red Heart or less. 2
Wire Coat Hanger 5.100.32 Wire Coat Hanger Tears up +0.7 tears. 3
Wooden Spoon 5.100.27 Wooden Spoon Speed up +0.3 speed. 1
X-Ray Vision 5.100.76 X-Ray Vision I've seen everything Reveals and opens all Secret RoomSecret Room and Super Secret RoomSuper Secret Room entrances. 2
(except in Rebirth) 8 Inch Nails 5.100.359 8 Inch Nails Stick it to 'em! +1.5 damage. Replaces Isaac's tears with nails, which have increased knockback. 3
(except in Rebirth) Athame 5.100.408 Athame Call to the void (except in Repentance) When Isaac takes damage, a damaging black ring briefly appears around him. This ring can cause enemies to drop Black HeartBlack Hearts.
(in Repentance) After Isaac kills an enemy, adds a luck-based chance to spawn a damaging black ring around them.
3
(except in Rebirth) Betrayal 5.100.391 Betrayal Turn your enemy (except in Repentance) Charms all enemies in the room when Isaac takes damage.
(in Repentance) Enemies are able to damage each other. If an enemy is damaged by another enemy, they will attack that enemy instead of Isaac.
1
(except in Rebirth) Binky 5.100.438 Binky Tears up Grants one Soul HeartSoul Heart, +0.75 tears and decreases Isaac's size. 3
(except in Rebirth) Black Powder 5.100.420 Black Powder Spin the black circle! Isaac leaves a trail of black powder on the floor. Walking in a circle will spawn a pentagram symbol on the floor, which deals 10 damage per tick to any enemies inside it. 1
(except in Rebirth) Bomber Boy 5.100.353 Bomber Boy Cross blast + 5 bombs +5 BombBombs. Isaac's bombs will now explode in a large cross-shaped pattern (roughly 5 bombs explosions wide). This also affects player-spawned Troll BombTroll Bombs. 2
(except in Rebirth) Bumbo 5.100.385 Bumbo 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
(except in Rebirth) Bursting Sack 5.100.377 Bursting Sack Spider love Spider enemies no longer target or deal contact damage to Isaac. 1
(except in Rebirth) Cambion Conception 5.100.412 Cambion Conception Feed them hate After taking damage a certain amount of times, a permanent demonic familiar spawns. 2
(except in Rebirth) Car Battery 5.100.356 Car Battery Active power up Causes Isaac's activated item to activate twice on each use. 3
(except in Rebirth) Censer 5.100.387 Censer Peace be with you Spawns a familiar which creates a circular aura that slows down enemies and enemy shots inside. 3
(except in Rebirth) Chaos 5.100.402 Chaos !!! Drops 1-6 random pickups on the floor. Causes items to be chosen from random item pools. 3
(except in Rebirth) Charged Baby 5.100.372 Charged Baby Bbbzzzzzt! Spawns a familiar that occasionally drops a Lil' BatteryLil' Battery, gives an active item charge, or petrifies all enemies in the room. 3
(except in Rebirth) Circle of Protection 5.100.423 Circle of Protection Protect me from myself Surrounds Isaac with a large white halo that occasionally deals Isaac's tear damage to enemies inside it, and can convert enemy shots into friendly homing tears. 2
(except in Rebirth) Continuum 5.100.369 Continuum Transcendent tears Grants spectral tears and increases range. Tears travel through walls and appear at the opposite side of the room. 2
(except in Rebirth) Crack Jacks 5.100.354 Crack Jacks HP up. Don't swallow the prize! Grants one full Red Heart container and drops a random trinket. (in Repentance) Heals 1 additional Red HeartRed Heart. 2
(except in Rebirth) Crown Of Light 5.100.415 Crown Of Light The untainted gain power +2 Soul HeartSoul Hearts. While Isaac has no empty red hearts, grants 2x damage, increased range, and -0.3 shot speed. Regardless of health, the crown deactivates for the current room when Isaac takes damage. 4
(except in Rebirth) Curse of the Tower 5.100.371 Curse of the Tower Embrace chaos Upon taking damage, spawns six Troll BombTroll Bombs around the room, similar to the effect of XVI - The TowerXVI - The Tower. 0
(except in Rebirth) Dead Eye 5.100.373 Dead Eye Accuracy brings power! Isaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot. 3
(except in Rebirth) Deep Pockets 5.100.416 Deep Pockets More money! (except in Repentance) Allows Isaac to carry two cards or pills (or a combination of both) at the same time.
