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. Afterbirth added 95 new items, for a total of 436 items. Afterbirth † added 111 new items, for a total of 547 items. Repentance added 169 new items, for a total of 716 items. An update for Repentance, V1.7.5, added 3 new items, for a total of 719 items. In Afterbirth † and prior, 13 items are considered special and will be less likely to appear if the player has already come across other special items. The Repentance expansion removed the Special Item mechanic, replacing it with the item weight and item quality mechanics.
For the grids of items that appear in the stats menu, see Collection Page.
Unless the player has 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 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.
In some special circumstances, activated items can be placed in the consumable slot instead of the standard activated item slot. This counts as both an extra activated item slot and an extra consumable slot, meaning that other activated items and consumables can be picked up as normal. Items in this slot are used with the consumable key, and can't be lost through any means (unless they're consumed like items from Dice Bag). Otherwise, they function the same as other activated items.
- Battery Bums and most Batteries charge the item(s) in the activated item slot first, then the item in the consumable slot. The exception to this is the Mega Battery, which recharges the items in both slots.
- Most trinkets that work with activated items (e.g. Vibrant Bulb, Panic Button, etc.) ignore the items in the consumable slot.
|A Pony||5.100.130||Flight + dash attack||Passively grants flight and increases speed to 1.5. Upon use, Isaac charges in the direction the pony is facing, giving invulnerability during the charge and dealing damage to enemies hit.||2|
|Anarchist Cookbook||5.100.65||Summon bombs||Spawns six Troll Bombs around the room.||1|
|Best Friend||5.100.136||Friends 'till the end||Spawns a decoy Isaac that explodes after 5 seconds. Enemies will always target the decoy and ignore Isaac.||1|
|Blank Card||5.100.286||Card mimic|| Copies the effect of the card or rune currently held by Isaac.
Copies the effect of the card currently held by Isaac. The charge time is based on the power of the card.
|Blood Rights||5.100.186||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||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||Reusable soul protection||Increases the chance of a Devil Room / Angel Room appearing while held. On use, gives one Soul Heart, and replaces the boss of the current floor with a Harbinger if possible.||3|
|Book of Secrets||5.100.287||Tome of knowledge||Gives the effect of Treasure Map, The Compass, or Blue Map for the duration of the current floor.||0|
|Book of Shadows||5.100.58||Temporary invincibility||Creates a protective shield, nullifying all types of damage in the current room for 10 seconds.||3|
|Box of Spiders||5.100.288||It's a box of spiders|| Spawns 1-4 Blue Spiders that deal 2.5x damage to enemies.
Spawns 4-8 Blue Spiders that deal 2x damage to enemies.
|Breath of Life||5.100.326||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||Reusable knock-back||Upon use, Isaac farts and knocks back nearby enemies and projectiles. Enemies pushed into walls or obstacles take 12 damage.||1|
|Converter||5.100.296||Convert your soul|| Converts two Soul Hearts or Black Hearts into one filled Red Heart Container.
Converts one Soul Heart or Black Heart into one filled Red Heart Container.
|Crack the Sky||5.100.160||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||I see my future||Upon use, reveals the map (except the Super Secret Room) and drops a Soul Heart or random card/rune.||3|
|D10||5.100.285||Reroll enemies||Re-rolls all monsters in the room. Will attempt to re-roll monsters into ones with a similar amount of HP.||0|
|D100||5.100.283||REEROLLLLL!|| Combines the effects of D4, The D6, and D20.
Combines the effects of D1, D4, The D6, D7, D8, D10, D12, and D20.
|D20||5.100.166||Reroll the basics||Rerolls all pickups in the current room.||2|
|D4||5.100.284||Reroll into something else||Rerolls all of Isaac's passive items.||3|
|Dad's Key||5.100.175||Opens all doors...||Upon activation, opens all doors in the current room in almost all circumstances, including doors which require a Key to open, entrances to Secret Rooms, and the door to Mega Satan.||1|
|Dead Sea Scrolls||5.100.124||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||Reusable card generator||Gives Isaac a random card.||2|
|Doctor's Remote||5.100.47||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||...||Turns all non-boss monsters in the room into poop. Instantly kills poop-themed bosses.||1|
|Forget Me Now||5.100.127||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||Reusable fly hive||Spawns 2-4 friendly Blue Flies that damage enemies.||3|
|Guppy's Paw||5.100.133||Soul converter||Upon use, converts one Red Heart Container into three Soul Hearts.||3|
|Head of Krampus||5.100.293||Krampus rage||Fires a powerful Brimstone beam in four cardinal directions, much like Krampus shoots.||2|
|How to Jump||5.100.282||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||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||Portable blood bank||Upon use, Isaac loses half a heart of health (or a full heart in Chapter 4 onward) for a random amount of coins, similar to a Blood Donation Machine.||1|
|Kamikaze!||5.100.40||Become the bomb!||Creates an explosion around Isaac, damaging him and nearby enemies as well as destroying obstacles.||0|
|Lemon Mishap||5.100.56||Oops...||Creates a tiny pool of yellow creep, damaging enemies that cross it.||1|
|Magic Fingers||5.100.295||Pay to win||Uses 1 coin to deal a large amount of damage to all enemies in the room.||1|
|Mom's Bottle of Pills||5.100.102||Reusable pill generator||On use, gives Isaac a random pill.||1|
|Mom's Bra||5.100.39||Mass paralysis||Petrifies all enemies in the current room for around 4 seconds.||1|
|Mom's Pad||5.100.41||Mass fear||Inflicts fear to all enemies in the room for 5 seconds.||0|
|Monster Manual||5.100.123||Temporary buddy generator|| Spawns a familiar from a specific selection for the current room.
Spawns a familiar from a specific selection for the current floor.
|Monstro's Tooth||5.100.86||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||Reusable bomb buddy||Places a Mr. Mega bomb that deals 110 damage.||1|
|My Little Unicorn||5.100.77||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||Rocks don't stand a chance|| Isaac destroys obstacles and opens Secret Rooms by walking into them, but cannot shoot or pick up items until it's cancelled.
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.
|Pandora's Box||5.100.297||??||Upon use, spawns specific pickups or items depending on the floor it is used on. Disappears after use.||2|
|Portable Slot||5.100.177||Gamble 24/7||Upon use, consumes 1 Penny and has a chance to drop a random pickup, like a Slot Machine.||0|
|Prayer Card||5.100.146||Reusable eternity||Gives an Eternal Heart per use.||3|
|Razor Blade||5.100.126||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||Flame on||Throws out a flame that damages everything in its path, diminishing in size as it hits enemies or blocks shots.||2|
|Remote Detonator||5.100.137||Remote bomb detonation||Bombs placed by Isaac only explode when Remote Detonator is used. Gives 5 bombs.||1|
|Satanic Bible||5.100.292||Reusable evil... but at what cost?||Gives one Black Heart. Replaces the boss room item on the current floor with a Devil Deal.||4|
|Scissors||5.100.325||Lose your head||Turns Isaac's head into a stationary familiar for the current room which fires tears automatically. Isaac's body also shoots a controllable fountain of blood shots for the room.||1|
|Shoop Da Whoop!||5.100.49||BLLLARRRRGGG!||Fires a laser from Isaac's mouth.||2|
|Spider Butt||5.100.171||Mass enemy slowdown + damage||Deals 10 damage to all enemies in the room and slows them for 4 seconds. Enemies killed by Spider Butt spawn Blue Spiders.||1|
|Tammy's Head||5.100.38||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.||2|
|Telepathy for Dummies||5.100.192||Temporary psychic shot||Gives homing tears for the current room. Also gives +3 range.||1|
|Teleport!||5.100.44||Teleport!||Teleports Isaac to a random room on the current floor.||0|
|The Bean||5.100.111||Toot on command||Isaac farts, poisoning any enemy in close range.||0|
|The Bible||5.100.33||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||Temporary DMG up|| +2 damage for the current room. Passively guarantees a Devil Room or Angel Room will appear while held.
+2 damage for the current room. Passively increases the chance of finding a Devil Room or Angel Room while held.
|The Book of Sin||5.100.97||Reusable item generator||Generates a random pickup, pill, card, or rune.||2|
|The Boomerang||5.100.338||It will never leave you||Throws a boomerang which retrieves pickups, as well as damages and petrifies enemies hit for 2 seconds.||2|
|The Candle||5.100.164||Reusable flames||Throws out a flame that damages everything in its path, diminishing in size as it travels.||2|
|The D6||5.100.105||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||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||Temporary enemy slowdown||All enemies in the room are slowed for 8 seconds.||1|
|The Jar||5.100.290||Save your life||When at full health, up to 4 extra Red Hearts can be stored in The Jar. Activating drops the stored hearts on the ground.||0|
|The Nail||5.100.83||Temporary demon form|| Gives one Soul Heart. For the current room; +0.7 damage, -0.18 speed, Isaac breaks rocks and deals contact damage.
