Binding of Isaac: Rebirth Wiki
Binding of Isaac: Rebirth Wiki

Items are an integral part of the game-play 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. Added in Afterbirth Afterbirth added 95 new items, for a total of 436 items. Added in Afterbirth † Afterbirth † added 111 new items, for a total of 547 items. Added in Repentance Repentance added 169 new items, for a total of 716 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 Added in Afterbirth †15►Schoolbag Schoolbag, 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 15►How to Jump How 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.

Added in RepentanceIn 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. Otherwise, they function the same as other activated items.

Name ID Icon Quote Description Added in Repentance Quality
A Pony 5.100.130
A Pony
2 rooms
Flight + dash attack Passively gives flight and increases speed to 1.5. Upon use, Isaac charges in the direction the pony is facing, giving invincibility during the charge and dealing 40 damage. 2
Anarchist Cookbook 5.100.65
Anarchist Cookbook
3 rooms
Summon bombs Spawns six Troll Bombs around the room. 1
Best Friend 5.100.136
Best Friend
3 rooms
Friends 'till the end Spawns a decoy Isaac that eventually explodes with an increased blast radius. 1
Blank Card 5.100.286
Blank Card
Variable
Card mimic Removed in Repentance Has the same effect as the card or rune currently held by Isaac.
Added in Repentance Has the same effect as the card currently held by Isaac.
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. 0
Bob's Rotten Head 5.100.42
Bob's Rotten Head
2 rooms
Reusable ranged bomb Upon use, Isaac holds a poison bomb 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 Gives one Soul Heart, increases the chance for a Devil or Angel Room, and changes the boss of the current floor to a Harbinger if possible. 3
Book of Secrets 5.100.287
Book of Secrets
6 rooms
Tome of knowledge Gives the effect of 15►Treasure Map Treasure Map, 15►The Compass The Compass, or 15►Blue Map Blue Map for the duration of the current floor. 0
Book of Shadows 5.100.58
Book of Shadows
3 rooms
Temporary invincibility Creates a protective shield, nullifying all types of damage for 10 seconds. 2
Box of Spiders 5.100.288
Box of Spiders
2 rooms
It's a box of spiders Removed in Repentance Spawns 1-4 Blue Spiders that deal 2.5x damage to enemies.
Added in Repentance Spawns 4-8 Blue Spiders that deal 2x damage to enemies.
1
Breath of Life 5.100.326
Breath of Life
6 seconds
Invincibility at a cost Grants a brief moment of invincibility when the charge bar hits zero. If the spacebar is held for an additional second after hitting zero, Isaac will take damage. 0
Butter Bean 5.100.294
Butter Bean
3 seconds
Reusable knock-back Upon use, Isaac farts and knocks back nearby enemies Added in Afterbirth and projectiles. Added in Repentance Enemies pushed into walls or obstacles take 12 damage. 0
Converter 5.100.296
Converter
Unlimited
Convert your soul Removed in Repentance Upon use, converts two Soul Hearts into one full Heart Container.

Added in Repentance Upon use, converts one Soul or Black Heart into one full Heart Container.

1
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 Room) and drops a Soul Heart or random card/rune. 2
D10 5.100.285
D10
1 rooms
Reroll enemies Rerolls the monsters in the room. Only rerolls monsters that are still alive (does not spawn new enemies). 0
D100 5.100.283
D100
6 rooms
REEROLLLLL! Removed in Repentance Combines the effects of 15►D4 D4, 15►The D6 The D6, and 15►D20 D20.
Added in Repentance Combines the effects of 15►D1 D1, 15►D4 D4, 15►The D6 The D6, 15►D7 D7, 15►D8 D8, 15►D10 D10, 15►D12 D12, and 15►D20 D20.
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. 3
Dad's Key 5.100.175
Dad's Key
2 rooms
Opens all doors... Opens all doors in the current room when activated, including doors which require a key to open and entrances to Secret Rooms. Opens the big doors in the first room of both Chest Chest and the Dark Room Dark Room. 1
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. 1
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 poop. Instantly kills poop-themed bosses. 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 rooms
Reusable fly hive Spawns 2-4 friendly Blue Flies that damage enemies. 3
Guppy's Paw 5.100.133
Guppy's Paw
Unlimited
Soul converter Upon use, converts one Heart Container into three Soul Hearts. 3
Head of Krampus 5.100.293
Head of Krampus
3 rooms
Krampus rage Fires a powerful 15►Brimstone Brimstone beam in four cardinal directions, much like Krampus shoots.

Added in Afterbirth / Removed in Afterbirth † Fires a powerful 15►Brimstone Brimstone beam in four cardinal directions, much like Krampus 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. Each tear shot by Isaac increases item charge by one. 0
IV Bag 5.100.135
IV Bag
Unlimited
Portable blood bank Upon use, Isaac loses half a heart of health (one in Womb Womb onward) for a random amount of coins, similar to a Blood Donation Machine. 1
Kamikaze! 5.100.40
Kamikaze!
Unlimited
Become the bomb! Upon use, creates an explosion in the same place as Isaac, damaging him for half a heart of health and dealing Removed in Repentance40 damage/Added in Repentance185 damage to all enemies caught in the blast. 0
Lemon Mishap 5.100.56
Lemon Mishap
2 rooms
Oops... Creates a tiny pool of yellow creep, damaging enemies that cross it. 1
Magic Fingers 5.100.295
Magic Fingers
Unlimited
Pay to win Uses 1 coin to deal twice Isaac's damage Added in Repentance + 10 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 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 around 4 seconds. 1
Mom's Pad 5.100.41
Mom's Pad
3 rooms
Mass fear Inflicts fear to all enemies in the room for 5 seconds. 0
Monster Manual 5.100.123
Monster Manual
6 rooms
Temporary buddy generator Removed in Repentance Spawns a familiar from a specific selection for the current room.

Added in Repentance Spawns a familiar from a specific selection for the current floor.

0
Monstro's Tooth 5.100.86
Monstro's Tooth
3 rooms
Summon Monstro A friendly Monstro jumps on a random enemy, dealing 120 area damage. Lands on Isaac if used in a room without enemies. 1
Mr. Boom 5.100.37
Mr. Boom
2 rooms
Reusable bomb buddy Places a Mr. Mega bomb that deals 110 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 40 contact damage to enemies. 1
Notched Axe 5.100.147
Notched Axe
Unlimited
Rocks don't stand a chance Removed in Repentance Isaac destroys obstacles and opens Secret Rooms by walking into them, but cannot shoot or pick up items until it's cancelled.

Added 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.

0
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 coin and has a chance to drop a random pickup, like a slot machine. 0
Prayer Card 5.100.146
Prayer Card
6 rooms
Reusable eternity Gives an Eternal Heart per use. 3
Razor Blade 5.100.126
Razor Blade
Unlimited
Feel my pain On use, takes one heart of health and grants +1.2 damage for the current room. 0
Red Candle 5.100.289
Red Candle
4 seconds
Flame on Throws a flame that that can pass over gaps (but not through obstacles). The flame 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 Bombs 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 Heart. Added 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 Removed in Repentance Turns Isaac's head into a stationary familiar for the current room which fires tears automatically.

Added in Repentance Turns Isaac's head into a stationary familiar for the current room which fires tears automatically, while causing Isaac to shoot a controllable fountain of blood shots.

