Items

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. Afterbirth added 95 new items, for a total of 436 items. Afterbirth † added 111 new items, for a total of 547 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.

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

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 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.

Name	ID	Icon	Quote	Description	Quality
A Pony	5.100.130		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		Summon bombs	Spawns six Troll Bombs around the room.	1
Best Friend	5.100.136		Friends 'till the end	Spawns a decoy Isaac that eventually explodes with an increased blast radius.	1
Blank Card	5.100.286		Card mimic	Has the same effect as the card or rune currently held by Isaac. Has the same effect as the card currently held by Isaac.	2
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	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		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 for 10 seconds.	2
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.	1
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. Upon use, Isaac farts and knocks back nearby enemies and projectiles. Upon use, Isaac farts and knocks back nearby enemies and projectiles. Enemies pushed into walls or obstacles take 12 damage.	0
Converter	5.100.296		Convert your soul	Upon use, Converts two Soul Hearts into one full Heart Container. Upon use, converts one Soul or Black Heart into one full Heart Container.	1
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.	2
D10	5.100.285		Rerolls enemies	Rerolls the monsters in the room. Only rerolls monsters that are still alive (does not spawn new enemies).	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.	3
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...	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 The Chest and the Dark Room.	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.	1
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 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. Fires a powerful 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		It's about 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 (one in The Womb onward) for a random amount of coins, similar to a Blood Donation Machine.	1
Kamikaze!	5.100.40		Become the bomb!	Upon use, creates an explosion in the same place as Isaac, damaging him for half a heart and dealing 40 damage to all enemies caught in the blast.	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 play	Uses 1 coin to deal twice Isaac's damage to all enemies in the room.	1
Mom's Bottle of Pills	5.100.102		Reusable pill generator	Gives Isaac a random pill.	1
Mom's Bra	5.100.39		Mass Fear	Petrifies all enemies in the current room for around 4 seconds.	1
Mom's Pad	5.100.41		Gross...	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 list of of familiars for the current room. Spawns a familiar from a list of of familiars for the current floor.	0
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.	0
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 coin 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 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 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. 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		BLLLARRRRGGG!	Fires a laser from Isaac's mouth.	1
Spider Butt	5.100.171		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		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		Temporary psychic shot	Gives homing tears for the current room.	0
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. Guarantees a Devil Room or Angel Room will be open after beating a boss while holding it. Increases the chance by 12.5%.	3
The Book of Sin	5.100.97		Reusable Item Generator	Spawns a random pickup, pill, card, or trinket.	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.	1
The Candle	5.100.164		Reusable flame	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		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.	0
The Nail	5.100.83		Temporary demon form	Gives one Soul Heart 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		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.	3
The Poop	5.100.36		Plop!	Spawns a pile of poop where the 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. If used in The Womb, it will create a trapdoor to Sheol, even if the player hasn't unlocked it.	0
White Pony	5.100.181		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		Reusable Regeneration	Restores one Red Heart of Isaac's health.	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 in the current room into other random objects, such as bomb rocks, metal blocks, TNT, or poops.	0
D7	5.100.437		Reroll rewards!	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.	1
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 Glass Cannon, it becomes Broken Glass Cannon and he is reduced to half a heart.	1
Glowing Hour Glass	5.100.422		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
Jar of Flies	5.100.434		Gotta catch 'em all?	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.	0
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 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
Mom's Box	5.100.439		What's inside?	When used, Mom's Box will drop a random trinket on the ground. While held, increases luck by 1 and doubles the effects of trinkets.	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 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
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 one random type of coin (Penny, Nickel, or Dime).	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, spawns a friendly Bony or an orbital bone for each enemy killed in the current room.	2
Broken Shovel	5.100.550		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
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	Upon use, makes a random item from a Shop, Devil deal, or Black Market 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 dice item that changes each use. Acts as any dice item, and can by cycled by pressing the drop key.	1
D1	5.100.476		What will it be?	Duplicates a random pickup in the room.	2
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 doors to the floor's Secret and Super Secret Rooms.	3
Metronome	5.100.488		Waggles a finger	Grants a random item effect for the current room.	0
Mom's Shovel	5.100.552		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.	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.	3
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, spawns a sprinkler that rotates and fires tears.	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 stat upgrades.	4