Gives half a Black Heart. For the current room; +2 damage, -0.18 speed, Isaac breaks rocks and deals contact damage.
|The Necronomicon||5.100.35||Mass room damage||Deals 40 damage to every enemy in the room.||1|
|The Pinking Shears||5.100.107||Cut and run||Gives flight for the current room, while turning Isaac's body into a fast, high damage familiar.||2|
|The Poop||5.100.36||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||Teleports Isaac to the Secret Room, Super Secret Room, Treasure Room, or I AM ERROR.||2|
|Unicorn Stump||5.100.298||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||Reusable level skip||Creates a trapdoor to go to the next floor.||2|
|White Pony||5.100.181||Flight + holy death||Passively grants flight and increases speed to 1.5. Upon use, Isaac charges in the direction the pony is facing, giving invulnerability during the charge while also creating damaging beams of light.||2|
|Yum Heart||5.100.45||Reusable regeneration||Restores one full Red Heart.||1|
|Box of Friends||5.100.357||Double your friends||Duplicates all of Isaac's familiars for the current room. If Isaac has no familiars, spawns a Demon Baby for the room instead.||1|
|D12||5.100.386||Rerolls rocks||Re-rolls all Rocks and Metal Blocks in the current room into other random objects, such as Bomb Rocks, TNT, or Poops. Poops and TNT cannot be rerolled into other objects with this item.||1|
|D7||5.100.437||Roll again||Restarts the current room and brings back all enemies, allowing more rewards to be acquired by completing the room.||1|
|D8||5.100.406||Reroll stats||Re-rolls Isaac's damage, tears, range, and speed.||2|
|Diplopia||5.100.347||Double item vision||Duplicates all pickups and item pedestals in the room.||3|
|Friendly Ball||5.100.382||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.||2|
|Glass Cannon||5.100.352||Be gentle...|| Fires a high-damage piercing spectral tear, but lowers Isaac's health to half a heart.
Fires a high-damage piercing spectral tear. If Isaac takes damage while holding this, he takes extra damage and it becomes Broken Glass Cannon.
|Glowing Hour Glass||5.100.422||Turn back time||Rewinds time, putting Isaac back in the previous room and undoing anything that happened in the current room.||3|
|Jar of Flies||5.100.434||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|
|Kidney Bean||5.100.421||Love toots!||Isaac farts, charming all nearby enemies.||1|
|Mega Bean||5.100.351||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|
|Mega Blast||5.100.441||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|
|Mine Crafter||5.100.427||Booom!||Places an explosive TNT barrel that can be pushed and used to destroy rocks or damage enemies. If used again in the same room while the previous TNT barrel is still intact, remotely detonates the TNT.||1|
|Mom's Box||5.100.439||What's inside?||Increases luck by 1 and doubles the effects of trinkets while held. When used, drops a random trinket on the ground.||3|
|Placebo||5.100.348||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|
|Tear Detonator||5.100.383||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|
|Teleport 2.0||5.100.419||I-Teleport!||Teleports Isaac to a room that has not been explored yet. Normal rooms are prioritized over special rooms, and common special rooms take priority over rarer ones.||3|
|Ventricle Razor||5.100.396||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|
|Wooden Nickel||5.100.349||Flip a coin||When used, has a 50% chance to drop a random coin.||1|
|Black Hole||5.100.512||Nothing can escape||Throws a black hole on the ground which sucks in and damages enemies.||1|
|Book of the Dead||5.100.545||Rise from the grave||Upon use, creates a friendly Bony, Black Bony, or an orbital bone for each enemy killed in the current room.
Can also create a friendly Bone Fly or Revenant.
|Broken Shovel||5.100.550||It feels cursed||While held, causes 1 or more copies of Mom's Foot to stomp on Isaac. One of two parts necessary to create Mom's Shovel.||4|
|Brown Nugget||5.100.504||Friendly fly||Spawns a stationary fly turret that fires tears at nearby enemies.||0|
|Clicker||5.100.482||Change||Transforms Isaac into a random character and removes the last item collected.||0|
|Compost||5.100.480||Gain more friends!||Doubles Isaac's Blue Flies and Blue Spiders, or spawns one if Isaac has none. Converts pickups in the current room into Blue Flies or Blue Spiders.||2|
|Coupon||5.100.521||Allow 6 weeks for delivery||While held, guarantees one item in every Shop will be on sale. On use, makes a random item in the current room free.||2|
|Crooked Penny||5.100.485||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|
|D Infinity||5.100.489||Reroll forever|| Grants a random die item that changes each use.
Acts as any die item, and can by cycled by pressing the drop key.
|D1||5.100.476||What will it be?||Duplicates a random pickup in the room. The new pickup may be different than the original (i.e. a different card, etc).||3|
|Dataminer||5.100.481||109||Displaces enemy sprites for the current room, randomly increases one stat and decreases another.||0|
|Delirious||5.100.510||Unleash the power!||Spawns Delirium as a random friendly boss that fights for Isaac.||1|
|Dull Razor||5.100.486||I feel numb...||Hurts Isaac without depleting health, activating any items that trigger upon taking damage.||1|
|Eden's Soul||5.100.490||...||Spawns two item pedestals then is consumed. Begins with no charges.||3|
|Mama Mega!||5.100.483||BOOOOOOOOOM!||Damages all enemies and destroys all obstacles. The effect occurs every time a new room is entered for the rest of the floor. Opens the doors to the floor's Secret Rooms and Super Secret Rooms.||3|
|Metronome||5.100.488||Waggles a finger||Grants a random item effect for the current room.||1|
|Mom's Shovel||5.100.552||Lost but not forgotten||Creates 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.||4|
|Moving Box||5.100.523||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|
|Mr. ME!||5.100.527||Caaan do!||Summons a controllable ghost that can perform various tasks depending on what it targets.||3|
|Mystery Gift||5.100.515||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|
|Pause||5.100.478||Stop!||Freezes all enemies until a fire button is pressed.||1|
|Plan C||5.100.475||My last resort||Kills all enemies in the room, then kills Isaac three seconds later.||0|
|Potato Peeler||5.100.487||A pound of flesh||Removes a Heart Container, increases damage and range, and grants a Cube of Meat.||2|
|Sacrificial Altar||5.100.536||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|
|Sharp Straw||5.100.507||More blood!||Damages all enemies in the room. Has a chance to drop a half red heart or half soul heart if an enemy is hit.||2|
|Smelter||5.100.479||Trinket melter!||Consumes Isaac's currently held trinket and applies its effect permanently.||3|
|Sprinkler||5.100.516||Sprinkles.||Upon use, creates a stationary sprinkler that rotates and fires tears in 8 directions. The tears copy Isaac's stats and most tear effects.||2|
|Telekinesis||5.100.522||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|
|Void||5.100.477||Consume||Consumes all pedestal items in the room. Active items will have their effects added to Void, and passive items will grant random stat upgrades.||4|
|Wait What?||5.100.484||I can't believe it's not butter bean!||Isaac farts, sending out rock waves.||1|
|Abyss||5.100.706||Come forth from the depths||Destroys all items in the room and gives Isaac a unique locust familiar for each item destroyed. Some items generate locusts with special effects.||4|
|Alabaster Box||5.100.585||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|
|Anima Sola||5.100.722||Repent||Chains down the nearest enemy for 5 seconds, preventing them from acting.||3|
|Bag of Crafting||5.100.710||Make your destiny||Collects and holds up to 8 pickups, which can then be used to craft an item. The power level of the item is based on the quality of pickups used.||4|
|Berserk!||5.100.704||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|
|Book of Virtues||5.100.584||Spiritual companionship||On use, spawns a destroyable orbiting Wisp familiar that fires tears and deals contact damage. Also acts as a passive item that causes other active items to spawn themed Wisps.||3|
|Broken Glass Cannon||5.100.474||You broke it!||Begins with no charges and turns into Glass Cannon when used. Only acquired by taking damage while holding Glass Cannon.||0|
|Clear Rune||5.100.263||Rune mimic||Has the same effect as the rune or soul stone currently held by Isaac.||2|
|Damocles||5.100.577||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|
|Dark Arts||5.100.705||One with the shadows||Briefly grants +1 speed and makes Isaac invulnerable and intangible. When the effect ends, destroys all projectiles and damages all enemies Isaac ran through.||3|
|Death Certificate||5.100.628||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|
|Decap Attack||5.100.729||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|
|Eraser||5.100.638||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|
|Esau Jr.||5.100.703||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|
|Eternal D6||5.100.609||???||Rerolls all items in the room. Each item has a 30% chance to disappear instead.||3|