0
Shoop Da Whoop! 5.100.49
Shoop Da Whoop!
2 rooms
BLLLARRRRGGG! Fires a laser from Isaac's mouth. 1
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. 1
Tammy's Head 5.100.38
Tammy's Head
1 rooms
Reusable tear burst Shoots 10 tears in a circle around Isaac, which retain the damage, shot speed, and special effects (such as poison) of Isaac's tears. 3
Telepathy for Dummies 5.100.192
Telepathy for Dummies
2 rooms
Temporary psychic shot Gives homing tears for the current room. 0
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 rooms
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 Mom, Mom's Heart, and It Lives when activated, but kills Isaac when used on Satan. 1
The Book of Belial 5.100.34
The Book of Belial
3 rooms
Temporary DMG up +2 damage for the current room.
Removed in Afterbirth Guarantees a Devil Room or Angel Room will be open after beating a boss while holding it. Added in Afterbirth Increases the chance by 12.5%.
3
The Book of Sin 5.100.97
The Book of Sin
4 rooms
Reusable item generator Spawns a random pickup, pill, card, or trinket. 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 temporary flame that can pass over gaps (but not through rocks). The flame damages anything in its path. 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 into a Pac-Man-like creature for 6 seconds, granting invulnerability, inflicting fear on all enemies, and replenishing a Half Red Heart for every two enemies killed. 2
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 Hearts can be stored in The Jar. 0
The Nail 5.100.83
The Nail
6 rooms
Temporary demon form Gives Removed in Repentance one Soul Heart Added in Repentance half a Black Heart. For the current room; +0.7 damage, -0.18 speed, allows Isaac to break rocks and damage enemies by walking over them. 3
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 Gives flight for the current room, while turning Isaac's body into a fast, high damage familiar. 3
The Poop 5.100.36
The Poop
1 rooms
Plop! Spawns a pile of poop 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 Room, Super Secret Room, Treasure Room, or I AM ERROR. 2
Unicorn Stump 5.100.298
Unicorn Stump
1 rooms
You feel stumped Gives invulnerability and increased speed for five 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. 0
White Pony 5.100.181
White Pony
2 rooms
Flight + holy death Passively gives 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 40 damage while also casting the effect of Crack the Sky. 2
Yum Heart 5.100.45
Yum Heart
4 rooms
Reusable regeneration Restores one Red Heart of Isaac's health. 1
Added in Afterbirth 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 15►Demon Baby Demon Baby for the room instead. 1
Added in Afterbirth D12 5.100.386
D12
3 rooms
Rerolls rocks Re-rolls all rocks in the current room into other random objects, such as bomb rocks, metal blocks, TNT, or poops. 0
Added in Afterbirth 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
Added in Afterbirth D8 5.100.406
D8
4 rooms
Reroll stats Re-rolls Isaac's damage, tears, range, and speed. 2
Added in Afterbirth Diplopia 5.100.347
Diplopia
One time use
Double item vision Duplicates all pickups and item pedestals in the room. 3
Added in Afterbirth 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
Added in Afterbirth Glass Cannon 5.100.352
Glass Cannon
4 seconds
Be gentle... Removed in Repentance Fires a high-damage piercing spectral tear, but lowers Isaac's health to half a heart.
Added in Repentance Fires a high-damage piercing spectral tear. If Isaac takes damage while holding this, he takes extra damage and it becomes 15►Broken Glass Cannon Broken Glass Cannon.
1
Added in Afterbirth Glowing Hour Glass 5.100.422
Glowing Hour Glass
3 rooms
Turn back time When used, this item will rewind time, put Isaac back in the previous room, and undo anything that happened in the current room. Any health, pickups, or items gained or lost will be reset back to the previous state. 1
Added in Afterbirth 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
Added in Afterbirth Kidney Bean 5.100.421
Kidney Bean
1 rooms
Love toots! Isaac farts, charming all nearby enemies. 0
Added in Afterbirth Mega Bean 5.100.351
Mega Bean
3 rooms
Giga fart! Petrifies all enemies in the current room for a couple of seconds, poisons any enemies near Isaac, and sends a rock wave across the room in the direction Isaac is facing. 1
Added in Afterbirth 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. 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
Added in Afterbirth Mine Crafter 5.100.427
Mine Crafter
1 rooms
Booom! Places an explosive TNT barrel that can be pushed and used to destroy rocks or damage enemies when used. If used a second time in the same room while the previous TNT barrel is still intact, it will remotely explode the TNT. 1
Added in Afterbirth Mom's Box 5.100.439
Mom's Box
4 rooms
What's inside? Passively increases luck by 1 and doubles the effects of trinkets while held. When used, drops a random trinket on the ground. 3
Added in Afterbirth Placebo 5.100.348
Placebo
Variable
Pill mimic When used, copies the effect of the pill Isaac is currently holding without consuming it. Does not copy the effects of cards or runes. 2
Added in Afterbirth Tear Detonator 5.100.383
Tear Detonator
16 seconds
Remote tear detonation! When used, will detonate any tears currently on the screen and cause each one to split into 6 more tears which will fire in a circle, similar to Tammy's Head. 1
Added in Afterbirth Teleport 2.0 5.100.419
Teleport 2.0
4 rooms
I-Teleport! Teleports Isaac to a random room that has not been explored yet when used. If all rooms are explored, including secret rooms, it will teleport Isaac to the Devil or Angel room. If all rooms are explored, including the Devil or Angel room, it will teleport Isaac to the I AM ERROR room. If used in a room with enemies, it will teleport Isaac out and back into the same room. 2
Added in Afterbirth Ventricle Razor 5.100.396
Ventricle Razor
Unlimited
Short cutter Can be used to place an orange portal and a blue portal. Upon entering a portal, Isaac is teleported to the other portal. 1
Added in Afterbirth Wooden Nickel 5.100.349
Wooden Nickel
1 rooms
Flip a coin When used, has a 50% chance to drop one random type of coin (Penny, Nickel, or Dime). 1
Added in Afterbirth † 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. 1
Added in Afterbirth † Book of the Dead 5.100.545
Book of the Dead
6 rooms
Rise from the grave Upon use, spawns a friendly Bony or an orbital bone for each enemy killed in the current room. 2
Added in Afterbirth † Broken Shovel 5.100.550
Broken Shovel
4 rooms
It feels cursed While held, causes multiple Mom's Foots to come down and stomp on Isaac. One of two parts necessary to create Mom's Shovel. 4
Added in Afterbirth † Brown Nugget 5.100.504
Brown Nugget
7 seconds
Friendly fly Spawns a stationary fly turret that fires tears at nearby enemies. 0
Added in Afterbirth † Clicker 5.100.482
Clicker
6 rooms
Change Transforms Isaac into a random character and removes the last item collected. 0
Added in Afterbirth † 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. 2
Added in Afterbirth † Coupon 5.100.521
Coupon
6 rooms
Allow 6 weeks for delivery Upon use, makes a random item from a Shop, Devil deal, or Black Market free. 2
Added in Afterbirth † 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. 1
Added in Afterbirth † D Infinity 5.100.489
D Infinity
Variable
Reroll forever Removed in Repentance Grants a random dice item that changes each use.
Added in Repentance Acts as any dice item, and can by cycled by pressing the drop key.
1
Added in Afterbirth † D1 5.100.476
D1
4 rooms
What will it be? Duplicates a random pickup in the room. 2
Added in Afterbirth † Dataminer 5.100.481
Dataminer
4 rooms
109 Displaces enemy sprites for the current room, randomly increases one stat and decreases another. 0
Added in Afterbirth † Delirious 5.100.510
Delirious
12 rooms
Unleash the power! Spawns Delirium as a random friendly boss that fights for Isaac. 1
Added in Afterbirth † 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
Added in Afterbirth † Eden's Soul 5.100.490
Eden's Soul
12 rooms
... Spawns two item pedestals then is consumed. Begins with no charges. 3
Added in Afterbirth † 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 doors to the floor's Secret and Super Secret Rooms. 3
Added in Afterbirth † Metronome 5.100.488
Metronome
2 rooms
Waggles a finger Grants a random item effect for the current room. 0
Added in Afterbirth † Mom's Shovel 5.100.552
Mom's Shovel
4 rooms
Lost but not forgotten Spawns a trapdoor that leads to the next floor upon activation. Unlocks The Forgotten when used on a mound of dirt that appears in Dark Room Dark Room. 4
Added in Afterbirth † Moving Box 5.100.523
Moving Box
4 rooms
Pack and unpack If the box is empty, picks up all 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. 1
Added in Afterbirth † Mr. ME! 5.100.527
Mr. ME!
4 rooms
Caaan do! Summons a controllable ghost that can perform various tasks depending on what it targets. 3
Added in Afterbirth † 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 A Lump of Coal or The Poop instead. 3
Added in Afterbirth † Pause 5.100.478
Pause
2 rooms
Stop! Freezes all enemies until a fire button is pressed. 1
Added in Afterbirth † 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
Added in Afterbirth † Potato Peeler 5.100.487
Potato Peeler
Unlimited
A pound of flesh Removes a heart container, increases damage and range, and grants a Cube of Meat. 3
Added in Afterbirth † Sacrificial Altar 5.100.536
Sacrificial Altar
One time use
He demands a sacrifice Sacrifices up to 2 familiars and spawns an item from the Devil Room pool for each familiar sacrificed. Converts all friendly spiders and flies into coins. 2
Added in Afterbirth † Sharp Straw 5.100.507
Sharp Straw
10 seconds
More blood! Damages all enemies in the room. Has a chance to drop a half red heart Removed in Repentanceor half soul heart if an enemy is hit. 2
Added in Afterbirth † Smelter 5.100.479
Smelter
6 rooms
Trinket melter! Consumes Isaac's currently held trinket and applies its effect permanently. 3
Added in Afterbirth † Sprinkler 5.100.516
Sprinkler
4 rooms
Sprinkles. Upon use, spawns a sprinkler that rotates and fires tears. 2
Added in Afterbirth † Telekinesis 5.100.522
Telekinesis
3 seconds
Power of the mind Upon use, for the next two seconds, any enemy shots that come near Isaac are held in place. After the charge is depleted, they are fired back as tears. 1
Added in Afterbirth † 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 stat upgrades. 4
Added in Afterbirth † Wait What? 5.100.484
Wait What?
10 seconds
I can't believe it's not butter bean! Isaac farts, sending out rock waves. 0
Added 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. 4
Added in Repentance Alabaster Box 5.100.585
Alabaster Box
12 rooms
A sacred offering Spawns three soul hearts and two Angel room items and is consumed. Starts with no charges, and can only be charged by picking up 6 soul hearts. 2
Added in Repentance Anima Sola 5.100.722
Anima Sola
15 seconds
Repent Chains down the nearest enemy for 5 seconds, preventing them from acting. 2
Added in Repentance Bag of Crafting 5.100.710
Bag of Crafting
Unlimited
Make your destiny Collects and holds up to 8 pickups. Holding the activate button crafts them into a passive item, with the power level based on the quality of pickups used. 3
Added 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. 3
Added in Repentance Book of Virtues 5.100.584
Book of Virtues
4 rooms
Spiritual companionship On use, spawns an orbital Wisp familiar that fires spectral tears but can be destroyed. Also becomes a passive item that causes other active items to spawn themed Wisps. 3
Added in Repentance Broken Glass Cannon 5.100.474
Broken Glass Cannon
4 rooms
You broke it! Begins with no charges and turns into 15►Glass Cannon Glass Cannon when used. Only acquired by taking damage while holding Glass Cannon. 0
Added 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. 2
Added 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
Added in Repentance Dark Arts 5.100.705
Dark Arts
6 seconds
One with the shadows Makes Isaac invulnerable and intangible for one second. When the effect ends, all enemies Isaac ran through take damage and Isaac temporarily gains +1 damage for each one. 2
Added in Repentance Death Certificate 5.100.628
Death Certificate
One time use
Where am I? Takes Isaac to an abandoned and expanded version of Home, 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
Added 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
Added in Repentance Eraser 5.100.638
Eraser
1 rooms
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
Added in Repentance Esau Jr. 5.100.703
Esau Jr.
1 rooms
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
Added in Repentance Eternal D6 5.100.609
Eternal D6
2 rooms
??? Rerolls all items in the room. Each item has a chance to disappear instead. 2
Added 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. 2
Added in Repentance Flip 5.100.711
Flip
6 rooms
Life and death Switch characters between Tainted Lazarus and Dead Tainted Lazarus. 3
Added in Repentance Fortune Cookie 5.100.557
Fortune Cookie
2 rooms
Reusable fortunes Gives Isaac a fortune, soul heart, tarot card, or trinket. 2
Added in Repentance Free Lemonade 5.100.578
Free Lemonade
4 rooms
Party time! Creates a large pool of yellow creep beneath Isaac. 2
Added 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
Added 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. 2
Added 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 chests and a trapdoor to the next floor. For every item Isaac lost, he gets to take an item from a set of three. 2
Added in Repentance Golden Razor 5.100.555
Golden Razor
Unlimited
Pain from gain Spends five coins to increase Isaac's damage by 1.2 for the current room. 2
Added in Repentance Hold 5.100.715
Hold
Unlimited
Saved for later Exclusive to Tainted ??? Tainted ???. Allows him to save one poop bomb for later, allowing him to gather more over time. 0
Added 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
Added 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. 3
Added 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
Added in Repentance Lemegeton 5.100.712
Lemegeton
6 rooms
Item summoner Spawns the ghost of a random passive item, which orbits Isaac but can be destroyed. While the ghost is alive, Isaac gains that item's effects. 3
Added in Repentance Magic Skin 5.100.642
Magic Skin
6 rooms
All your desires fulfilled Consumes one heart container or two soul 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
Added 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
Added 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
Added in Repentance Mom's Bracelet 5.100.604
Mom's Bracelet
Unlimited
Mother's strength Lets Isaac pick up and throw rocks, TNT, poops, and other obstacles. 2
Added in Repentance Plum Flute 5.100.650
Plum Flute
4 rooms
Play time! Summons the boss Baby Plum to fight for Isaac in the current room. 2
Added 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
Added in Repentance Recall 5.100.714
Recall
3 seconds
Come back Retrieves the Forgotten's body from any distance. Only available as the 15►Birthright Birthright effect for Tainted Forgotten Tainted Forgotten. 0
Added in Repentance Red Key 5.100.580
Red Key
4 rooms
Explore the other side Creates a new room adjacent to a viable wall, indicated by the outline of a door. These rooms have a chance to be various special rooms. 3
Added in Repentance Sharp Key 5.100.623
Sharp Key
Unlimited
Open your enemies Adds 5 keys on pickup. Allows Isaac to throw his keys to deal damage to enemies, destroy obstacles, and open doors. 1
Added 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
Added in Repentance Spindown Dice 5.100.723
Spindown Dice
6 rooms
-1 Transforms all items in the room by decreasing their internal ID number. 4
Added 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
Added in Repentance Sulfur 5.100.556
Sulfur
3 rooms
Temporary demon form Grants 15►Brimstone Brimstone for the current room. 2
Added in Repentance Sumptorium 5.100.713
Sumptorium
1 seconds
Return Holding down the fire button converts hearts into familiars that fire tears but can be destroyed. Activating converts the familiars back into hearts. 3
Added in Repentance Suplex! 5.100.709
Suplex!
6 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. 3
Added in Repentance The Scooper 5.100.605
The Scooper
3 rooms
Plop! Summons a Peeper familiar for the current room, which leaves a trail of red creep. 0
Added 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
Added in Repentance Vade Retro 5.100.653
Vade Retro
Unlimited
Begone! While held, enemies leave behind ghosts on death. Using the item causes the ghosts to explode, dealing damage to nearby enemies. Stronger enemies leave bigger ghosts. 3
Added in Repentance Wavy Cap 5.100.582
Wavy Cap
0.5 seconds
Tears up. A mind changing experience! Increases tears, decreases speed, and distorts the screen. All effects become more pronounced with repeated use, and wear off by clearing rooms. 1
Added in Repentance Yuck Heart 5.100.639
Yuck Heart
6 rooms
Gross! Gives Isaac a Rotten Heart. 3