(in Repentance) Increases the coin cap to 999. If a room would otherwise yield no reward, 1-3 coins will spawn.
2
(except in Rebirth) Eden's Blessing 5.100.381 Eden's Blessing Tears up + your future shines brighter +0.7 tears up. Grants a random item at the start of the next run. 3
(except in Rebirth) Empty Vessel 5.100.409 Empty Vessel I reward an empty vessel Grants two Black HeartBlack Hearts. While Isaac has no red hearts, grants flight and periodically grants an invincibility shield for a few seconds. 2
(except in Rebirth) Epiphora 5.100.368 Epiphora Intensifying tears Shooting in one direction increases Isaac's rate of fire until the cap is reached. As soon as Isaac changes direction or stops shooting, rate of fire is reset to its normal amount. 2
(except in Rebirth) Evil Eye 5.100.410 Evil Eye Eye shot! Adds a chance to fire a slow-moving eye that fires tears in the same direction as Isaac. The eye is destroyed when it hits an enemy or obstacle. 2
(except in Rebirth) Explosivo 5.100.401 Explosivo Sticky bomb shot! Isaac's tears have a chance to stick to enemies and explode. 3
(except in Rebirth) Farting Baby 5.100.404 Farting Baby 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
(except in Rebirth) Fate's Reward 5.100.361 Fate's Reward Your fate beside you A blue head familiar that will follow Isaac and fire tears copying his tear effects and damage. 2
(except in Rebirth) Friend Zone 5.100.364 Friend Zone Friendly fly Spawns a white attack fly that orbits somewhere between Collectible Distant Admiration iconDistant Admiration and Collectible Forever Alone iconForever Alone, dealing 45 damage per second. 1
(except in Rebirth) Fruit Cake 5.100.418 Fruit Cake Rainbow effects! Isaac's tears gain a random effect that changes every shot. 2
(except in Rebirth) GB Bug 5.100.405 GB Bug Double tap glitch (except in Repentance) 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.
(in Repentance) 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
(except in Rebirth) Glitter Bombs 5.100.432 Glitter Bombs Prize bombs! +5 BombBombs. Bombs have a chance to drop random pickups or charm enemies when they explode. 2
(except in Rebirth) God's Flesh 5.100.398 God's Flesh Shrink shot! Tears have a chance to shrink enemies, making them run away from Isaac. Shrunk enemies can be crushed and killed by walking over them. 1
(except in Rebirth) Head of the Keeper 5.100.429 Head of the Keeper Penny tears! Isaac's tears become coins and now have a chance to drop Pennies on the floor upon successfully hitting an enemy. 2
(except in Rebirth) Holy Light 5.100.374 Holy Light Holy death shot Adds a chance to fire holy tears, which will create a damaging light beam in the area if they hit an enemy. 3
(except in Rebirth) Host Hat 5.100.375 Host Hat Blast resistance A host familiar that sits on Isaac's head and has a random chance to block enemy shots and retaliate with 3 tears. Grants immunity to explosions. 3
(except in Rebirth) Immaculate Conception 5.100.413 Immaculate Conception Feed them love Upon picking up a certain amount of health, spawn a permanent angelic familiar. 1
(except in Rebirth) Incubus 5.100.360 Incubus Dark friend Spawns a demonic familiar that shoots tears identical to Isaac's in terms of damage, tears, and tear effects. 4
(except in Rebirth) Key Bum 5.100.388 Key Bum He wants your keys! Spawns a familiar that follows Isaac and collects KeyKeys for himself, giving random ChestChests in return. 0
(except in Rebirth) Kidney Stone 5.100.440 Kidney Stone Matt's kidney stone Randomly while firing tears, Isaac will stop firing and turn red, where he will charge and release a lot of 'tears' in one go. The burst of tears also includes a kidney stone, which deals a lot of damage. 2
(except in Rebirth) Lil Chest 5.100.362 Lil Chest 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