|Everything Jar||5.100.720||Anything is possible||Spawns certain pickups based on how many charges it has. If fully charged, instead has one of many unique effects.||2|
|Flip||5.100.711||Twist of fate||Item pedestals have a second uninteractable "ghostly" item behind them. Activating will flip the real and ghostly items around. If playing as Tainted Lazarus, also flips between them and Dead Tainted Lazarus.||4|
|Fortune Cookie||5.100.557||Reusable fortunes||Gives Isaac a fortune, Soul Heart, Card, Rune, or trinket, similar to a Fortune Telling Machine. Fortunes are much more likely to be given than anything else.||2|
|Free Lemonade||5.100.578||Party time!||Creates a large pool of yellow creep beneath Isaac.||1|
|Friend Finder||5.100.687||Best friends forever!||Spawns a random friendly monster that mimics Isaac's movements and attacks.||3|
|Gello||5.100.728||Demonic gestation||Spawns a demon familiar that's attached to Isaac and moves and fires in the direction Isaac shoots, using Isaac's damage, tears, range, shot speed, and special tear effects.||3|
|Genesis||5.100.622||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|
|Golden Razor||5.100.555||Pain from gain||Spends five coins to increase Isaac's damage by 1.2 for the current room.||1|
|Hold||5.100.715||Saved for later||Exclusive to Tainted ???. Allows him to save one poop bomb for later, allowing him to gather more over time.||0|
|Jar of Wisps||5.100.685||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|
|Keeper's Box||5.100.719||Portable shop||Spawns a random shop item or pickup which can be bought for its normal price.||2|
|Larynx||5.100.611||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|
|Lemegeton||5.100.712||Item summoner||Spawns a wisp representing a random passive item, which orbits Isaac but can be destroyed. While the wisp is alive, Isaac gains that item's effects. Generation uses the current room's item pool 25% of the time, otherwise a random pool.||3|
|Magic Skin||5.100.642||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|
|Meat Cleaver||5.100.631||Slice but no dice||Splits all enemies in the room into two smaller versions of themselves with much less health.||1|
|Mega Mush||5.100.625||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|
|Mom's Bracelet||5.100.604||Mother's strength||Lets Isaac pick up and throw rocks, TNT, poops, friendly Dips, Bombs, and other obstacles.||2|
|Plum Flute||5.100.650||Play time!||Summons the boss Baby Plum to fight for Isaac in the current room.||2|
|R Key||5.100.636||Time to start over||Brings Isaac back to the first floor of a new run, retaining all of his items.||4|
|Recall||5.100.714||Come back||Retrieves the Forgotten's body from any distance. Only available as the Birthright effect for Tainted Forgotten.||0|
|Red Key||5.100.580||Explore the other side||Creates a Red Room adjacent to a viable wall, indicated by the outline of a door. These rooms have a 10% chance to be a special room.||3|
|Sharp Key||5.100.623||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|
|Spin to Win||5.100.655||Let it rip!||When used, gives Isaac +0.5 speed and greatly increases the rotation speed of Isaac's orbitals for 3 seconds. Gives Isaac a spinning top orbital that blocks enemy shots and deals contact damage to enemies while held.||1|
|Spindown Dice||5.100.723||-1||Transforms all items in the room by decreasing their internal ID number.||4|
|Stitches||5.100.635||Bait and switch||Passively spawns a familiar that moves in the direction Isaac shoots. On use, Isaac swaps places with the familiar.||1|
|Sulfur||5.100.556||Temporary demon form||Grants Brimstone for the current room.||2|
|Sumptorium||5.100.713||Blood to blood||Removes half a heart and creates a Clot familiar that mimics Isaac's movements and tear effects. As Tainted Eve, passively converts health into Clots while firing. Activating returns all Clots to health.||3|
|Suplex!||5.100.709||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|
|The Scooper||5.100.605||Plop!||Summons a Peeper familiar for the current room, which leaves a trail of red creep.||0|
|Urn of Souls||5.100.640||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|
|Vade Retro||5.100.653||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. Ghost enemies and bosses are also destroyed if this is used while they have less than half HP.||3|
|Wavy Cap||5.100.582||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|
|Yuck Heart||5.100.639||Gross!||Gives Isaac a Rotten Heart.||2|
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.
|???'s Only Friend||5.100.320||Controlled friend||Spawns a controllable familiar that deals 37.5 damage per second on touch. It can be moved using the shooting directional keys||2|
|<3||5.100.15||HP up||Grants Isaac one Red Heart container and fully restores Isaac's health.||2|
|1up!||5.100.11||Extra life||Gives Isaac an extra life. Upon death, he will respawn in the most recent non-hostile room with full health, after which 1up! will disappear.||2|
|20/20||5.100.245||Double shot||Isaac fires two tears at once, one from each eye.
0.75x damage multiplier.
|3 Dollar Bill||5.100.191||Rainbow tears|| Gives Isaac a random tear effect every room.
Gives Isaac a random tear effect every few seconds.
|9 Volt||5.100.116||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||$$$||Gives Isaac 100 pennies.||3|
|A Lump of Coal||5.100.132||My Xmas present||The more distance tears travel, the more damage they will do.||3|
|A Quarter||5.100.74||+25 coins||Gives Isaac 25 coins.||1|
|A Snack||5.100.346||HP up||Grants one full Red Heart container. Heals 1 additional Red Heart.||1|
|Abaddon||5.100.230||Evil + DMG up + fear shot|| +1.5 damage, +0.2 speed. Removes all Red Heart containers, grants six Black Hearts, and adds a chance to shoot fear tears.
+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.
|Abel||5.100.188||Mirrored buddy||Spawns a familiar that mirrors Isaac's movements and shoots in the opposite direction.||0|
|Anemic||5.100.214||Toxic blood||+5 +1.5 range. After Isaac is damaged, a trail of red creep will be left behind him until he leaves the current room.||1|
|Ankh||5.100.161||Eternal life?||Upon death, Isaac will respawn as ??? in the most recent non-hostile room, with 3 Soul Hearts.||1|
|Anti-Gravity||5.100.222||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.||2|
|Aquarius||5.100.308||Trail of tears||A trail of blue creep is left behind Isaac, which damages enemies. The creep inherits most of Isaac's tear effects, like homing, etc.||1|
|Aries||5.100.300||Ramming speed||+0.25 Speed. Running into enemies while at a high speed will deal damage. Prevents Isaac from taking contact damage while moving at high speed.||2|
|Ball of Bandages||5.100.207||Gotta lick 'em all!||Creates an orbital familiar. Collecting additional copies gives it the ability to shoot Charm tears, then chase enemies to deal contact damage, then deal even more contact damage.||2|
|Ball of Tar||5.100.231||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||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||Sworn protector||When hit, spawns a quickly orbiting attack fly similar to Forever Alone for the current room that deals high damage.||0|
|BFFS!||5.100.247||Your friends rule!||Increases the size and effectiveness of most familiars.||2|
|Big Fan||5.100.279||Fat protector||Spawns a large orbital familiar that blocks enemy shots and deals 30 damage per second to enemies.||2|
|Black Candle||5.100.260||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||HP up x3!||Grants one Red Heart, one Soul Heart, and one Black Heart.||2|
|Blood Bag||5.100.119||HP up||Grants one Red Heart container, restores 5 Red Hearts, and increases speed by 0.3.||2|
|Blood Clot||5.100.254||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||DMG up||Increases damage by 1, and turns Isaac's tears into blood tears.||3|
|Bloody Lust||5.100.157||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||HP + tears up + shot speed down||Gives one full Red Heart container, +0.7 tears, and -0.16 shot speed. Heals 2 additional hearts of health.||3|
|Blue Map||5.100.246||Secrets||Reveals the locations of Secret Rooms and Super Secret Rooms on the map.||2|
|Bob's Brain||5.100.273||Explosive thoughts||Spawns a familiar that charges forward when shooting tears and explodes upon contact with an enemy, damaging and poisoning them. The familiar respawns after a few seconds.||1|
|Bob's Curse||5.100.140||+5 poison bombs||Gives 5 bombs and grants Isaac's bombs a poison effect. Gives Isaac immunity to poison.||1|
|Bobby-Bomb||5.100.125||Homing bombs!||+5 bombs. Bombs gain a homing effect, slowly moving towards the nearest enemy.||2|
|Bogo Bombs||5.100.250||1+1 BOOM!||All normal Bombs become Double Bombs.||1|
|Bomb Bag||5.100.131||Gives bombs||Spawns a familiar that drops a Bomb every 3 rooms.||2|
|Boom!||5.100.19||10 bombs||Grants 10 bombs.||0|
|Box||5.100.198||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||HP up||Grants one full Red Heart container. Heals 1 additional Red Heart.||1|
|Brimstone||5.100.118||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||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||Friends 'till the end||A familiar that follows Isaac around shooting normal tears.||1|
|Bucket of Lard||5.100.129||HP up|| Grants two empty Red Heart containers, heals Isaac by half a Red Heart, -0.2 speed.