Wait What?	5.100.484		I can't believe it's not Butter Bean!	Isaac farts, sending out rock waves.	0
Abyss	5.100.706		Come forth from the depths	Destroys all items in the room and gives Isaac a unique attack fly familiar for each item destroyed.	4
Alabaster Box	5.100.585		A sacred offering	Spawns three soul hearts and two angel room items. Must 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.	2
Bag of Crafting	5.100.710		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
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 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
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	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
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 chance to disappear instead.	2
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		Life and death	Switch characters between Tainted Lazarus and Dead Tainted Lazarus.	3
Fortune Cookie	5.100.557		Reusable fortunes	Gives Isaac a fortune, soul heart, tarot card, or trinket.	2
Free Lemonade	5.100.578		Party time!	Creates a large pool of yellow creep beneath Isaac.	2
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, shotspeed, and special tear effects.	2
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.	2
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/pickup.	3
Larynx	5.100.611		Hear my pain	Makes Isaac shout, damaging and pushing 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 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
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, 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 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
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		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
Suplex!	5.100.709		Angel breaker	Allows Isaac to dash into and pick up enemies, then slam them into the ground to deal damage and create rock waves that damage nearby enemies and destroy obstacles.	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, non-ghost enemies leave behind small, red ghosts on death; using the item causes the ghosts to explode, dealing damage to nearby enemies. Stronger enemies leave behind stronger ghosts that create more powerful explosions.	3
Wavy Cap	5.100.582		Tears up. A mind changing experience!	Increases fire rate, decreases speed, and distorts the screen. All effects become more pronounced with repeated use, and wear off by clearing rooms.	1
Yuck Heart	5.100.639		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	Quality
???'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 previous room with full health and lose the 1up!.	2
20/20	5.100.245		Double shot	Isaac fires two tears at once, one from each eye.	4
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.	2
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 99 coins.	2
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	Adds 25 to Isaac's coin count, capping at 99.	2
A Snack	5.100.346		HP up	Gives one full Red Heart container. Gives one Heart container and heals 2 hearts of health.	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.	4
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 range. After Isaac is damaged, a trail of red creep will be left behind Isaac until he leaves the current room.	0
Ankh	5.100.161		Eternal life?	Upon death, the player will respawn as ??? with 3 Soul Hearts.	2
Anti-Gravity	5.100.222		Antigravity 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		Trail of tears	A trail of blue creep is left behind Isaac, which damages enemies.	0
Aries	5.100.300		Ramming speed	+0.25 Speed. Running into enemies while at a high speed will deal 18 points of damage. Does not prevent contact damage.	1
Ball of Bandages	5.100.207		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		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 dealing 75 damage per second.	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. Gives one Red Heart container, 2 Hearts of health, +0.7 tears and -0.16 shot speed.	3
Blue Map	5.100.246		Secrets	Shows Secret and Super Secret Room locations 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.	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 Bomb pickups 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 Isaac one full Red Heart container.	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.	0
Bucket of Lard	5.100.129		HP up	Grants two empty Red Heart containers and heals Isaac by half a Red Heart, but decreases speed by 0.2.	1
Bum Friend	5.100.144		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		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 upon taking damage.	3
Capricorn	5.100.307		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		Shot speed + damage up	+1 damage, +0.23 shot speed.	3
Celtic Cross	5.100.162		You feel blessed	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		Sin 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 half of a Red Heart for every 13 enemies killed.	0
Chemical Peel	5.100.154		DMG up	Tears fired from the left eye have +2 flat damage.	1
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 multiplies it by 1.5x.	4
Cube of Meat	5.100.73		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		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 himself. For every 1½ Red Hearts collected, Dark Bum will give a Soul Heart, a hostile Spider, a friendly Blue Spider, or a random card, rune or pill.	4
Dark Matter	5.100.259		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		Penetrative shot + damage 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.	1
Dinner	5.100.23		HP Up	Grants one full Red Heart container. and 1 extra heart of health.	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 changed 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		Shot speed down + DMG up	Doubles damage, halves tears stat, and greatly reduces shot speed.	1
Experimental Treatment	5.100.240		Some stats up, some stats down	Randomly increases and decreases some of the character's stats.	1
Fanny Pack	5.100.204		It's 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 Door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.	3
Godhead	5.100.331		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		Speed + DMG up	+1 damage, +0.4 speed.	3
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		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		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.	3
Halo of Flies	5.100.10		Projectile protection	Spawns two Pretty Flies that block enemy shots and deal contact damage to flies.	3
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.	2
Holy Grail	5.100.184		Flight + HP up	Grants flight and one Red Heart container.	3