Passive Collectibles

An unlimited amount of passive collectibles can be held at a time, and the effects they grant are permanent. Their effects are vast and diverse, from simple stat and health increases to completely changing the way Isaac's tears behave.

Name ID Icon Quote Description Added 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 2
<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 and lose the 1up!. 2
20/20 5.100.245 20/20 Double shot Isaac fires two tears at once, one from each eye. 4
3 Dollar Bill 5.100.191 3 Dollar Bill Rainbow tears Removed in Afterbirth Gives Isaac a random tear effect every room.
Added in Afterbirth 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 coins. 2
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 coins. 2
A Snack 5.100.346 A Snack HP up Grants one full Red Heart container. Added in Repentance Heals 1 additional heart of health. 1
Abaddon 5.100.230 Abaddon Evil + DMG up + fear shot Removed in Repentance+1.5 damage, +0.2 speed. Removes all Red Heart containers, grants six Black Hearts, and adds a chance to shoot fear tears.
Added in Repentance+1.5 damage, +0.2 speed. Grants two Black Hearts, converts all Red Heart containers into Black Hearts, and adds a chance to shoot fear tears.
4
Abel 5.100.188 Abel Mirrored buddy Spawns a familiar that mirrors Isaac's movements and shoots in the opposite direction. 0
Anemic 5.100.214 Anemic Toxic blood Increases range. After Isaac is damaged, a trail of red creep will be left behind him until he leaves the current room. 0
Ankh 5.100.161 Ankh Eternal life? Upon death, the player will respawn as ??? ??? with 3 Soul Hearts. 2
Anti-Gravity 5.100.222 Anti-Gravity Anti-gravity tears + tears up -2 Tear Delay. Tears float in position until firing ceases, after which they will fly off in the direction they were shot in. 3
Aquarius 5.100.308 Aquarius Trail of tears A trail of blue creep is left behind Isaac, which damages enemies. 0
Aries 5.100.300 Aries Ramming speed +0.25 Speed. Running into enemies while at a high speed will deal damage. Removed in Repentance Does not prevent contact damage. 1
Ball of Bandages 5.100.207 Ball of Bandages Gotta lick 'em all! Spawns an orbital familiar that blocks enemy shots, dealing 105 damage per second. Collecting additional copies gives it the ability to shoot charm tears, then chase enemies, then increases the damage. 2
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 15►Forever Alone Forever Alone for the current room dealing Removed in Repentance75 Added in Repentance150 damage per second. 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 Heart. Increases the chance for a Devil or Angel Room to appear. 3
Black Lotus 5.100.226 Black Lotus HP up x3! Grants one Red Heart, one Soul Heart, and one Black Heart. 2
Blood Bag 5.100.119 Blood Bag HP up Grants one Red Heart container, restores 5 Red Hearts, and increases speed by 0.3. 2
Blood Clot 5.100.254 Blood Clot DMG + range up Tears fired from the left eye have +1 flat damage, +5 range, and +0.5 tear height. 2
Blood of the Martyr 5.100.7 Blood of the Martyr DMG up Increases damage by 1, and turns Isaac's tears into 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. 3
Blue Cap 5.100.342 Blue Cap HP + tears up + shot speed down Removed in Repentance Gives one full Red Heart container, +0.7 tears, and -0.16 shot speed.

Added in Repentance Gives one Red Heart container, 2 Hearts of health, +0.7 tears, and -0.16 shot speed.