Grants two Red Heart containers, heals Isaac by half a Red Heart, -0.2 speed.
|Bum Friend||5.100.144||He's greedy||Spawns a familiar that picks up Error: The given entity ("coin") does not exist.s for himself, giving random pickups in return. Does not spawn collectibles.||0|
|Butt Bombs||5.100.209||Toxic blast +5 bombs||+5 bombs. Bombs now cloud up the screen, briefly damaging and confusing all enemies.||2|
|Caffeine Pill||5.100.340||Speed up + size down||Grants +0.3 speed, reduces character size, and gives a random pill.||1|
|Cain's Other Eye||5.100.319||Near-sighted friend||Spawns a familiar that floats slowly around the room on a zig-zag pattern similar to The Peeper and shoots normal tears in the same direction as Isaac.||0|
|Cancer||5.100.301||HP up + you feel protected||Adds 3 Soul Hearts. Grants The Wafer effect for the current room after taking damage.||3|
|Capricorn||5.100.307||All stats up|| Adds 1 Red Heart Container, gives +0.5 Damage, +0.1 Speed, +1.5 Range, and -1.0 Tear Delay, and gives 1 Bomb, Coin, and Key.
Adds 1 Red Heart Container, gives +0.5 Damage, +0.1 Speed, +0.75 Range, and -1.0 Tear Delay, and gives 1 Bomb, Coin, and Key.
|Cat-O-Nine-Tails||5.100.165||Shot speed + damage up||+1 damage, +0.23 shot speed.||3|
|Celtic Cross||5.100.162||Blessing of protection||Grants a chance to trigger the 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||DMG + evil up||Grants 3 Black Hearts, and +1 damage.||3|
|Champion Belt||5.100.208||DMG + challenge up||Increases damage, but also increases the chance of champion enemies appearing.||3|
|Charm of the Vampire||5.100.62||Kills heal||Heals Isaac for a Half Red Heart for every 13 enemies killed. +0.3 damage.||1|
|Chemical Peel||5.100.154||DMG up||Tears fired from the left eye have +2 flat damage.||2|
|Chocolate Milk||5.100.69||Charge shots||Grants charged tears that deal greater damage when fully charged.||3|
|Contract From Below||5.100.241||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||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||DMG up||Increases Damage by 0.5, and increases damage multiplier by x1.5.||4|
|Cube of Meat||5.100.73||Gotta meat 'em all!||Creates an orbital familiar. Collecting additional copies gives it the ability to shoot tears, then chase enemies to deal contact damage, then deal even more contact damage.||2|
|Cupid's Arrow||5.100.48||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 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's love||Daddy Long Legs' shadow follows Isaac and occasionally stomps enemies for 40 damage total.||3|
|Dark Bum||5.100.278||He wants to take your life||Spawns a familiar that follows Isaac around and collects Red Hearts. For every 1½ Red Hearts collected, Dark Bum will give a reward.||3|
|Dark Matter||5.100.259||DMG up + fear shot||+1 damage, adds a chance to shoot fear tears.||3|
|Dead Bird||5.100.117||Protective buddy||After Isaac takes damage, spawns a flying familiar that chases enemies for the current room, dealing ~5 damage per second.||0|
|Dead Cat||5.100.81||9 lives||Sets Isaac's Red Heart Containers to 1, but grants 9 extra lives. After dying, Isaac respawns with 1 Red Heart Container.||3|
|Dead Dove||5.100.185||Flight + spectral tears||Grants spectral tears and flight.||3|
|Dead Onion||5.100.336||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||Piercing shots + DMG up||+1.5 damage, -0.3 tears. Tears are replaced with large piercing scythes.||3|
|Demon Baby||5.100.113||Auto-turret friend||Spawns a familiar that follows Isaac and automatically fires at enemies in its reach.||2|
|Dessert||5.100.24||HP up||Grants one full Red Heart container. Heals 1 additional Red Heart.||1|
|Dinner||5.100.23||HP up||Grants one full Red Heart container. Heals 1 additional Red Heart.||1|
|Distant Admiration||5.100.57||Attack fly||Spawns an attack fly that circles further out than Halo of Flies, but closer than Forever Alone, dealing 75 damage per second.||2|
|Dr. Fetus||5.100.52||???||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||Immortal friend||Spawns a familiar that follows Isaac around and blocks enemy projectiles. Upon blocking a shot, it has a chance of triggering The Necronomicon effect.||3|
|E. Coli||5.100.236||Turdy touch||Enemies that touch Isaac are transformed into poop.||1|
|Epic Fetus||5.100.168||On-demand air strike||Isaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.||4|
|Eve's Mascara||5.100.310||DMG up, tears + shot speed down||Doubles damage, halves tears stat, and greatly reduces shot speed.||2|
|Experimental Treatment||5.100.240||Some stats up, some stats down|| Randomly increases and decreases some of Isaac's stats.
Increases four random stats and decreases the other two.
|Fanny Pack||5.100.204||Filled with goodies||Has a chance to drop a random pickup when Isaac takes damage.||1|
|Fate||5.100.179||Flight eternal||Grants flight and one Eternal Heart.||3|
|Fire Mind||5.100.257||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||Attack fly||Spawns an attack fly that orbits a long distance from Isaac, dealing 30 damage per second.||1|
|Gemini||5.100.318||Conjoined friend||Spawns a conjoined familiar which chases enemies close to Isaac, dealing ~8 damage per second.||1|
|Ghost Baby||5.100.163||Spectral buddy||Spawns a familiar that follows Isaac around and fires spectral tears.||1|
|Gimpy||5.100.225||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||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||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||God tears|| Grants homing tears with a damaging halo. +0.5 Damage, -0.3 Tears -0.3 Shot Speed, +0.8 Tear Height, and +1.2 Range.
Grants homing tears with a damaging halo. +0.5 Damage, -0.3 Tears -0.3 Shot Speed, and +0.8 Tear Height.
|Growth Hormones||5.100.70||Speed + DMG up|| +1 damage, +0.4 speed.
+1 damage, +0.2 speed.
|Guardian Angel||5.100.112||Extra protection||Spawns an orbital familiar that blocks enemy shots, deals 105 damage per second to enemies, and increases the speed of all orbital familiars.||2|
|Guillotine||5.100.206||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.||2|
|Guppy's Collar||5.100.212||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||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||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||Item martyr||When Isaac is hit, his active item gains 1 room's worth of charge.||2|
|Halo of Flies||5.100.10||Projectile protection||Spawns two Pretty Flies that block enemy shots and deal contact damage to flies.||2|
|Harlequin Baby||5.100.167||Double shot buddy||Spawns a familiar that follows Isaac around and fires two tears at once in a V-pattern.||1|
|Headless Baby||5.100.269||Bloody friend||Spawns a familiar that follows Isaac, leaving blood creep on the ground.||1|
|Hive Mind||5.100.248||Giant spiders and flies||Increases the size of Blue Spiders and Blue Flies and doubles the amount of damage they deal. Also increases the effectiveness of fly and spider familiars.||2|
|Holy Grail||5.100.184||Flight + HP up||Grants flight and one Red Heart container.||3|
|Holy Mantle||5.100.313||Holy shield||Grants a shield that negates the first instance of damage taken, once per room. Does not apply to or negate self-damage ( Blood Donation Machines, etc).||4|
|Holy Water||5.100.178||Splash!|| Spawns a bottle familiar that breaks when Isaac takes damage, leaving a puddle of blue creep.
A bottle familiar that flies forward when Isaac shoots. It breaks upon hitting an enemy, leaving a puddle of blue creep that petrifies enemies.
|Hot Bombs||5.100.256||Burning blast +5 bombs||Grants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact.||1|
|Humbling Bundle||5.100.203||1+1 free 4Evar||Transforms Bombs, Keys, Pennies, and Red Hearts into their respective Double versions. This will occur only 50% of the time.||3|
|Infamy||5.100.242||Blocks damage... sometimes||Chance to block projectiles coming from any direction.||2|
|Infestation||5.100.148||Fly revenge|| 1-3 Blue Flies randomly spawn every time Isaac gets hit.
2-6 Blue Flies randomly spawn every time Isaac gets hit.
|Infestation 2||5.100.234||Infestation shot||Spawns allied Blue Spiders from killed enemies.||4|
|Ipecac||5.100.149||Explosive shots||Replaces tears with explosive and poisoning projectiles fired in an arc from the mouth.||4|
|Iron Bar||5.100.201||DMG up + concussive tears||Increases damage by 0.3 and adds a chance to shoot concussive tears, causing enemies to walk around randomly.||2|
|Isaac's Heart||5.100.276||Protect it||Isaac himself is now immune to all damage, and a heart familiar follows him. If the heart is hurt, Isaac is hurt. 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||Damage + range up||+0.5 damage, +0.25 range, +0.5 tear height.||2|
|Judas' Shadow||5.100.311||Sweet revenge||Upon death, respawns Isaac as Dark Judas with two Black Hearts in the most recent non-hostile room.||3|
|Juicy Sack||5.100.266||Sticky babies||Spawns a familiar that follows Isaac and drips a trail of slow creep, spawning 1-2 Blue Spiders after each room.||2|
|Key Piece 1||5.100.238||???||Combined with Key Piece 2, unlocks the golden gate in the starting room of Chest and Dark Room to fight Mega Satan.||0|
|Key Piece 2||5.100.239||???||Combined with Key Piece 1, unlocks the golden gate in the starting room of Chest and Dark Room to fight Mega Satan.||0|
|Latch Key||5.100.343||Luck up||Grants 1 Soul Heart and +1 luck. Spawns 2 Keys.||2|
|Lazarus' Rags||5.100.332||Eternal life?|| Upon dying, resurrect as Lazarus Risen in the current room with one Red Heart container and Anemic.