Holy Mantle	5.100.313		Holy shield	Upon entering a room, grants a shield that negates the first damage taken.	4
Holy Water	5.100.178		Splash!	Spawns a bottle familiar that breaks when Isaac takes damage, leaving a puddle of blue creep. The bottle respawns upon entering a different room. A bottle familiar that flies forward when Isaac shoots. It breaks upon hitting an enemy, leaving a puddle of blue creep that petrifies enemies. The bottle respawns after a few seconds.	0
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!	Replaces all regular red hearts, pennies, keys, and bombs with double versions worth twice as much. 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		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.	0
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		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		Protect It	Isaac himself is now immune to all damage, and a heart familiar appears and follows Isaac. If the heart is hurt, Isaac is hurt.	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	Adds an extra life; upon death, it respawns Isaac as Dark Judas with two Black Hearts.	4
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 The 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 The 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 with one heart container and Anemic.	1
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 shoots a thin Brimstone beam. Must charge like Brimstone before 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 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.	2
Lunch	5.100.22		HP Up	Grants one full Red Heart container. Heals 1 extra heart of health.	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.	2
Magic 8 Ball	5.100.194		Shot speed up	+0.16 shot speed, spawns a random tarot card.	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 range, and +0.3 speed. Restores all health on pickup.	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).	2
Missing No.	5.100.258		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		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 from 40 to 80.	0
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	Allows Isaac 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	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 1 additional 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		Chargeable burst attack	Increases damage and grants a charged shot that fires multiple 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.	1
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	+1.5 tears, -17.62 range	2
Odd Mushroom	5.100.121		DMG + HP 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		Fire rate up	+1.7 tears, +0.3 speed, slightly reduces damage.	3
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		HP up + regen	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, the tear 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	Isaac heals 1 Red Heart instead of taking damage from an explosive source. Adds 5 bombs.	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	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		Speed and range up	+0.6 speed, +5.25 range, +0.5 tear height.	2
Rosary	5.100.72		Tears + faith up	Adds 3 Soul Hearts. The Bible will appear in any item pool. Also a +0.5 tears up.	1
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	Adds one full Red Heart container.	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	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		My fate protects me	Spawns a dagger orbital familiar, dealing 225 damage per second and blocking enemy shots.	3
Sad Bombs	5.100.220		Tear blast +5 bombs	+5 Bombs. Upon exploding, bombs shoot 10 tears around them, affected by tear modifiers.	3
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		Penetrative shot + 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.	2
Screw	5.100.255		Tears and shot speed up.	+0.5 tears, +0.2 shot speed.	3
Sharp Plug	5.100.205		Charge with blood	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.	0
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.	3
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 up to 2 Blue Spiders.	1
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 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	Increases damage, and adds 1 heart container.	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 roughly half speed.	4
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 up + range	+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		Laser	Decreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.	2
The Battery	5.100.63		Stores energy	Activated collectibles can be "overcharged" to allow for an additional use.	2
The Belt	5.100.28		Speed up	Increases speed by 0.3.	2
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 all special rooms (except secret rooms of any kind).	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.	3
The Mark	5.100.79		DMG + speed up	Grants one Soul Heart, +1 damage, and +0.2 speed.	3
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.	1
The Pact	5.100.80		DMG + Tears UP	Grants two Soul Hearts Black Hearts, +0.5 damage, and +0.7 tears.	3
The Parasite	5.100.104		Split Shot	Isaac's tears split in two when they hit something.	2
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.	0
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 The Chest. Also allows access to Home.	2
The Relic	5.100.98		Soul generator	Spawns a cross familiar that drops a Soul Heart every 5-6 rooms.	4
The Sad Onion	5.100.1		Tears up	Increases tears by 0.7.	3
The Small Rock	5.100.90		DMG up	Increases damage by 1, increases tears by 0.2, and decreases speed by 0.2.	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	Inflicts poison to enemies who make contact with Isaac. Speed down. Poisoned enemies have a chance to drop a black heart when killed.	0
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	There will be 2 items available to choose from after defeating a boss. Choosing 1 item causes the other to 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	Range up and makes shot tears revolve around Isaac until they drop.	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 greater damage than regular tears.	3
Transcendence	5.100.20		We all float down here...	Grants flight.	3
Treasure Map	5.100.54		Full visible map	Reveals all rooms for every floor. However, it does not reveal icons or 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 (one red heart for Eve), ignoring any Soul or Black Hearts.	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 Up. 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.	2