3
Blue Map 5.100.246 Blue Map Secrets Shows Secret and Super Secret Room locations 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 Gives 5 bombs and grants Isaac's bombs a poison effect. 1
Bobby-Bomb 5.100.125 Bobby-Bomb Homing bombs! +5 bombs. Bombs gain a homing effect, slowly moving towards the nearest enemy. 2
Bogo Bombs 5.100.250 Bogo Bombs 1+1 BOOM! All Bomb pickups become Double Bombs. 1
Bomb Bag 5.100.131 Bomb Bag Gives bombs Spawns a familiar that drops a bomb every 3 rooms. 2
Boom! 5.100.19 Boom! 10 bombs Grants 10 bombs. 0
Box 5.100.198 Box Stuff Spawns various pickups: 1 coin, 1 key, 1 bomb, 1 Red Heart, 1 card/rune, 1 pill and 1 trinket. 1
Breakfast 5.100.25 Breakfast HP up Grants one full Red Heart container. Added in Repentance Heals 1 additional heart of health. 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 Chance upon entering a room to slow down or speed up every enemy and their attacks. The chance to slow enemies is quite higher than the chance to speed them up. 1
Brother Bobby 5.100.8 Brother Bobby Friends 'till the end A familiar that follows Isaac around shooting normal tears. 0
Bucket of Lard 5.100.129 Bucket of Lard HP up Grants two Removed in Repentanceempty Added in Repentancefull Red Heart containers and heals Isaac by half a Red Heart, but decreases speed by 0.2. 1
Bum Friend 5.100.144 Bum Friend He's greedy Spawns a familiar that picks up coins for himself, giving random pickups in return. Does not spawn collectibles. 0
Butt Bombs 5.100.209 Butt Bombs Toxic blast +5 bombs +5 bombs. 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 Spawns a familiar that floats slowly around the room on a zig-zag pattern similar to The Peeper and shoots normal tears in the same direction as Isaac. 0
Cancer 5.100.301 Cancer HP up + you feel protected Adds 3 Soul Hearts. Grants {{i{The Wafer}} effect for the current room upon taking damage. 3
Capricorn 5.100.307 Capricorn All stats up Increases health, damage, speed, and range, lowers tear delay, and gives one coin, bomb, and key. 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 15►Book of Shadows Book 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 Hearts, and +1 damage. 3
Champion Belt 5.100.208 Champion Belt DMG + challenge up Increases damage, but also increases the chance of champion enemies appearing. 3
Charm of the Vampire 5.100.62 Charm of the Vampire Kills heal Heals Isaac for half of a Red Heart for every 13 enemies killed. Added in Repentance +0.3 damage. 0
Chemical Peel 5.100.154 Chemical Peel DMG up Tears fired from the left eye have +2 flat damage. 1
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 Grants -1 tear delay and reduces range. When tears hit an object or deplete their range, they spawn 4 smaller tears, whose range and damage scale with Isaac's. 3
Cricket's Head 5.100.4 Cricket's Head DMG up Increases damage by 0.5, and multiplies it by 1.5x. 4
Cube of Meat 5.100.73 Cube of Meat Gotta meat 'em all! Spawns an orbital familiar that blocks enemy shots, dealing 105 damage per second. Collecting additional copies grants it the ability to shoot, then chase enemies, then increases the damage. 2
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 Hearts for himself. For every 1½ Red Hearts collected, Dark Bum will give a Removed in RepentanceSoul Heart, a Black Heart, a hostile Spider, a friendly Blue Spider, Added in Repentance or a random card, rune, or pill. 4
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 ~5 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. Added in Repentance Heals 1 additional heart of health. 1
Dinner 5.100.23 Dinner HP up Grants one full Red Heart container. Added in Repentance Heals 1 additional heart of health. 1
Distant Admiration 5.100.57 Distant Admiration Attack fly Spawns an attack fly that circles further out than 15►Halo of Flies Halo of Flies, but closer than 15►Forever Alone Forever Alone, dealing 75 damage per second. 2
Dr. Fetus 5.100.52 Dr. Fetus ??? Tears are replaced by bombs 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 15►The Necronomicon The Necronomicon effect. 3
E Coli 5.100.236 E Coli Turdy touch Enemies that touch Isaac are transformed into poop. 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 15►Doctor's Remote Doctor's Remote. 4
Eve's Mascara 5.100.310 Eve's Mascara DMG up, tears + shot speed down Doubles damage, halves tears stat, and greatly reduces shot speed. 1
Experimental Treatment 5.100.240 Experimental Treatment Some stats up, some stats down Removed in Afterbirth † Randomly increases and decreases some of Isaac's stats.
Added in Afterbirth † 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 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 ~8 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 Heart when taking damage. Enemies have a chance to drop a Half 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 Room / Angel 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 Grants homing tears with a damaging halo. +0.5 damage, -0.3 tears, +1.2 range, -0.3 shot speed, +0.8 tear height. 4
Growth Hormones 5.100.70 Growth Hormones Speed + DMG up +1 damage, Removed in Repentance +0.4 speed, Added in Repentance +0.2 speed. 3
Guardian Angel 5.100.112 Guardian Angel Extra protection Spawns an orbital familiar that blocks enemy shots, deals 105 damage per second to enemies, and increases the speed of all orbital familiars. 2
Guillotine 5.100.206 Guillotine DMG + tears up. An out-of-body experience! Isaac's head is removed from his body and floats around him as an orbital. Gives +1 damage and grants -1 tear delay. 3
Guppy's Collar 5.100.212 Guppy's Collar Eternal life? Grants a permanent 50% chance to respawn with 1/2 of a Red Heart after death. 2
Guppy's Hair Ball 5.100.187 Guppy's Hair Ball 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 chest and a 1/3 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. 3
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. 3
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. Added 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. 3
Holy Mantle 5.100.313 Holy Mantle Holy shield Upon entering a room, grants a shield that negates the first damage taken. 4
Holy Water 5.100.178 Holy Water Splash! Removed in Repentance Spawns a bottle familiar that breaks when Isaac takes damage, leaving a puddle of blue creep.
Added 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.
0
Hot Bombs 5.100.256 Hot Bombs Burning blast +5 bombs Grants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact. 1
Humbling Bundle 5.100.203 Humbling Bundle 1+1 free 4Evar Removed in Repentance Replaces all regular red hearts, pennies, keys, and bombs with double versions worth twice as much.
Added in Repentance Regular red hearts, pennies, keys, and bombs have a chance to be replaced with double versions worth twice as much.
3
Infamy 5.100.242 Infamy Blocks damage... sometimes Chance to block projectiles coming from any direction. 2
Infestation 5.100.148 Infestation Fly revenge Removed in Repentance 1-3 Blue Flies randomly spawn every time Isaac gets hit.
Added in Repentance 2-6 Blue Flies randomly spawn every time Isaac gets hit.
0
Infestation 2 5.100.234 Infestation 2 Infestation shot Spawns allied Blue Spiders from killed enemies. 4
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 Increases damage by 0.3 and adds a chance to shoot concussive tears, causing enemies to walk around randomly. 3
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. Added 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 +0.5 damage, +0.25 range, +0.5 tear height. 2
Judas' Shadow 5.100.311 Judas' Shadow Sweet revenge Adds an extra life; upon death, it respawns Isaac as Dark Judas Dark Judas with two Black Hearts. 4
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 Key Piece 2, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan. 0
Key Piece 2 5.100.239 Key Piece 2 ??? Combined with Key Piece 1, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan. 0
Latch Key 5.100.343 Latch Key Luck up Grants 1 Soul Heart and +1 luck. Spawns 2 Keys. 2
Lazarus' Rags 5.100.332 Lazarus' Rags Eternal life? Upon dying, resurrect as Lazarus Risen Lazarus Risen with one heart container and Anemic. 1
Leech 5.100.270 Leech Blood sucker Spawns a leech familiar that chases enemies, dealing ~3 damage per second. Heals a Half Red Heart whenever Leech kills an enemy. 1
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 coins, 6 bombs, and 6 keys and balances out all attributes. 1
Lil Brimstone 5.100.275 Lil Brimstone Evil friend Grants a familiar that charges a thin 15►Brimstone Brimstone laser while Isaac is shooting. 3
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. 1
Little C.H.A.D. 5.100.96 Little C.H.A.D. Gives kisses Spawns a familiar who drops a Half Red Heart every 3 rooms. 2
Little Chubby 5.100.88 Little Chubby Attack buddy Spawns a charger familiar that charges forward and deals contact damage to any enemies in its path. 1
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. 1
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. -0.16 shot speed. 2
Lucky Foot 5.100.46 Lucky Foot Luck up +1 luck. Increases chance of winning Shell Games and Fortune Tellers (independent from the luck stat).
Added 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. Added in Repentance Heals 1 additional heart of health. 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 Hearts. 2
Magic 8 Ball 5.100.194 Magic 8 Ball Shot speed up +0.16 shot speed, spawns a random tarot card. Added in Repentance Increases the chance of finding a Planetarium. 1
Magic Mushroom 5.100.12 Magic Mushroom All stats up! Makes Isaac bigger. Adds one Red Heart container, +0.3 damage, x1.5 damage multiplier, +5.25 range, and +0.3 speed. Restores all health on pickup. 4
Magic Scab 5.100.253 Magic Scab HP + luck up Grants one full Red Heart container, +1 luck. 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 Heart, spawns two or three Bombs. 1
MEAT! 5.100.193 MEAT! DMG + HP up Grants one full Red Heart container, +0.3 damage. 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 coins. 2
Mini Mush 5.100.71 Mini Mush Speed + range up Decreases Isaac's size, making him less likely to be hit. Removed in Repentance+0.3 speed, +1.5 tear height, -4.25 range (effective range is increased). Added in Repentance +0.3 speed, +1.50 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. 2
Missing Page 2 5.100.262 Missing Page 2 Evil up. Your enemies will pay! Grants one Black Heart. Upon taking damage that reduces Isaac's health to one heart or less, deals damage to all enemies in the room. Added in Repentance Increases the damage of Black Hearts and 15►The Necronomicon The Necronomicon-like effects by 40. 0
Mitre 5.100.173 Mitre Blessing of purity Grants a chance of converting any Red Heart pickups into Soul 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 +0.25 range. Adds a chance to shoot petrifying tears, which stop enemies in place and prevent them from moving or attacking. 3