Upon dying, resurrect as Lazarus Risen in the current room with one less Red Heart container (but no less than 1), Anemic, and a permanent +0.5 Damage up. Going to the next floor reverts him back into Lazarus, with his inherent extra life effect.
|Leech||5.100.270||Blood sucker||Spawns a leech familiar that chases enemies, dealing ~3 damage per second. Heals a Half Red Heart whenever Leech kills an enemy.||1|
|Leo||5.100.302||Stompy||Isaac can destroy rocks by walking into them.||1|
|Libra||5.100.304||You feel balanced||Gives 6 coins, 6 bombs, and 6 keys and balances out all attributes.||1|
|Lil Brimstone||5.100.275||Evil friend||Grants a familiar that charges a thin Brimstone laser while Isaac is shooting.||3|
|Lil Haunt||5.100.277||Fear him||Spawns a familiar that chases down enemies, dealing 4 damage per second and inflicting fear.||1|
|Little Baggy||5.100.252||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||Gives kisses||Spawns a familiar who drops a Half Red Heart every 3 rooms.||2|
|Little Chubby||5.100.88||Attack buddy||Spawns a charger familiar that charges forward and deals contact damage to any enemies in its path.||1|
|Little Gish||5.100.99||Sticky friend||Spawns a familiar that follows Isaac around and fires slowing tears, impeding enemies' speed.||2|
|Little Steven||5.100.100||Psychic friend||Spawns a familiar who follows Isaac around and fires homing tears.||1|
|Loki's Horns||5.100.87||Cross tears||Gives a random chance for projectiles to fire in all 4 cardinal directions.||1|
|Lord of the Pit||5.100.82||Demon wings||Grants flight and +0.3 speed.||3|
|Lost Contact||5.100.213||Shielded tears||Isaac's tears can hit and destroy enemy projectiles. -0.16 shot speed.||2|
|Lucky Foot||5.100.46||Luck up||+1 luck. Increases chance of winning Shell Games and Fortune Tellers (independent from the luck stat).
Converts all bad pills into good pills, without identifying them.
|Lunch||5.100.22||HP up||Grants one full Red Heart container. Heals 1 additional Red Heart.||1|
|Maggy's Bow||5.100.312||HP up + you feel healthy||Gives one Red Heart Container and doubles the healing provided by Red Hearts. Also heals 1 Red Heart when obtained.||2|
|Magic 8 Ball||5.100.194||Shot speed up||+0.16 shot speed, spawns a random tarot card. Increases the chance of finding a Planetarium.||1|
|Magic Mushroom||5.100.12||All stats up!||Makes Isaac bigger. Adds one Red Heart Container, +0.3 Damage, x1.5 damage multiplier, +5.25 / +1.5 Range, and +0.3 Speed, and restores all Health.||4|
|Magic Scab||5.100.253||HP + luck up||Grants one full Red Heart container, +1 luck.||2|
|Magneto||5.100.53||Item snatcher||Pulls pickups towards Isaac.||1|
|Match Book||5.100.344||Evil up||Grants Isaac one Black Heart, spawns two or three Bombs.||1|
|MEAT!||5.100.193||DMG + HP up||Grants one full Red Heart container, +0.3 damage.||2|
|Midas' Touch||5.100.202||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||Speed + range up||Decreases Isaac's size, making him less likely to be hit. +0.3 speed, +1.5 tear height, -4.25 range (effective range is increased). +0.3 speed, +1.50 range.||2|
|Missing No.||5.100.258||Syntax error||Randomizes all passive items and stats upon pickup and at the start of each succeeding floor.||1|
|Missing Page 2||5.100.262||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.
Increases the damage of Black Hearts and The Necronomicon-like effects by 40.
|Mitre||5.100.173||Blessing of purity||Grants a chance of converting any Red Heart pickups into Soul Hearts instead.||3|
|Mom's Coin Purse||5.100.195||What's all this...?||Spawns 4 random pills near Isaac.||1|
|Mom's Contacts||5.100.110||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||Eye in the back of your head||Gives Isaac a chance to fire tears from the back of his head.||1|
|Mom's Eyeshadow||5.100.200||Charm tears||Tears have a chance to charm enemies.||1|
|Mom's Heels||5.100.30||Range up||+5.25 range, +0.5 tear height. Enemies that touch Isaac take 12 damage.||1|
|Mom's Key||5.100.199||Better chest loot +2 keys||Adds 2 keys. Chests will drop additional pickups.||3|
|Mom's Knife||5.100.114||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||Range up||+5.25 range, +0.5 tear height. Spawns one random heart.||1|
|Mom's Perfume||5.100.228||Fear shot + tears up||Adds a chance to shoot fear tears and decreases tear delay by 1.||2|
|Mom's Purse||5.100.139||More trinket room||Allows Isaac to hold one additional trinket. Drops a random trinket.||3|
|Mom's Underwear||5.100.29||Range up||+5.25 range, +0.5 tear height. Spawns 3-6 Blue Flies on pickup.||1|
|Mom's Wig||5.100.217||You feel itchy...||Adds a chance to spawn Blue Spiders when firing tears. Restores 1 Red Heart.||3|
|Money = Power||5.100.109||$$$ = 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 friend||Spawns a familiar that copies the tears of Isaac's other familiars.||2|
|Monstro's Lung||5.100.229||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||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||Quad shot||Grants quadruple shot but decreases Tears.||3|
|My Reflection||5.100.5||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||Toxic splash damage||Tears leave a small, short lasting pool of creep on impact or when their range is depleted.||3|
|Mystery Sack||5.100.271||?||Spawns a familiar that drops a Heart, coin, Bomb, or Key every 5-6 rooms.||2|
|Number One||5.100.6||Tears up + range down||Grants +1.5 tears, but severely reduces range.||2|
|Odd Mushroom||5.100.121||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||Tears + speed up, DMG down||+1.7 tears, +0.3 speed, slightly reduces damage.||2|
|Old Bandage||5.100.219||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||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||Ultimate grand supreme||Spawns seven random coins around Isaac.||0|
|Pentagram||5.100.51||DMG up||+1 damage, increases Devil Room / Angel Room chance by 10%.||3|
|PHD||5.100.75||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||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||Tears up + knock-back shots||-1 Tear Delay, adds knock-back shots and increases tear size.||2|
|Placenta||5.100.218||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||Mega tears||Isaac fires huge tears that deal massive damage, but fire rate is greatly decreased. If a tear kills an enemy, it travels on with any leftover damage.||4|
|Proptosis||5.100.261||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||Scape goat||Spawns a Mulligan familiar that wanders randomly. Enemies will attack the Mulligan if it's closer.||1|
|Pyro||5.100.190||99 bombs||Grants 99 Bombs.||3|
|Pyromaniac||5.100.223||It hurts so good +5 bombs||+5 bombs. Grants immunity to explosion damage and causes explosions to heal Isaac. Also grants immunity to fire.||4|
|Rainbow Baby||5.100.174||Random buddy||Spawns a familiar that follows Isaac around and fires tears with random effects.||1|
|Raw Liver||5.100.16||HP up||Grants 2 Red Heart containers and completely restores health.||2|
|Robo-Baby||5.100.95||Friends 'till the bbbbzzzt||Spawns a familiar that shoots Technology lasers.||1|
|Robo-Baby 2.0||5.100.267||We worked out all the kinks||Spawns a familiar that fires lasers at any enemy in its line of sight and moves based on the direction Isaac is firing tears.||1|
|Roid Rage||5.100.14||Speed and range up|| +0.6 speed, +5.25 range, +0.5 tear height.
+0.3 speed, +1.50 range, +0.5 tear height.
|Rosary||5.100.72||Tears + faith up||Grants 3 Soul Hearts. Causes The Bible to appear in any item pool. +0.5 tears.||2|
|Rotten Baby||5.100.268||Infested friend||Spawns a familiar that spawns a Blue Fly when Isaac shoots. It can only have one Fly at a time.||3|
|Rotten Meat||5.100.26||HP up||Grants one full Red Heart container. Heals 1 additional Red Heart.||1|
|Rubber Cement||5.100.221||Bouncing tears||Tears bounce off walls, enemies, and environmental objects.||3|
|Sack of Pennies||5.100.94||Gives money||Spawns a familiar that drops a coin every 2 rooms.||1|
|Sacred Heart||5.100.182||Homing shots + DMG up|| Adds a Red Heart Container. Grants homing tears, a x2.3 Damage multiplier, +1 flat Damage, -0.4 Tears, -0.25 Shot Speed, and +4.125 Range.