(except in Rebirth) Lil Gurdy 5.100.384 Lil Gurdy A gurd of your own! A Boss Gurdy Jr. ingameGurdy Jr. familiar that charges up while Isaac is firing, bouncing around the room when released and dealing contact damage based on its speed. 2
(except in Rebirth) Lil Loki 5.100.435 Lil Loki 4-way buddy! Spawns a Loki familiar that follows Isaac and fires 4 tears in a cross pattern. 1
(except in Rebirth) Lost Fly 5.100.365 Lost Fly Lost protector Spawns fly familiar that moves in a straight line and circles around the first wall or obstacle it hits. (except in Repentance) It deals 105 damage per second on contact. (in Repentance) It deals 56 damage per second and forces nearby enemies to attack it. 2
(except in Rebirth) Lusty Blood 5.100.411 Lusty Blood Their blood brings rage! Isaac's damage increases for the current room each time he kills an enemy. 3
(except in Rebirth) Marked 5.100.394 Marked Directed tears Isaac will automatically fire tears directed at a red target on the ground. The target can be moved with tear controls. +0.7 tears, increases range. 1
(except in Rebirth) Maw Of The Void 5.100.399 Maw Of The Void Consume thy enemy! Charged by firing for 2.5 seconds and when released, creates a black ring around Isaac that rapidly deals damage. (except in Repentance) +1 damage, the ring can cause enemies to drop Black HeartBlack Hearts. 3
(except in Rebirth) Milk! 5.100.436 Milk! Don't cry over it... Spawns a glass familiar that spills on the floor upon taking damage. (except in Repentance) After the milk spills, Isaac's tear delay is decreased by 2 for the current room. (in Repentance) After the milk spills, Isaac's fire rate is increased by 1 for the current room. 1
(except in Rebirth) Mom's Pearls 5.100.355 Mom's Pearls Range + luck up (except in Repentance) +1.25 range, +0.5 tear falling speed, +1 luck.
(in Repentance) +2.5 range, +1 luck. Grants one Soul HeartSoul Heart.
2
(except in Rebirth) More Options 5.100.414 More Options There's options Two item pedestals are presented in every Treasure RoomTreasure Room. Only one can be taken; the other will disappear. 3
(except in Rebirth) Mr. Dolly 5.100.370 Mr Range + tears up (except in Repentance) +0.7 tears, +5.25 range, +0.5 tear falling speed, Spawns a combination of 3 Red HeartRed Hearts, Soul HeartSoul Hearts or Black HeartBlack Hearts on the floor when picked up.
(in Repentance) +0.7 tears, +2.5 range, spawns 3 random types of Red HeartHearts on the floor when picked up.
3
(except in Rebirth) Multidimensional Baby 5.100.431 Multidimensional Baby 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
(except in Rebirth) My Shadow 5.100.433 My Shadow Me! And my shaaaadow! (except in Repentance) Inflicts fear on all enemies in the room upon taking damage and spawns black friendly ChargerChargers that attack enemies.
(in Repentance)Spawns a shadow familiar that closely follows behind Isaac. It spawns a black friendly ChargerCharger whenever an enemy touches it.
2
(except in Rebirth) Night Light 5.100.425 Night Light Scared of the dark? A cone of light shines in the direction Isaac is moving that slows enemies and enemy shots. 1
(except in Rebirth) Number Two 5.100.378 Number Two Uh oh... Continuously firing tears for three seconds causes Isaac to drop a Butt Bomb, which damages and confuses all enemies in the room when it explodes. 2
(except in Rebirth) Obsessed Fan 5.100.426 Obsessed Fan 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
(except in Rebirth) Papa Fly 5.100.430 Papa Fly Turret follower Spawns a familiar that follows Isaac's movements on a 3 second delay, firing tears at nearby enemies. 1
(except in Rebirth) Pay To Play 5.100.380 Pay To Play Money talks (except in Repentance) +5 PennyCoins. Most doors require one PennyPenny to open instead of a KeyKey.