Mom's Eye 5.100.55 Mom's Eye Eye in the back of your head Allows Isaac 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 +5.25 range, +0.5 tear height. Added in Repentance 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. Chests 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 +5.25 range, +0.5 tear height. Added in Repentance Spawns one random heart. 1
Mom's Perfume 5.100.228 Mom's Perfume Fear shot + tears up Adds a chance to shoot fear tears and decreases tear delay by 1. 2
Mom's Purse 5.100.139 Mom's Purse More trinket room Allows Isaac to hold 1 additional trinket. 3
Mom's Underwear 5.100.29 Mom's Underwear Range up +5.25 range, +0.5 tear height. Added in Repentance 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 heart. 3
Money = Power 5.100.109 Money = Power $$$ = DMG Increases damage by 0.04 for every coin 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 Monstro. 2
Mr. Mega 5.100.106 Mr. Mega Bigger boom Grants 5 bombs, and makes all dropped bombs larger, which have an increased blast radius and increased damage. 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 Gives Isaac's tears a boomerang effect. +1.5 range, +1 tear height, x1.6 shot speed multiplier. 0
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. 1
Mystery Sack 5.100.271 Mystery Sack ? Spawns a familiar that drops a Heart, coin, bomb, or key 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 Grants one empty Heart container, +0.3 damage, +0.25 range, +0.5 tear height, and -0.1 speed. 2
Odd Mushroom 5.100.120 Odd Mushroom Tears + speed up, DMG down +1.7 tears, +0.3 speed, slightly reduces damage. 3
Old Bandage 5.100.219 Old Bandage HP up Grants an empty Red Heart container. Adds a chance of dropping a Red Heart after taking damage. 2
Ouija Board 5.100.115 Ouija Board Spectral tears Grants spectral tears that travel through obstacles (but not enemies) instead of breaking on impact with them. 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 Room / Angel 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 Hearts and increases the payout of Blood Donation Machines. 2
Piggy Bank 5.100.227 Piggy Bank My life savings Gives 3 pennies on pick-up. Every time Isaac is damaged, he will drop one additional penny. 1
Pisces 5.100.309 Pisces Tears up + knock-back shots -1 Tear Delay, 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 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, the tear 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. 4
Punching Bag 5.100.281 Punching Bag Scape goat Spawns a Mulligan familiar that wanders randomly. Enemies will attack the Mulligan if it's closer. 1
Pyro 5.100.190 Pyro 99 bombs Grants 99 bombs. 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. Added 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 15►Technology Technology lasers. 1
Robo-Baby 2.0 5.100.267 Robo-Baby 2.0 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. 0
Roid Rage 5.100.14 Roid Rage Speed and range up Removed in Repentance +0.6 speed, Added in Repentance +0.3 speed, +5.25 range, +0.5 tear height. 2
Rosary 5.100.72 Rosary Tears + faith up Adds 3 Soul Hearts. The Bible will appear in any item pool.
Added in RepentanceAlso a +0.5 tears up.
1
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. Added in Repentance Heals 1 additional heart of health. 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 coin every 2 rooms. 1
Sacred Heart 5.100.182 Sacred Heart Homing shots + DMG up Grants homing tears, x2.3 damage multiplier, +1 flat damage, +4.125 range, +0.75 tear height, -0.4 tears, -0.25 shot speed, a red Heart Container and replenishes all Red Hearts. 4
Sacrificial Dagger 5.100.172 Sacrificial Dagger My fate protects me Spawns a dagger orbital familiar, dealing 225 damage per second and blocking enemy shots. 3
Sad Bombs 5.100.220 Sad Bombs Tear blasts +5 bombs +5 Bombs. Upon exploding, bombs shoot 10 tears around them, affected by tear modifiers. 3
Safety Pin 5.100.339 Safety Pin Evil + range + shot speed up Grants one Black Heart, +5.25 range, +0.5 tear height, +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 Heart. 2
Scorpio 5.100.305 Scorpio Poison tears Grants poison tears, which deal damage over time when inflicted. 2
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. 1
Sissy Longlegs 5.100.280 Sissy Longlegs She loves you Spawns a familiar that wanders randomly, occasionally spawning Blue Spiders. 1
Sister Maggy 5.100.67 Sister Maggy Friends 'till the end Spawns a familiar that follows Isaac around shooting normal tears. 0
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 keys. 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. 3
SMB Super Fan 5.100.189 SMB Super Fan All stats up +1 Red Heart container, +0.3 damage, +0.2 tears, +0.2 speed, +0.5 range, +1 tear height. 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 Rooms and Super Secret Rooms. 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 Removed in Repentance When hit, spawns 1-2 Blue Spiders.
Added in Repentance When hit, spawns 3-5 Blue Spiders.
1
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 Increases tears by 0.4, spawns 2 Soul 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. 1
Steven 5.100.50 Steven DMG up Increases damage by 1. 3
Stigmata 5.100.138 Stigmata DMG + HP up Increases damage, and adds 1 heart container. 2
Stop Watch 5.100.232 Stop Watch Let's slow this down a bit... Removed in Afterbirth Automatically inflicts slow to all enemies in every room.
Added in Afterbirth / Removed in Repentance Upon taking damage, inflicts slow to all enemies for the current room.
Added in Repentance 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 Hearts. 2
Synthoil 5.100.345 Synthoil DMG + range up +1 damage, +5.25 range, +0.5 tear height. 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 15►My Little Unicorn My Little Unicorn effect for 5 seconds. 1
Tech.5 5.100.244 Tech.5 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 Decreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously. 2
The Battery 5.100.63 The Battery Stores energy Activated collectibles can be "overcharged" to allow for an additional use. 2
The Belt 5.100.28 The Belt Speed up Increases speed by 0.3. 2
The Black Bean 5.100.180 The Black Bean Toot on touch When taking damage, Isaac farts, causing poison damage to all enemies in range. 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 all special rooms (except secret rooms of any kind). 2
The Halo 5.100.101 The Halo All stats up Grants one full Red Heart container, +0.3 damage, +0.2 tears, +0.25 range, +0.3 speed, and +0.5 tear height. 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. 3
The Mark 5.100.79 The Mark DMG + speed up Grants one Soul 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 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 (same effect as 15►The Necronomicon The Necronomicon). Allows entrance into the Dark Room Dark Room. Added in Repentance Also allows access to Home Home. 1
The Pact 5.100.80 The Pact DMG + tears up Grants two Removed in RepentanceSoul Hearts Added in RepentanceBlack 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. 2
The Peeper 5.100.155 The Peeper Plop! Spawns a familiar that floats slowly around the room on a zig-zag pattern, damaging enemies it passes through. 0
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 Chest Chest. Added in Repentance Also allows access to Home Home. 2
The Relic 5.100.98 The Relic Soul generator Spawns a cross familiar that drops a Soul Heart every 5-6 rooms. 4
The Sad Onion 5.100.1 The Sad Onion Tears up Increases tears by 0.7. 3
The Small Rock 5.100.90 The Small Rock DMG up Increases damage by 1, increases tears by 0.2, and decreases speed by 0.2. 3
The Soul 5.100.335 The Soul I am all Grants two Soul 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. Removed in Repentance -0.1 speed. Added in Repentance +0.2 speed. Added in Afterbirth / Removed in Repentance Poisoned enemies have a chance to drop a black heart when killed. 0
The Wafer 5.100.108 The Wafer Damage resistance All 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 spawn 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 Range up and makes shot tears revolve around Isaac until they drop. 0
Toothpicks 5.100.183 Toothpicks 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 greater damage than regular tears. 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 all rooms for every floor. However, it does not reveal icons or 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. 3
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 half a red heart or less (one red heart for Eve), ignoring any Soul or Black Hearts. 2
Wire Coat Hanger 5.100.32 Wire Coat Hanger Tears up Increases tears by 0.7. 3
Wooden Spoon 5.100.27 Wooden Spoon Speed up Increases speed by 0.3. 1
X-Ray Vision 5.100.76 X-Ray Vision I've seen everything Reveals and opens all Secret Room and Super Secret Room entrances. 2
Added in Afterbirth 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
Added in Afterbirth Athame 5.100.408 Athame Call to the void When Isaac takes damage, a black ring briefly appears around him, dealing damage to all nearby enemies. 2
Added in Afterbirth Betrayal 5.100.391 Betrayal Turn your enemy Every time Isaac takes damage, a charm effect is applied to every enemy in the room, causing them to attack each other rather than Isaac. 0
Added in Afterbirth Binky 5.100.438 Binky Tears up Grants one Soul Heart, +0.75 tears and decreases Isaac's size. 3
Added in Afterbirth 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
Added in Afterbirth Bomber Boy 5.100.353 Bomber Boy Cross blast + 5 bombs +5 bombs. Isaac's bombs will now explode in a large cross-shaped pattern (roughly 5 bombs explosions wide). This also affects player-spawned Troll Bombs. 2
Added in Afterbirth 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
Added in Afterbirth Bursting Sack 5.100.377 Bursting Sack Spider love Spider enemies no longer target or deal contact damage to Isaac. 1
Added in Afterbirth Cambion Conception 5.100.412 Cambion Conception Feed them hate After taking damage a certain amount of times, a permanent demonic familiar spawns. 2
Added in Afterbirth Car Battery 5.100.356 Car Battery Active power up Causes Isaac's activated item to activate twice on each use. 3
Added in Afterbirth 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
Added in Afterbirth Chaos 5.100.402 Chaos !!! Drops 1-6 random pickups on the floor. Causes items to be chosen from random item pools. 3
Added in Afterbirth Charged Baby 5.100.372 Charged Baby Bbbzzzzzt! Spawns a familiar that occasionally drops a Lil' Battery, gives an active item charge, or petrifies all enemies in the room. 3
Added in Afterbirth 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. 1
Added in Afterbirth 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
Added in Afterbirth 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. 2