Adds a Red Heart Container. Grants homing tears, a x2.3 Damage multiplier, +1 flat Damage, -0.4 Tears, and -0.25 Shot Speed.
|Sacrificial Dagger||5.100.172||My fate protects me||Spawns a dagger orbital familiar, blocking enemy shots and dealing a high amount of damage to enemies in contact.||2|
|Sad Bombs||5.100.220||Tear blasts +5 bombs||+5 Bombs. Upon exploding, bombs shoot 10 tears around them, affected by tear modifiers.||2|
|Safety Pin||5.100.339||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||Piercing shots + speed up||Increases speed by +0.2 and grants piercing tears.||3|
|Samson's Chains||5.100.321||The ol' ball and chain||Attaches a ball and chain to Isaac that pulls behind him that damages enemies, blocks shots, and destroys most obstacles.||1|
|Scapular||5.100.142||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||Poison tears||Grants poison tears, which deal damage over time when inflicted.||3|
|Screw||5.100.255||Tears + shot speed up||+0.5 tears, +0.2 shot speed.||3|
|Sharp Plug||5.100.205||Infinite charge... at a cost||Damages Isaac in exchange for fully recharging Isaac's current activated item.||1|
|Sissy Longlegs||5.100.280||She loves you||Spawns a familiar that wanders randomly, occasionally spawning Blue Spiders.||1|
|Sister Maggy||5.100.67||Friends 'till the end||Spawns a familiar that follows Isaac around shooting normal tears.||1|
|Skatole||5.100.9||Fly love||Flies become harmless or less dangerous depending on the type.||0|
|Skeleton Key||5.100.17||99 keys||Gives Isaac 99 Keys.||3|
|Smart Fly||5.100.264||Revenge fly||Spawns an orbital familiar that blocks enemy shots. Upon taking damage, the familiar will pursue enemies for the rest of the room, dealing 22.5 damage per second.||2|
|SMB Super Fan||5.100.189||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||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 + shot speed up||+0.3 speed, +0.2 shot speed.||2|
|Spelunker Hat||5.100.91||See-through doors||Reveals type of adjacent rooms, including location for Secret Rooms and Super Secret Rooms.||2|
|Spider Bite||5.100.89||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||Spider revenge|| When hit, spawns 1-2 Blue Spiders.
When hit, spawns 3-5 Blue Spiders.
|Spirit of the Night||5.100.159||Scary||Grants spectral tears and flight.||3|
|Spoon Bender||5.100.3||Homing shots||Grants Isaac homing tears.||3|
|Squeezy||5.100.196||Tears up||Increases tears by 0.4, spawns 2 Soul Hearts.||3|
|Starter Deck||5.100.251||Extra card room||Isaac can hold 2 cards at once and all pills are replaced by cards.||2|
|Steam Sale||5.100.64||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||HP + shot speed up||Grants one full Red Heart container and +0.16 shot speed.||1|
|Steven||5.100.50||DMG up||Increases damage by 1.||3|
|Stigmata||5.100.138||DMG + HP up||+0.3 damage, grants one full Red Heart container. Heals 1 additional Red Heart.||2|
|Stop Watch||5.100.232||Let's slow this down a bit...|| Automatically inflicts slow to all enemies in every room.
Upon taking damage, inflicts slow to all enemies for the current room.
Slows all enemies in every room to 80% speed.
|Strange Attractor||5.100.315||Magnetic tears||Pickups, trinkets, and monsters are magnetically attracted to Isaac's tears.||0|
|Super Bandage||5.100.92||+2 hearts||Grants one full Red Heart container and 2 Soul Hearts.||2|
|Synthoil||5.100.345||DMG + range up||+1 damage, +5.25 range, +0.5 tear height.||3|
|Taurus||5.100.299||Speed down + rage is building||-0.3 Speed. Isaac builds speed while in a room with enemies. At max speed, he gains the My Little Unicorn effect for 5 seconds.||1|
|Tech.5||5.100.244||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||Laser tears||Replaces tears with a piercing laser with unlimited range.||3|
|Technology 2||5.100.152||Extra laser||Replaces the tears fired from Isaac's right eye with a rapid-firing low damage piercing laser. Damage down.||2|
|The Battery||5.100.63||Stores energy||Activated collectibles can store an extra level of charge, allowing them to be used twice in one room.||2|
|The Belt||5.100.28||Speed up||Increases speed by 0.3.||1|
|The Black Bean||5.100.180||Toot on touch||When taking damage, Isaac farts, causing poison damage to all enemies in range.||0|
|The Body||5.100.334||I feel all||Adds 3 Red Heart Containers.||3|
|The Common Cold||5.100.103||Poison damage||Adds a chance to shoot poison tears, dealing damage over time when inflicted.||1|
|The Compass||5.100.21||The end is near||Reveals the locations and types of all special rooms on the map, except Secret Rooms and Super Secret Rooms.||2|
|The Halo||5.100.101||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||Triple shot||Grants triple shot but decreases tears.||2|
|The Ladder||5.100.60||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||Controlled tears||Instead of firing tears, Isaac controls one floating tear that hover over obstacles. This tear deals constant damage when held in place over an enemy.||2|
|The Mark||5.100.79||DMG + speed up|| Grants one Soul Heart, +1 damage, and +0.2 speed.
Grants one Black Heart, +1 damage, and +0.2 speed.
|The Mind||5.100.333||I know all||Reveals the entire map, including all special rooms and Secret Rooms.||3|
|The Mulligan||5.100.151||They grow inside||Tears have a 1/6 chance of spawning allied Blue Flies when they hit an enemy.||3|
|The Negative||5.100.328||Fate chosen||If Isaac has half a red heart or no red hearts after taking damage, all enemies in the room take significant damage. Allows entrance into the Dark Room. Also allows access to Home.||2|
|The Pact||5.100.80||DMG + tears up|| Grants two Soul Hearts, +0.5 damage, and +0.7 tears.
Grants two Black Hearts, +0.5 damage, and +0.7 tears.
|The Parasite||5.100.104||Split shot||Isaac's tears split in two when they hit something.||3|
|The Peeper||5.100.155||Plop!||Spawns a familiar that floats slowly around the room on a zig-zag pattern, damaging enemies it passes through.||2|
|The Polaroid||5.100.327||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. Also allows access to Home.||2|
|The Relic||5.100.98||Soul generator||Spawns a cross familiar that drops a Soul Heart after clearing enough rooms.||3|
|The Sad Onion||5.100.1||Tears up||Increases tears by 0.7.||3|
|The Small Rock||5.100.90||DMG up + speed down||+1 damage, +0.2 tears, -0.2 speed.||3|
|The Soul||5.100.335||I am all||Grants two Soul Hearts. Isaac gains a pulsing aura that repels enemies and projectiles.||3|
|The Virus||5.100.13||Poison touch + speed up||Isaac poisons enemies on contact. -0.1 speed. +0.2 speed. Poisoned enemies have a chance to drop a black heart when killed.||2|
|The Wafer||5.100.108||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||More options||Two items appear after defeating a Boss. Only one can be taken; the other will disappear.||3|
|Thunder Thighs||5.100.314||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||Orbiting tears + range up||Massively increases Range and grants spectral tears. Tears orbit around Isaac at a fixed distance until they hit the ground.||0|
|Toothpicks||5.100.183||Tears + shot speed up||+0.7 tears, +0.16 shot speed.||3|
|Torn Photo||5.100.341||Tears + shot speed up||+0.7 tears, +0.16 shot speed.||3|
|Tough Love||5.100.150||Tooth shot||Adds a chance to shoot a tooth instead of a tear, which deals x3.2 Isaac's damage.||3|
|Transcendence||5.100.20||We all float down here...||Grants flight.||3|
|Treasure Map||5.100.54||Full visible map||Reveals the map of each floor. It does not identify special rooms and does not reveal the locations of Secret Rooms / Super Secret Rooms.||2|
|Trinity Shield||5.100.243||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||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||Curse up||Grants +1.5 Damage and +0.3 Speed whenever Isaac has half a Red Heart or less.||2|
|Wire Coat Hanger||5.100.32||Tears up||Increases tears by 0.7.||3|
|Wooden Spoon||5.100.27||Speed up||Increases speed by 0.3.||1|
|X-Ray Vision||5.100.76||I've seen everything||Reveals and opens all Secret Room and Super Secret Room entrances.||2|
|8 Inch Nails||5.100.359||Stick it to 'em!||+1.5 damage. Replaces Isaac's tears with nails, which have increased knockback.||3|
|Athame||5.100.408||Call to the void||When Isaac takes damage, a black ring briefly appears around him, dealing damage to all nearby enemies.||1|
|Betrayal||5.100.391||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|
|Binky||5.100.438||Tears up||Grants one Soul Heart, +0.75 tears and decreases Isaac's size.||3|
|Black Powder||5.100.420||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|
|Bomber Boy||5.100.353||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|
|Bumbo||5.100.385||Bumbo want coin!||Spawns a beggar familiar which picks up any nearby coins, leveling up after collecting several coins. At level 2, Bumbo gains a body. At level 3, it begins to fire tears. At level 4, Bumbo follows enemies and gains contact damage.||1|
|Bursting Sack||5.100.377||Spider love||Spider enemies no longer target or deal contact damage to Isaac.||1|
|Cambion Conception||5.100.412||Feed them hate||After taking damage a certain amount of times, a permanent demonic familiar spawns.||2|
|Car Battery||5.100.356||Active power up||Causes Isaac's activated item to activate twice on each use.||3|
|Censer||5.100.387||Peace be with you||Spawns a familiar which creates a circular aura that slows down enemies and enemy shots inside.||3|
|Chaos||5.100.402||!!!||Drops 1-6 random pickups on the floor. Causes items to be chosen from random item pools.||3|
|Charged Baby||5.100.372||Bbbzzzzzt!||Spawns a familiar that occasionally drops a Lil' Battery, gives an active item charge, or petrifies all enemies in the room.||3|
|Circle of Protection||5.100.423||Protect me from myself||Surrounds Isaac with a large white halo that occasionally deals Isaac's tear damage to enemies inside it, and can convert enemy shots into friendly homing tears.||2|
|Continuum||5.100.369||Transcendent tears||Grants spectral tears and increases range. Tears travel through walls and appear at the opposite side of the room.||2|
|Crack Jacks||5.100.354||HP up. Don't swallow the prize!||Grants one full Red Heart container and drops a random trinket.||2|
|Crown of Light||5.100.415||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|
|Curse of the Tower||5.100.371||Embrace chaos||Upon taking damage, spawns six Troll Bombs around the room, similar to the effect of XVI - The Tower.||1|
|Dead Eye||5.100.373||Accuracy brings power!||Isaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.||3|
|Deep Pockets||5.100.416||More money!|| Allows Isaac to carry two cards or pills (or a combination of both) at the same time.