(in Repentance) +5 PennyCoins. All locked doors, Locked ChestLocked Chests, and Key Blocks must be opened with one PennyPenny instead of KeyKeys.
2
(except in Rebirth) PJs 5.100.428 PJs You feel cozy Grants 4 Soul HeartSoul Hearts and fully restores Isaac's health. 2
(except in Rebirth) Pupula Duplex 5.100.379 Pupula Duplex Wide shot Gives Isaac spectral tears and gives his tears a wide arc shape, increasing their size. 2
(except in Rebirth) Purity 5.100.407 Purity Aura stat boost Boosts one of Isaac's stats depending on the color of the aura around him. The aura disappears upon taking damage and reappears with a random color upon entering a new room. Red boosts damage, blue boosts tears, yellow boosts speed, and orange boosts range. 3
(except in Rebirth) Restock 5.100.376 Restock Never ending stores! Causes ShopShops to instantly restock their items when they are bought. (in Repentance) Outside of Greed Mode, the restocked item's cost is increased after each purchase. 2
(except in Rebirth) Rune Bag 5.100.389 Rune Bag Rune generator Spawns a familiar that drops a random rune after clearing enough rooms. 3
(except in Rebirth) Sack Head 5.100.424 Sack Head More sacks! Spawns a Grab BagGrab Bag on pickup. PennyCoins, BombBombs, KeyKeys, cards, runes and batteries have a chance to become Grab BagGrab Bags. 3
(except in Rebirth) Scatter Bombs 5.100.366 Scatter Bombs We put bombs in your bombs! +5 BombBombs. Isaac's bombs explode into 2-4 tiny bombs. 1
(except in Rebirth) Seraphim 5.100.390 Seraphim Sworn friend Spawns an angel familiar who follows Isaac and fires homing tears which deal 10 damage and have 75% shot speed. 3
(except in Rebirth) Serpent's Kiss 5.100.393 Serpent's Kiss The kiss of death Tears have a chance to apply a poison effect to enemies. Isaac poisons enemies on contact. Poisoned enemies have a chance to drop a Black HeartBlack Heart when killed. 2
(except in Rebirth) Spear Of Destiny 5.100.400 Spear Of Destiny Your destiny In addition to tears, Isaac holds a spear in front of him which deals contact damage equal to 2x his tear damage, and occasionally inflicts fear. 2
(except in Rebirth) Spider Mod 5.100.403 Spider Mod 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' BatteryLil' Battery/Blue spider upon clearing a room. 1
(except in Rebirth) Sticky Bombs 5.100.367 Sticky Bombs Egg sack bombs! +5 BombBombs. Bombs stick to enemies and spawn 2-4 Blue Spiders if they kill an enemy. (in Repentance) They also leave a long-lasting puddle of slowing white creep. 2
(except in Rebirth) Succubus 5.100.417 Succubus 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
(except in Rebirth) Sworn Protector 5.100.363 Sworn Protector 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 HeartEternal Heart. 3
(except in Rebirth) Tech X 5.100.395 Tech X Laser ring tears Tears are replaced with laser rings that pierce through enemies and deal damage to enemies within them. Can be charged to increase the effectiveness of the ring. 4
(except in Rebirth) The Wiz 5.100.358 The Wiz Double wiz shot! Grants spectral tears. Tears simultaneously fire out of both eyes diagonally, similar to the effect of the R U a Wizard? pill. 0
(except in Rebirth) Toxic Shock 5.100.350 Toxic Shock Mass poison Upon entering a room, poisons all enemies, dealing double Isaac's tear damage. Killing enemies leaves a small, short-lasting pool of green creep on the ground. 3
(except in Rebirth) Tractor Beam 5.100.397 Tractor Beam Controlled tears Isaac's tears are bound to a beam emitting in the direction he's firing. (except in Repentance) +0.5 Tears, +5.25