Added in Afterbirth Crown of Light 5.100.415 Crown of Light The untainted gain power +2 soul hearts. While Isaac has no empty red hearts, grants 2x damage, +5.25 range, and -0.3 shot speed. Regardless of health, the crown deactivates for the current room when Isaac takes damage. 4
Added in Afterbirth Curse of the Tower 5.100.371 Curse of the Tower Embrace chaos Upon taking damage, spawns six Troll Bombs around the room, similar to the effect of XVI - The Tower XVI - The Tower. 1
Added in Afterbirth 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
Added in Afterbirth Deep Pockets 5.100.416 Deep Pockets More money! Removed in Repentance Allows Isaac to carry two cards or pills (or a combination of both) at the same time.
Added in Repentance Increases the coin cap to 999. If a room would otherwise yield no reward, 1-3 coins will spawn.
2
Added in Afterbirth 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
Added in Afterbirth Empty Vessel 5.100.409 Empty Vessel I reward an empty vessel Grants two Black Hearts. While Isaac has no red hearts, grants flight and periodically grants an invincibility shield for a few seconds. 2
Added in Afterbirth 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. 1
Added in Afterbirth Evil Eye 5.100.410 Evil Eye Eye shot! While firing tears, Isaac has a chance to fire an eye across the screen with a very slow shot speed, which will fire tears of its own in the same direction as Isaac. The eye will be destroyed if it comes into contact with an enemy or obstacle. 2
Added in Afterbirth Explosivo 5.100.401 Explosivo Sticky bomb shot! Isaac's tears have a chance to stick to enemies and explode. 1
Added in Afterbirth 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
Added in Afterbirth 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
Added in Afterbirth Friend Zone 5.100.364 Friend Zone Friendly fly Spawns a white attack fly that orbits somewhere between 15►Distant Admiration Distant Admiration and 15►Forever Alone Forever Alone, dealing 45 damage per second. 1
Added in Afterbirth Fruit Cake 5.100.418 Fruit Cake Rainbow effects! Isaac's tears gain a random effect that changes every shot. 2
Added in Afterbirth GB Bug 5.100.405 GB Bug Double tap glitch Removed 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.
Added 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.
0
Added in Afterbirth Glitter Bombs 5.100.432 Glitter Bombs Prize bombs! +5 bombs. Bombs have a chance to drop random pickups or charm enemies when they explode. 2
Added in Afterbirth 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
Added in Afterbirth 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
Added in Afterbirth 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
Added in Afterbirth 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
Added in Afterbirth Immaculate Conception 5.100.413 Immaculate Conception Feed them love Upon picking up a certain amount of health, spawn a permanent angelic familiar. 1
Added in Afterbirth 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
Added in Afterbirth Key Bum 5.100.388 Key Bum He wants your keys! Spawns a familiar that follows Isaac and collects Keys for himself, giving random Chests in return. 0
Added in Afterbirth 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. 1
Added in Afterbirth 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
Added in Afterbirth Lil Gurdy 5.100.384 Lil Gurdy A gurd of your own! A Gurdy Jr. familiar that charges up while Isaac is firing, bouncing around the room when released and dealing contact damage based on its speed. 1
Added in Afterbirth 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
Added in Afterbirth 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, dealing 105 damage per second on contact. 0
Added in Afterbirth 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
Added in Afterbirth 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, +3.15 range. 0
Added in Afterbirth 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. Removed in Repentance +1 damage, the ring can cause enemies to drop Black Hearts. 4
Added in Afterbirth Milk! 5.100.436 Milk! Don't cry over it... Spawns a glass familiar that spills on the floor upon taking damage. After the milk spills, Isaac's tear delay is decreased by 2 for the current room. 1
Added in Afterbirth Mom's Pearls 5.100.355 Mom's Pearls Range + luck up +1.25 range, +0.5 tear height, +1 luck. Added in Repentance Grants one Soul Heart. 2
Added in Afterbirth More Options 5.100.414 More Options There's options Two items spawn in every Treasure Room. Only one can be taken; the other will disappear. 3
Added in Afterbirth Mr. Dolly 5.100.370 Mr. Dolly Range + tears up +0.7 tears, +5.25 range, +0.5 tear height, spawns 3 random types of Hearts on the floor when picked up. 3
Added in Afterbirth 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. 1
Added in Afterbirth My Shadow 5.100.433 My Shadow Me! And my shaaaadow! Each time Isaac takes damage, inflicts fear on all enemies in the room and spawns a black friendly Charger that will attack enemies. The Charger will be killed if it is damaged too much. 0
Added in Afterbirth 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. 2
Added in Afterbirth No. 2 5.100.378 No. 2 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
Added in Afterbirth Obsessed Fan 5.100.426 Obsessed Fan Follows my every move... Spawns a familiar that follows Isaac's movements on a 3 second delay and deals contact damage to enemies. 0
Added in Afterbirth 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
Added in Afterbirth Pay to Play 5.100.380 Pay to Play Money talks +5 coins. Turns doors that require a single key into doors which need a coin to enter instead. 2
Added in Afterbirth PJs 5.100.428 PJs You feel cozy Grants 4 Soul Hearts and fully restores Isaac's health. 2
Added in Afterbirth 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
Added in Afterbirth 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. 2
Added in Afterbirth Restock 5.100.376 Restock Never ending stores! Causes shops to instantly restock their items when they are bought. Granted by default for every character in Greed Mode. 3
Added in Afterbirth Rune Bag 5.100.389 Rune Bag Rune generator Spawns a familiar that drops a random rune every 5-6 rooms. 3
Added in Afterbirth Sack Head 5.100.424 Sack Head More sacks! Coins, bombs, keys, cards, runes and batteries have a chance to become sacks. 3
Added in Afterbirth Scatter Bombs 5.100.366 Scatter Bombs We put bombs in your bombs! Adds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs. 1
Added in Afterbirth Seraphim 5.100.390 Seraphim Sworn friend Spawns an angel familiar which follows Isaac and fires homing tears which deal 10 damage and have 75% shot speed. 3
Added in Afterbirth 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 heart when killed. 4
Added in Afterbirth 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. 1
Added in Afterbirth 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' Battery/Blue spider upon clearing a room. 1
Added in Afterbirth Sticky Bombs 5.100.367 Sticky Bombs Egg sack bombs! +5 bombs. Bombs stick to enemies and spawn 2-4 Blue Spiders if they kill an enemy. 1
Added in Afterbirth 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
Added in Afterbirth 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 Heart. 3
Added in Afterbirth 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
Added in Afterbirth The Wiz 5.100.358 The Wiz Double wiz shot! Tears simultaneously fire out of both eyes diagonally, similar to the effect of the R U a Wizard? pill. Isaac's tears also travel above all obstacles. 1
Added in Afterbirth 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
Added in Afterbirth Tractor Beam 5.100.397 Tractor Beam Controlled tears Increases tears, range, and shot speed. Isaac emits a beam from his face that his tears follow along. 2
Added in Afterbirth Zodiac 5.100.392 Zodiac The heavens will change you Gives Isaac a random zodiac item effect that changes every floor. 1
Added in Afterbirth † 7 Seals 5.100.526 7 Seals Lil harbingers! Spawns a random Harbinger familiar that changes every 10 seconds. Harbingers have different behaviors and spawn themed Locusts. 2
Added in Afterbirth † Acid Baby 5.100.491 Acid Baby Pills pills pills! Spawns a familiar that drops a random pill every 3 rooms. Upon using a pill, all enemies in the room are poisoned. 2
Added in Afterbirth † Adrenaline 5.100.493 Adrenaline Panic = power Increases damage based on how many empty Red Heart containers Isaac has. 1
Added in Afterbirth † Analog Stick 5.100.465 Analog Stick 360 tears! +0.35 tears up. Allows Isaac to fire tears diagonally. 2
Added in Afterbirth † Angelic Prism 5.100.528 Angelic Prism Eclipsed by the moon Spawns an orbital familiar with a large orbital radius. Tears that pass through the prism split into four multi-colored tears. 3
Added in Afterbirth † Angry Fly 5.100.511 Angry Fly He's violent Spawns a fly familiar that orbits around a random enemy and deals 30 damage per second to enemies it comes in contact with. 1
Added in Afterbirth † Apple! 5.100.443 Apple! Trick or treat? Increases tears. Adds a chance to fire a high-damage razor blade. 3
Added in Afterbirth † Backstabber 5.100.506 Backstabber Watch your back! Isaac's tears deal double damage and inflict bleeding on enemies if they're facing away from Isaac. 1
Added in Afterbirth † Belly Button 5.100.458 Belly Button What's in there? Drops a random trinket. Grants a second trinket slot. 3
Added in Afterbirth † Big Chubby 5.100.473 Big Chubby Chub chub Spawns a familiar that follows Isaac and charges across the room when Isaac fires, blocking shots and dealing 40.5 damage per second on contact. 1
Added in Afterbirth † Blanket 5.100.535 Blanket You feel Safe Grants one Soul Heart. Upon entering a boss room, grants a shield that blocks one hit, then disappears. 1
Added in Afterbirth † Bloodshot Eye 5.100.509 Bloodshot Eye Bloody friend Spawns an orbital familiar that deals 30 damage per second and fires a randomly angled tear every 2 seconds. 1
Added in Afterbirth † Bozo 5.100.513 Bozo Party time! +0.1 flat damage, grants a Soul Heart. Enemies can randomly become briefly charmed or feared. Taking damage has a chance to spawn a rainbow poop. 2
Added in Afterbirth † Brittle Bones 5.100.549 Brittle Bones Everything hurts Replaces all Red Hearts with 6 empty Bone Hearts. Upon losing a Bone Heart, Isaac fires bones in 8 directions and permanently gains a tears up. 3
Added in Afterbirth † Broken Modem 5.100.514 Broken Modem Lag! Enemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals. 1
Added in Afterbirth † Broken Shovel 5.100.551 Broken Shovel It feels cursed One of two parts necessary to create Mom's Shovel. 4
Added in Afterbirth † Buddy in a Box 5.100.518 Buddy in a Box What could it be?! Spawns a familiar with a random tear effect. The familiar is randomized at the start of each floor. 2