Increases the coin cap to 999. If a room would otherwise yield no reward, 1-3 coins will spawn.
|Eden's Blessing||5.100.381||Tears up + your future shines brighter||+0.7 tears up. Grants a random item at the start of the next run.||3|
|Empty Vessel||5.100.409||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|
|Epiphora||5.100.368||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|
|Evil Eye||5.100.410||Eye shot!||Adds a chance to fire a slow-moving eye that fires tears in the same direction as Isaac. The eye will be destroyed if it hits an enemy or obstacle.||2|
|Explosivo||5.100.401||Sticky bomb shot!||Isaac's tears have a chance to stick to enemies and explode.||2|
|Farting Baby||5.100.404||He farts!||Spawns a familiar that follows Isaac and blocks enemy shots. If a shot hits Farting Baby, it has a chance to fart, which charms, poisons, or knocks back nearby enemies.||1|
|Fate's Reward||5.100.361||Your fate beside you||A blue head familiar that will follow Isaac and fire tears copying his tear effects and damage.||2|
|Friend Zone||5.100.364||Friendly fly||Spawns a white attack fly that orbits somewhere between Distant Admiration and Forever Alone, dealing 45 damage per second.||1|
|Fruit Cake||5.100.418||Rainbow effects!||Isaac's tears gain a random effect that changes every shot.||2|
|GB Bug||5.100.405||Double tap glitch|| Spawns a familiar that bounces diagonally around the room, applying a random status effect to enemies it hits and has a chance to re-roll pickups it passes over.
Spawns a familiar that follows Isaac. Double tapping the fire button launches it forward, causing it to reroll the first monster or pickup it hits.
|Glitter Bombs||5.100.432||Prize bombs!||+5 Bombs. Bombs have a chance to drop random pickups or charm enemies when they explode.||2|
|God's Flesh||5.100.398||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|
|Head of the Keeper||5.100.429||Penny tears!||Isaac's tears become coins and now have a chance to drop Pennies on the floor upon successfully hitting an enemy.||2|
|Holy Light||5.100.374||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|
|Host Hat||5.100.375||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|
|Immaculate Conception||5.100.413||Feed them love||Upon picking up a certain amount of health, spawn a permanent angelic familiar.||2|
|Incubus||5.100.360||Dark friend||Spawns a demonic familiar that shoots tears identical to Isaac's in terms of damage, tears, and tear effects.||4|
|Key Bum||5.100.388||He wants your keys!||Spawns a familiar that follows Isaac and collects Keys for himself, giving random Chests in return.||0|
|Kidney Stone||5.100.440||Matt's kidney stone||Randomly while firing tears, Isaac will stop firing and turn red, where he will charge and release a lot of 'tears' in one go. The burst of tears also includes a kidney stone, which deals a lot of damage.||2|
|Lil Chest||5.100.362||What's in the box?||Spawns a chest familiar that spawns a random pickup (25% chance) or trinket (10% chance) upon clearing a room.||2|
|Lil Gurdy||5.100.384||A gurd of your own!||A Gurdy Jr. familiar that charges up while Isaac is firing, bouncing around the room when released and dealing contact damage based on its speed.||2|
|Lil Loki||5.100.435||4-way buddy!||Spawns a Loki familiar that follows Isaac and fires 4 tears in a cross pattern.||1|
|Lost Fly||5.100.365||Lost protector|| Spawns fly familiar that moves in a straight line and circles around the first wall or obstacle it hits, dealing 105 damage per second on contact.
Spawns fly familiar that moves in a straight line and circles around the first wall or obstacle it hits, dealing 56 damage per second and forcing nearby enemies to attack it.
|Lusty Blood||5.100.411||Their blood brings rage!||Isaac's damage increases for the current room each time he kills an enemy.||3|
|Marked||5.100.394||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.||1|
|Maw of the Void||5.100.399||Consume thy enemy!||Charged by firing for 2.5 seconds and when released, creates a black ring around Isaac that rapidly deals damage. +1 damage, the ring can cause enemies to drop Black Hearts.||4|
|Milk!||5.100.436||Don't cry over it...||Spawns a glass familiar that spills on the floor upon taking damage. After the milk spills, Isaac's tear delay is decreased by 2 for the current room.||1|
|Mom's Pearls||5.100.355||Range + luck up||+1.25 range, +0.5 tear height, +1 luck. Grants one Soul Heart.||2|
|More Options||5.100.414||There's options||Two item pedestels are presented in every Treasure Room. Only one can be taken; the other will disappear.||3|
|Mr. Dolly||5.100.370||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|
|Multidimensional Baby||5.100.431||ydduB Buddy||Spawns a familiar that will follow Isaac's movements on a 2.5-second delay. Tears that pass through the baby will be doubled and increase in speed.||2|
|My Shadow||5.100.433||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|
|Night Light||5.100.425||Scared of the dark?||A cone of light shines in the direction Isaac is moving that slows enemies and enemy shots.||2|
|Number Two||5.100.378||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|
|Obsessed Fan||5.100.426||Follows my every move...||Spawns a familiar that follows Isaac's movements on a delay and deals 30 contact damage per second to enemies.||0|
|Papa Fly||5.100.430||Turret follower||Spawns a familiar that follows Isaac's movements on a 3 second delay, firing tears at nearby enemies.||1|
|Pay to Play||5.100.380||Money talks||+5 Coins. Doors ( except including those requiring 2 Keys), Key Blocks, and Chests all now require one Penny to open.||2|
|PJs||5.100.428||You feel cozy||Grants 4 Soul Hearts and fully restores Isaac's health.||2|
|Pupula Duplex||5.100.379||Wide shot||Gives Isaac spectral tears and gives his tears a wide arc shape, increasing their size.||2|
|Purity||5.100.407||Aura stat boost||Boosts one of Isaac's stats depending on the color of the aura around him. The aura disappears upon taking damage and reappears with a random color upon entering a new room. Red boosts damage, blue boosts tears, yellow boosts speed, and orange boosts range.||3|
|Restock||5.100.376||Never ending stores!||Causes shops to instantly restock their items when they are bought. Outside of Greed Mode, the restocked item's cost is increased after each purchase.||2|
|Rune Bag||5.100.389||Rune generator||Spawns a familiar that drops a random rune after clearing enough rooms.||3|
|Sack Head||5.100.424||More sacks!||Coins, bombs, keys, cards, runes and batteries have a chance to become sacks.||3|
|Scatter Bombs||5.100.366||We put bombs in your bombs!||Adds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs.||1|
|Seraphim||5.100.390||Sworn friend||Spawns an angel familiar which follows Isaac and fires homing tears which deal 10 damage and have 75% shot speed.||3|
|Serpent's Kiss||5.100.393||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.||2|
|Spear of Destiny||5.100.400||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|
|Spider Mod||5.100.403||Mod buddy!||Displays Isaac's tear damage and enemy health bars. Spawns a familiar that wanders around and inflicts random status effects on enemies it touches. Can spawn a Lil' Battery/Blue spider upon clearing a room.||1|
|Sticky Bombs||5.100.367||Egg sack bombs!||+5 bombs. Bombs stick to enemies and spawn 2-4 Blue Spiders if they kill an enemy.||1|
|Succubus||5.100.417||Damage booster||Spawns a flying familiar that bounces around the room with a black aura, dealing rapid damage to any enemies inside it. While standing in the aura, Isaac gains a 1.5x tear damage multiplier.||3|
|Sworn Protector||5.100.363||Protective friend||Spawns an orbital familiar which does 105 damage per second and attracts and blocks enemy shots. Upon blocking 10 shots in a room, it drops an Eternal Heart.||3|
|Tech X||5.100.395||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|
|The Wiz||5.100.358||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|
|Toxic Shock||5.100.350||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|
|Tractor Beam||5.100.397||Controlled tears||Increases Tears, Range, and Shot Speed. Isaac emits a beam from his face that his tears are bound to.||3|