Added in Afterbirth † Camo Undies 5.100.497 Camo Undies Camo kid Isaac becomes camouflaged at the beginning of each room. Until he shoots, all non-boss enemies will be confused. 0
Added in Afterbirth † Compound Fracture 5.100.453 Compound Fracture Bone tears! Increases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle. 2
Added in Afterbirth † Cone Head 5.100.457 Cone Head Hard headed! Grants a Soul Heart. Gives Isaac a chance to ignore any damage taken. 2
Added in Afterbirth † Contagion 5.100.466 Contagion Outbreak! The first enemy killed in a room explodes and poisons nearby enemies. Poisoned enemies will also explode upon death. 2
Added in Afterbirth † Dad's Lost Coin 5.100.455 Dad's Lost Coin I remember this... +1.5 range. Drops a Lucky Penny. 2
Added in Afterbirth † Dad's Ring 5.100.546 Dad's Ring Father's blessing Creates a ring of light around Isaac that petrifies enemies in contact. 3
Added in Afterbirth † Dark Prince's Crown 5.100.442 Dark Prince's Crown Loss is power When at exactly one Red Heart, grants Removed in Repentance+0.75 Added in Repentance+2.0 tears, +1.5 range, +1 tear height, +0.2 shot speed. 1
Added in Afterbirth † Dead Tooth 5.100.446 Dead Tooth Toxic breath While firing, Isaac gains a green aura that poisons nearby enemies. 1
Added in Afterbirth † Death's List 5.100.530 Death's List Just hope you're not next... Grants a pickup or stat upgrade if all enemies in a room are killed in the order they are marked. 2
Added in Afterbirth † Depression 5.100.469 Depression :( Spawns a familiar that leaves a trail of creep that damages enemies at 6 damage per second. Has a chance to spawn damaging beams of light onto enemies that touch the cloud. 1
Added in Afterbirth † Divorce Papers 5.100.547 Divorce Papers Tears up + you feel empty Grants one Bone Heart, +0.7 tears, spawns a Mysterious Paper. 2
Added in Afterbirth † Dog Tooth 5.100.445 Dog Tooth Bark at the moon! +0.3 damage, +0.1 speed. Plays a howl or bark sound when entering a room with undiscovered Secret Rooms or Crawl Spaces. 1
Added in Afterbirth † Duality 5.100.498 Duality You feel very balanced Whenever a Devil or Angel Room would spawn after defeating a boss, both rooms spawn. Only one can be entered. 1
Added in Afterbirth † Eucharist 5.100.499 Eucharist Peace be with you An Angel Room door will always spawn after every boss fight, excluding the first floor and floors after Womb Womb II/Utero Utero II/. 3
Added in Afterbirth † Euthanasia 5.100.496 Euthanasia Needle shot Adds a chance to fire needles that instantly kill basic enemies and deal triple damage to bosses. If a needle kills an enemy, it bursts into more tears/needles. 3
Added in Afterbirth † Eye of Belial 5.100.462 Eye of Belial Possessed tears! Grants piercing tears. After piercing one enemy, tears start homing and deal double damage. 3
Added in Afterbirth † Eye of Greed 5.100.450 Eye of Greed Gold tears! Every 20 tears, Isaac loses 1 coin and shoots an additional gold tear that petrifies enemies and turns them into gold. Any enemy killed while in this state will drop coins. 2
Added in Afterbirth † Fast Bombs 5.100.517 Fast Bombs Rapid bomb drops Grants 7 bombs and allows bombs to be placed rapidly. 1
Added in Afterbirth † Finger! 5.100.467 Finger! Watch where you point that! Spawns a finger familiar that points at enemies, dealing scaling damage. 1
Added in Afterbirth † Flat Stone 5.100.540 Flat Stone Skipping tears Tears bounce off the floor, creating splashes. Splashes deal 25% of Isaac's tear damage to all enemies in a small area. 2
Added in Afterbirth † Ghost Pepper 5.100.495 Ghost Pepper Flame tears Removed in RepentanceGives a chance to shoot fires alongside tears that block enemy shots and deal damage to enemies that touch them.
Added in RepentanceGives a chance to shoot blue fires alongside tears that become smaller as they travel.
2
Added in Afterbirth † Glaucoma 5.100.460 Glaucoma Blind tears! Adds a chance to shoot tears that confuse enemies for an extremely long time. 2
Added in Afterbirth † Glyph of Balance 5.100.464 Glyph of Balance A gift from above Grants 2 Soul Hearts and modifies drops from Champion monsters based on certain conditions. Added in Repentance Also modifies room clear drops. 1
Added in Afterbirth † Greed's Gullet 5.100.501 Greed's Gullet Money = health! Grants a Red Heart container for every 25 coins Isaac has. 1
Added in Afterbirth † Haemolacria 5.100.531 Haemolacria I'm seeing red... Tears are now fired in an arc. Upon hitting the floor, an obstacle, or an enemy, they burst into many smaller tears in all directions. Increases tear delay. 2
Added in Afterbirth † Hallowed Ground 5.100.543 Hallowed Ground Portable sanctuary Spawns a white poop familiar, which turns into a white poop when Isaac is hurt. White poop has an aura that increases tear fire rate and can block enemy shots. 1
Added in Afterbirth † Hushy 5.100.470 Hushy Lil hush! Spawns a Hush familiar that bounces diagonally around the room and deals contact damage. While firing tears, it stops moving. 0
Added in Afterbirth † Jacob's Ladder 5.100.494 Jacob's Ladder Electric tears Tears fire sparks of electricity in random directions upon hitting an obstacle or enemy. 2
Added in Afterbirth † Jaw Bone 5.100.548 Jaw Bone Fetch! Spawns a familiar that flies through the room while firing, dealing a flat 7 contact damage to enemies and retrieving pickups. 1
Added in Afterbirth † Jumper Cables 5.100.520 Jumper Cables Bloody recharge Grants an active item charge every 15 enemies killed. 3
Added in Afterbirth † King Baby 5.100.472 King Baby Hail to the king baby Spawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, other familiars stop moving. 0
Added in Afterbirth † Lachryphagy 5.100.532 Lachryphagy Feed them! Isaac's tears decelerate as they travel. Upon stopping or hitting an obstacle, they burst into 8 tears in all directions. Tears can be fired into other tears to feed them, increasing their damage. 2
Added in Afterbirth † Large Zit 5.100.502 Large Zit Creep shots Adds a chance to fire a creep shot that deals double damage and leaves a trail of slowing white creep. 1
Added in Afterbirth † Lead Pencil 5.100.444 Lead Pencil He's a bleeder! After every 15 tears fired, Isaac will fire a high-damage cluster of tears. 3
Added in Afterbirth † Leprosy 5.100.525 Leprosy You're tearing me apart! Upon taking damage, grants a body part as an orbital, which blocks enemy shots and deals 7 damage per tick to enemies it comes in contact with. The orbitals will be destroyed if they take enough damage from enemies or enemy shots. 1
Added in Afterbirth † Lil Delirium 5.100.519 Lil Delirium Delirious friend Grants a familiar that transforms into another random familiar every 10 seconds. 2
Added in Afterbirth † Lil Monstro 5.100.471 Lil Monstro Ain't he cute? Spawns a familiar that fires clusters of tears. Must be charged before shooting. 2
Added in Afterbirth † Lil Spewer 5.100.537 Lil Spewer Puking buddy Drops a random pill, and spawns a familiar that charges up and fires creep. Using pills changes the creep type. 1
Added in Afterbirth † Linger Bean 5.100.447 Linger Bean Crying makes me toot Constantly shooting causes Isaac to release gas clouds that can be pushed by his tears and damage nearby enemies. 0
Added in Afterbirth † Little Horn 5.100.503 Little Horn Big brother is watching Removed in Repentance Adds a chance to fire a piercing tear that instantly kills any enemy that it touches.
Added in Repentance Adds a chance to fire a tear that summons Big Horn's hand to crush the first enemy it hits, instantly killing monsters or greatly damaging bosses.
3
Added in Afterbirth † Marbles 5.100.538 Marbles Choking hazard Spawns 3 random trinkets, 5% chance to swallow held trinket after taking damage, gaining its effect permanently. 2
Added in Afterbirth † Marrow 5.100.541 Marrow HP up? Grants one bone heart and spawns three red heart pickups. 1
Added in Afterbirth † Metal Plate 5.100.449 Metal Plate It itches... Grants one Soul Heart. Enemy shots have a chance to be reflected at the shooter as confusing tears. 1
Added in Afterbirth † Midnight Snack 5.100.456 Midnight Snack HP up Grants one full Red Heart container. Added in Repentance Heals 1 additional heart of health. 1
Added in Afterbirth † Mom's Razor 5.100.508 Mom's Razor It's sharp! Spawns an orbiting razor that deals contact damage and inflicts bleeding on enemies, causing them to slowly take damage over time. 1
Added in Afterbirth † Mystery Egg 5.100.539 Mystery Egg Sacrificial insemination Spawns an egg familiar, which cracks into a random friendly monster when Isaac is hurt. The egg regenerates upon entering a different room. 1
Added in Afterbirth † Parasitoid 5.100.461 Parasitoid Egg tears! Adds a chance to fire an egg sack which creates slowing creep and spawns a Blue Fly or Blue Spider upon hitting an enemy. 3
Added in Afterbirth † Pointy Rib 5.100.544 Pointy Rib Stabbing time Spawns a bone familiar that hovers back and forth in front of Isaac, dealing damage equal to Isaac's damage. 2
Added in Afterbirth † Poke Go 5.100.505 Poke Go Gotta catch em... Upon entering a room with enemies in it, has a chance to spawn a random friendly enemy that persists across rooms. 0
Added in Afterbirth † Polydactyly 5.100.454 Polydactyly Hold me! Allows Isaac to carry two cards, pills, or any combination of both. Spawns one random card, rune, or pill. 2
Added in Afterbirth † Pop! 5.100.529 Pop! Eyeball tears! Replaces Isaac's tears with eyeballs that can bounce off of each other. The eyeballs are not limited by range, and will instead dissipate when they stop moving or when hitting an enemy or obstacle. 2
Added in Afterbirth † Sack of Sacks 5.100.500 Sack of Sacks Gives sacks Spawns a familiar that drops a sack every 5-6 rooms cleared. 3
Added in Afterbirth † Schoolbag 5.100.534 Schoolbag Extra active item room Allows Isaac to hold two active items. 3
Added in Afterbirth † Shade 5.100.468 Shade It follows Spawns a shadow familiar that follows Isaac's movements on a 1 second delay and deals contact damage to enemies. After dealing enough damage, it is absorbed by Isaac and spawns friendly Chargers. 0
Added in Afterbirth † Shard of Glass 5.100.448 Shard of Glass Blood and guts! Upon taking damage, Isaac has a chance to drop a full red heart, Removed in Repentancegain 5 range, and leave a trail of damaging red creep for the current room.
Added in RepentanceTaking damage causes Isaac to bleed, spraying a volley of blood in the direction he fires. Bleeding will eventually damage him, but it can be stopped by picking up a Red Heart.
0
Added in Afterbirth † Sinus Infection 5.100.459 Sinus Infection Booger tears! Adds a chance to fire a booger that sticks to enemies and deals damage over time. 3
Added in Afterbirth † Slipped Rib 5.100.542 Slipped Rib Projectile shield Spawns a bone familiar that circles around Isaac and reflects enemy shots. 2
Added in Afterbirth † Sulfuric Acid 5.100.463 Sulfuric Acid Acid tears! +0.3 damage. Adds a chance to fire acidic tears which can destroy obstacles. 2