|Zodiac||5.100.392||The heavens will change you||Gives Isaac a random zodiac item effect that changes every floor.||1|
|7 Seals||5.100.526||Lil harbingers!||Spawns a random Harbinger familiar that changes every 10 seconds. Harbingers have different behaviors and spawn themed Locusts.||2|
|Acid Baby||5.100.491||Pills pills pills!||Spawns a familiar that drops a random pill every 3 rooms. Upon using a pill, all enemies in the room are poisoned.||2|
|Adrenaline||5.100.493||Panic = power||Increases damage based on how many empty Red Heart containers Isaac has.||1|
|Analog Stick||5.100.465||360 tears!||+0.35 tears up. Allows Isaac to fire tears diagonally.||2|
|Angelic Prism||5.100.528||Eclipsed by the moon||Spawns an orbital familiar with a large orbital radius. Tears that pass through the prism split into four multi-colored tears.||3|
|Angry Fly||5.100.511||He's violent||Spawns a fly familiar that orbits around a random enemy and deals 30 damage per second to enemies it comes in contact with.||1|
|Apple!||5.100.443||Trick or treat?||Increases tears. Adds a chance to fire a high-damage razor blade.||3|
|Backstabber||5.100.506||Watch your back!||Isaac's tears deal double damage and inflict bleeding on enemies if they're facing away from Isaac.||2|
|Belly Button||5.100.458||What's in there?||Drops a random trinket. Grants a second trinket slot.||3|
|Big Chubby||5.100.473||Chub chub||Spawns a familiar that follows Isaac and charges across the room when Isaac fires, blocking shots and dealing 40.5 damage per second on contact.||1|
|Blanket||5.100.535||You feel Safe||Grants one Soul Heart. Upon entering a boss room, grants a shield that blocks one hit, then disappears.||2|
|Bloodshot Eye||5.100.509||Bloody friend||Spawns an orbital familiar that deals 30 damage per second and fires a randomly angled tear every 2 seconds.||1|
|Bozo||5.100.513||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|
|Brittle Bones||5.100.549||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|
|Broken Modem||5.100.514||Lag!||Enemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals.||2|
|Broken Shovel||5.100.551||It feels cursed||One of two parts necessary to create Mom's Shovel. No effect if somehow obtained on its own.||4|
|Buddy in a Box||5.100.518||What could it be?!||Spawns a familiar with a random tear effect. The familiar is randomized at the start of each floor.||2|
|Camo Undies||5.100.497||Camo kid||Isaac becomes camouflaged at the beginning of each room. Until he shoots, all non-boss enemies will be confused. Isaac gains +0.5 Speed while camouflaged, and gains Tears and Damage upon breaking it.||2|
|Compound Fracture||5.100.453||Bone tears!||Increases Range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.||3|
|Cone Head||5.100.457||Hard headed!||Grants a Soul Heart. Gives Isaac a chance to ignore any damage taken.||2|
|Contagion||5.100.466||Outbreak!||The first enemy killed in a room explodes and poisons nearby enemies. Poisoned enemies will also explode upon death.||2|
|Dad's Lost Coin||5.100.455||I remember this...||+1.5 range. Drops a Lucky Penny.||2|
|Dad's Ring||5.100.546||Father's blessing||Creates a ring of light around Isaac that petrifies enemies in contact.||3|
|Dark Prince's Crown||5.100.442||Loss is power||When at exactly one Red Heart, increases tears, range, tear height, and shot speed.||1|
|Dead Tooth||5.100.446||Toxic breath||While firing, Isaac gains a green aura that poisons nearby enemies.||1|
|Death's List||5.100.530||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|
|Depression||5.100.469||:(||Spawns a familiar that leaves a trail of creep that damages enemies at 6 damage per second. Has a chance to spawn damaging beams of light onto enemies that touch the cloud.||1|
|Divorce Papers||5.100.547||Tears up + you feel empty||Grants one Bone Heart, +0.7 tears, spawns a Mysterious Paper.||3|
|Dog Tooth||5.100.445||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|
|Duality||5.100.498||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|
|Eucharist||5.100.499||Peace be with you||An Angel Room door will always spawn after every boss fight, excluding the first floor and floors after Womb II/ Utero II/.||3|
|Euthanasia||5.100.496||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|
|Eye of Belial||5.100.462||Possessed tears!||Grants piercing tears. After piercing one enemy, tears start homing and deal double damage.||3|
|Eye of Greed||5.100.450||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|
|Fast Bombs||5.100.517||Rapid bomb drops||Grants 7 bombs and allows bombs to be placed rapidly.||1|
|Finger!||5.100.467||Watch where you point that!||Spawns a finger familiar that points at enemies, dealing scaling damage.||1|
|Flat Stone||5.100.540||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|
|Ghost Pepper||5.100.495||Flame tears||Gives a chance to shoot fires alongside tears that block enemy shots and deal damage to enemies that touch them.
Gives a chance to shoot blue fires alongside tears that become smaller as they travel.
|Glaucoma||5.100.460||Blind tears!||Adds a chance to shoot tears that confuse enemies for an extremely long time.||1|
|Glyph of Balance||5.100.464||A gift from above||Grants 2 Soul Hearts and modifies drops from Champion monsters based on certain conditions. Also modifies room clear drops.||3|
|Greed's Gullet||5.100.501||Money = health!||Grants a Red Heart container for every 25 coins Isaac has.||1|
|Haemolacria||5.100.531||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.||3|
|Hallowed Ground||5.100.543||Portable sanctuary||Spawns a white poop familiar, which turns into a White Poop when Isaac is hurt. White poop has an aura that increases tear fire rate and can block enemy shots. The aura also increases damage b 20% and gives homing.||1|
|Hushy||5.100.470||Lil hush!||Spawns a Hush familiar that bounces diagonally around the room and deals contact damage. While firing tears, it stops moving.||0|
|Jacob's Ladder||5.100.494||Electric tears||Tears fire sparks of electricity in random directions upon hitting an obstacle or enemy.||3|
|Jaw Bone||5.100.548||Fetch!||Spawns a familiar that flies through the room while firing, dealing a flat 7 contact damage to enemies and retrieving pickups.||1|
|Jumper Cables||5.100.520||Bloody recharge||Grants an active item charge every 15 enemies killed.||3|
|King Baby||5.100.472||Hail to the king baby||Spawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, other familiars stop moving.||1|
|Lachryphagy||5.100.532||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|
|Large Zit||5.100.502||Creep shots||Adds a chance to fire a creep shot that deals double damage and leaves a trail of slowing white creep.||1|
|Lead Pencil||5.100.444||He's a bleeder!||After every 15 tears fired, Isaac will fire a high-damage cluster of tears.||3|
|Leprosy||5.100.525||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|
|Lil Delirium||5.100.519||Delirious friend||Grants a familiar that transforms into another random familiar every 10 seconds.||2|
|Lil Monstro||5.100.471||Ain't he cute?||Spawns a familiar that fires clusters of tears. Must be charged before shooting.||2|
|Lil Spewer||5.100.537||Puking buddy||Drops a random pill, and spawns a familiar that charges up and fires creep. Using pills changes the creep type.||1|
|Linger Bean||5.100.447||Crying makes me toot||Constantly shooting causes Isaac to release gas clouds that can be pushed by his tears and damage nearby enemies.||0|
|Little Horn||5.100.503||Big brother is watching|| Adds a chance to fire a piercing tear that instantly kills any enemy that it touches.
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.
|Marbles||5.100.538||Choking hazard||Spawns 3 random trinkets, 5% chance to swallow held trinket after taking damage, gaining its effect permanently.||2|
|Marrow||5.100.541||HP up?||Grants one Bone Heart and spawns three Red Hearts.||1|
|Metal Plate||5.100.449||It itches...||Grants one Soul Heart. Enemy shots have a chance to be reflected at the shooter as confusing tears.||1|
|Midnight Snack||5.100.456||HP up||Grants one full Red Heart container. Heals 1 additional Red Heart.||1|