Added in Afterbirth † Tarot Cloth 5.100.451 Tarot Cloth I see the future Drops a random card or rune. Removed in Repentance Doubles the effects of most cards and runes. Added in Repentance Doubles the effects of tarot cards. 3
Added in Afterbirth † Technology Zero 5.100.524 Technology Zero Static tears! Connects Isaac's tears with electricity that can damage enemies. 3
Added in Afterbirth † Trisagion 5.100.533 Trisagion Smite thy enemy Damage down. Tears are replaced with piercing white blasts of light that can damage the same enemy multiple times. 2
Added in Afterbirth † Varicose Veins 5.100.452 Varicose Veins I'm leaking... Taking damage releases a ring of 10 high damage tears. 2
Added in Afterbirth † YO LISTEN! 5.100.492 YO LISTEN! Yo listen! +1 luck. Spawns a fairy familiar that points out Secret Rooms, Crawl Space entrances, and tinted rocks. 2
Added in Repentance 120 Volt 5.100.559 120 Volt Zap! Repeatedly zaps enemies that are close to Isaac. 3
Added in Repentance 2Spooky 5.100.554 2Spooky 4me Enemies near Isaac are afflicted with fear. 2
Added in Repentance 4.5 Volt 5.100.647 4.5 Volt Beat the juice out of them! Active items don't charge when clearing rooms. Instead, they're charged by dealing damage to enemies. 2
Added in Repentance A Bar of Soap 5.100.564 A Bar of Soap Tears + shot speed up Gives Isaac +0.5 Tears and +0.2 Shot Speed. 3
Added in Repentance A Pound of Flesh 5.100.672 A Pound of Flesh Blood money Devil deals now cost coins, shop items now cost health, and consumables in shops are free but surrounded by spikes. 1
Added in Repentance Act of Contrition 5.100.601 Act of Contrition Tears up, you feel forgiven Increases tears and grants an Eternal Heart. Allows Angel Rooms to appear even if a Devil deal has been taken before. Greatly boosts Devil/Angel Deal chance if Isaac has taken Red Heart damage. 3
Added in Repentance Akeldama 5.100.641 Akeldama Spill your guts While in an uncleared room, Isaac forms a trail of bloody tears that drags behind him, bursting and dealing damage upon contact with enemies. 2
Added in Repentance Almond Milk 5.100.561 Almond Milk DMG down + tears up + you feel nutty Quadruples fire rate, with x0.3 damage multiplier. Tears are given random worm trinket effects. 1
Added in Repentance Astral Projection 5.100.677 Astral Projection The true out-of-body experience! Causes Isaac to turn into a ghost if he gets hit while in an uncleared room, giving him flight and spectral tears and blocking the next hit he takes. 2
Added in Repentance Azazel's Rage 5.100.699 Azazel's Rage Ancient power Isaac builds rage every time a room is cleared. After four rooms, fires a large 15►Brimstone Brimstone laser when entering the next room. 3
Added in Repentance Battery Pack 5.100.603 Battery Pack Instant energy! Recharges Isaac's currently held active item and drops 2-4 batteries. 1
Added in Repentance Belly Jelly 5.100.690 Belly Jelly Bounce away! Causes enemies to bounce off of Isaac, dealing damage to them if they hit an enemy or obstacle. Also gives Isaac the chance to deflect enemy shots. 2
Added in Repentance Binge Eater 5.100.664 Binge Eater All you can eat +1 red heart container and fully heals Isaac. Item pedestals cycle between their normal items and food, and collecting food grants a temporary damage boost and permanent bonuses to 2 stats. 3
Added in Repentance Bird Cage 5.100.610 Bird Cage Fat buddy The first time Isaac takes damage in a room, a familiar leaps on an enemy, dealing damage and releasing a rock wave. For the rest of the room, it chases enemies similar to 15►Dead Bird Dead Bird. 1
Added in Repentance Bird's Eye 5.100.616 Bird's Eye It burns Gives a chance to shoot fires alongside tears that block enemy shots and deal damage to enemies that touch them. 2
Added in Repentance Birthright 5.100.619 Birthright ??? Has a different effect for each character. 2
Added in Repentance Blood Bombs 5.100.614 Blood Bombs Bloody blast + HP up Grants a Red Heart container and restores 5 hearts. Bombs leave behind damaging red creep. Isaac can place bombs at the cost of half a heart if he doesn't have any. 1
Added in Repentance Blood Oath 5.100.569 Blood Oath Bleed me dry Stabs Isaac at the beginning of each floor, draining his red hearts. Increases damage and speed for the floor based on the amount drained. 2
Added in Repentance Blood Puppy 5.100.565 Blood Puppy What a cute little thing! Spawns a familiar that chases enemies. After killing enough enemies, it becomes more powerful and drops red hearts after killing enemies, but will also try to hurt Isaac. Attacking it returns it to normal. 2
Added in Repentance Bloody Gust 5.100.695 Bloody Gust May your rage bring haste When Isaac takes damage, he gains speed and tears for the rest of the floor. 3
Added in Repentance Boiled Baby 5.100.607 Boiled Baby Messy friend Gives Isaac a familiar that fires chaotic bursts of tears in all directions. 1
Added in Repentance Bone Spurs 5.100.683 Bone Spurs Break your enemies Enemies spawn floating bones on death, which block shots and damage/repel enemies that touch them. 2
Added in Repentance Booster Pack 5.100.624 Booster Pack Collect them all! Spawns 5 random cards. 1
Added in Repentance Bot Fly 5.100.629 Bot Fly Defense drone Spawns an orbiting fly familiar that fires shielded tears at incoming enemy projectiles. 3
Added in Repentance Brimstone Bombs 5.100.646 Brimstone Bombs Demon blast +5 bombs Gives Isaac +5 bombs and causes his bombs to fire 15►Brimstone Brimstone lasers in the cardinal directions upon exploding. 3
Added in Repentance C Section 5.100.678 C Section Fetus shots Not fully implemented. 4
Added in Repentance Candy Heart 5.100.671 Candy Heart Power of love Gives Isaac a permanent stat boost whenever he heals with red heart pickups. 2
Added in Repentance Card Reading 5.100.660 Card Reading A link to your future Spawns two portals that each lead to either the Boss Room, Secret Room, or Treasure Room at the beginning of each floor. 3
Added in Repentance Consolation Prize 5.100.644 Consolation Prize +1 to lowest stat Increases Isaac's lowest stat and drops either 3 coins, 1 bomb, or 1 key depending on what Isaac has the least of. 1
Added in Repentance Cracked Orb 5.100.675 Cracked Orb Shards of knowledge Unlocks doors and reveals a random room on the map when Isaac takes damage. 1
Added in Repentance Cube Baby 5.100.652 Cube Baby Kick it! Spawns an ice cube familiar that slides around when walked into. It slows and deals contact damage, freezing monsters it kills. 1
Added in Repentance Dad's Note 5.100.668 Dad's Note ... Begins the sequence to access Home. 0
Added in Repentance Dirty Mind 5.100.576 Dirty Mind Filthy friends Destroying poop spawns Dip Familiars that follow Isaac and damage enemies. Destroying different types of poop spawns different Dips with special effects. 2
Added in Repentance Divine Intervention 5.100.568 Divine Intervention Double tap shield Double tapping a fire key creates a shield that pushes away enemies and reflects enemy projectiles and lasers. 2
Added in Repentance Dogma 5.100.633 Dogma Ascended Grants flight, +0.1 speed, +2 damage, and the 15►Holy Mantle Holy Mantle effect. Grants enough health to have 6 full hearts, if possible. Automatically given to Isaac after defeating Dogma. 0
Added in Repentance Dream Catcher 5.100.566 Dream Catcher Sweet dreams During the transition between floors, Isaac's nightmare shows the floor's Treasure Room item and boss. Grants half a soul heart when entering a new floor. 2
Added in Repentance Echo Chamber 5.100.700 Echo Chamber I can see see the future future future When Isaac uses a card, pill, or rune, he also uses a copy of every card/pill/rune he used after picking up Echo Chamber. 2
Added in Repentance Empty Heart 5.100.676 Empty Heart It multiplies If Isaac has one red heart or less at the beginning of a floor, he gains an empty red heart container. 2
Added in Repentance Evil Charm 5.100.632 Evil Charm Luck up + you feel protected Increases luck by 2.0. Provides immunity to burn, confusion, fear, and poison. 1
Added in Repentance Eye Drops 5.100.600 Eye Drops Tears up Lowers the tear delay in Isaac's left eye, causing his eyes to fire at different rates. 3
Added in Repentance Eye of the Occult 5.100.572 Eye of the Occult DMG up + range up + controlled tears Isaac's tears are now controlled mid-flight with tear controls. Also increases damage and range, but decreases shot speed. 3
Added in Repentance Eye Sore 5.100.558 Eye Sore More eyes Causes Isaac to occasionally extra fire tears in random directions while shooting. 2
Added in Repentance False PHD 5.100.654 False PHD Worse pills + evil up Converts good pills into bad pills and identifies all pills. Bad pills now have secondary positive effects. Grants one Black Heart. 2
Added in Repentance Freezer Baby 5.100.608 Freezer Baby Iced iced baby Spawns a shooting familiar that has a chance to petrify enemies, and Freezes monsters upon killing them. 2
Added in Repentance Fruity Plum 5.100.649 Fruity Plum Bouncy friend Gives Isaac a miniature Baby Plum familiar that propels itself diagonally around the room, firing tears behind itself as it travels. 1
Added in Repentance Ghost Bombs 5.100.727 Ghost Bombs Spooky blast +5 bombs +5 bombs. Bombs become spectral and spawn ghosts that deal contact damage to enemies and explode after 10 seconds. 2
Added in Repentance Giant Cell 5.100.658 Giant Cell Micro friends Causes Isaac to spawn micro-Isaacs when he takes damage, which chase and shoot at nearby enemies. 1
Added in Repentance Glitched Crown 5.100.689 Glitched Crown ????? Before being picked up, item pedestals cycle between 5 random items. 4
Added in Repentance Guppy's Eye 5.100.665 Guppy's Eye An eye for secrets Shows the contents of Chests, Sacks, and Fire Places before they're opened. 2
Added in Repentance Heartbreak 5.100.694 Heartbreak Eternal sorrow Grants 3 broken hearts and +0.25 damage for every broken heart Isaac has. Every otherwise fatal hit will add 2 more until Isaac has nothing but broken hearts. 3
Added in Repentance Hemoptysis 5.100.726 Hemoptysis Double tap sneeze Double-tapping a fire button causes Isaac to sneeze blood, dealing damage to enemies in front of him. 3
Added in Repentance Hungry Soul 5.100.684 Hungry Soul Out for blood Enemies have a chance to spawn ghosts on death, which chase and deal contact damage to enemies and explode after a short time. 3
Added in Repentance Hypercoagulation 5.100.724 Hypercoagulation Thick blooded After Isaac takes damage from an enemy or donates health, launches red hearts from Isaac that despawn after 1.5 seconds. 3
Added in Repentance IBS 5.100.725 IBS Your stomach rumbles Causes Isaac to throw poop, create buffing creep, or drop bombs while fighting enemies. 2
Added in Repentance Immaculate Heart 5.100.573 Immaculate Heart Halo of tears Adds one red heart container and fully restores health. x1.2 damage multiplier. Isaac will occasionally fire extra tears that orbit around him. 3
Added in Repentance Inner Child 5.100.688 Inner Child Let him free Upon death, Isaac respawns in the current room with