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		Explosive blast!	+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 activate 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.	1
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		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 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 pennies will spawn.	2
Eden's Blessing	5.100.381		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!	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
Explosivo	5.100.401		Sticky bomb shot!	Isaac's tears have a chance to stick to enemies and explode.	1
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. It respawns after clearing a room.	0
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.	1
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.	1
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.	1
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.	0
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
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.	2
More Options	5.100.414		There's options	Two items spawn 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.	1
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
No. 2	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 3 second delay and deals contact damage 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. Turns doors that require a single key into doors which need a coin to enter instead.	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.	2
Restock	5.100.376		Never ending stores!	Causes shops to instantly restock their items when they are bought. Granted by default for every character in Greed Mode.	3
Rune Bag	5.100.389		Rune generator	Spawns a familiar that drops a random rune every 5-6 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.	4
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 size 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		Control your tears	Increases tears, range, and shot speed. Isaac emits a beam from his face that his tears follow along.	2
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.	1
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.	1
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!	Increases damage by a flat 0.1 and 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.	1
Broken Shovel	5.100.551		It feels cursed	One of two parts necessary to create Mom's Shovel.	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.	0
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.	2
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, grants +0.75 tears, +1.5 range, +1 tear height, +0.2 shot speed.	1
Dead Tooth	5.100.446		Halitosis	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.	2
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 The 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	Adds a chance to shoot a fire that damages enemies and remains in place until it deals enough damage or the room is left.	2
Glaucoma	5.100.460		Blind tears!	Adds a chance to shoot tears that confuse enemies for an extremely long time.	2
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.	1
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.	2
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 halves tear delay and can block enemy shots.	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.	2
Jaw Bone	5.100.548		Fetch!	Spawns a familiar that flies through the room while firing, dealing a flat 7 contact damage to enemies 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.	0
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.	3
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 heart pickups.	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.	1
Mom's Razor	5.100.508		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
Mystery Egg	5.100.539		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
Parasitoid	5.100.461		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
Pointy Rib	5.100.544		Stabbing time	Spawns a bone familiar that hovers back and forth in front of Isaac, dealing damage equal to Isaac's damage.	2
Poke Go	5.100.505		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
Polydactyly	5.100.454		Hold me!	Allows Isaac to carry two cards, pills, or any combination of both. Spawns one random card, rune or pill.	2
Pop!	5.100.529		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
Sack of Sacks	5.100.500		Gives sacks	Spawns a familiar that drops a sack every 5-6 rooms cleared.	3
Schoolbag	5.100.534		Extra active item room	Allows Isaac to hold two active items.	3
Shade	5.100.468		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
Shard of Glass	5.100.448		Blood and guts!	Upon taking damage, Isaac has a chance to drop a full red heart, gain 5 range, and leave a trail of damaging red creep for the current room. Taking 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
Sinus Infection	5.100.459		Booger tears!	Adds a chance to fire a booger that sticks to enemies and deals damage over time.	3
Slipped Rib	5.100.542		Projectile shield	Spawns a bone familiar that circles around Isaac and reflects enemy shots.	2
Sulfuric Acid	5.100.463		Acid tears!	+0.3 damage. Adds a chance to fire acidic tears which can destroy obstacles.	2
Tarot Cloth	5.100.451		I see the future	Drops a random card or rune. Doubles the effects of most cards and runes. Doubles the effects of tarot cards.	3
Technology Zero	5.100.524		Static tears!	Connects Isaac's tears with electricity that can damage enemies.	3
Trisagion	5.100.533		Smite thy enemy	Damage down. Tears are replaced with piercing white blasts of light that can damage the same enemy multiple times.	2
Varicose Veins	5.100.452		I'm leaking...	Taking damage releases a ring of 10 high damage tears.	2
YO LISTEN!	5.100.492		Yo listen!	+1 luck. Spawns a fairy familiar that points out Secret Rooms, Crawl Space entrances, and tinted rocks.	2
120 Volt	5.100.559		Zap!	Repeatedly zaps enemies that are close to Isaac.	3
2Spooky	5.100.554		4me	Enemies near Isaac are afflicted with fear.	2
4.5 Volt	5.100.647		Beat the juice out of them!	Active items don't charge when clearing rooms. Instead, they're charged by dealing damage to enemies.	2
A Bar of Soap	5.100.564		Tears + shot speed up	Gives Isaac +0.5 Tears and +0.2 Shot Speed.	3
A Pound of Flesh	5.100.672		Blood money	Devil deals now cost coins, shop items now cost health, and consumables in shops are free but surrounded by spikes.	1
Act of Contrition	5.100.601		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.	3
Akeldama	5.100.641		Spill your guts	Creates a chain of tears behind Isaac while in combat.	2
Almond Milk	5.100.561		DMG down + tears up + you feel nutty	Quadruples fire rate, with x0.3 damage multiplier. Tears are given random worm trinket effects.	1
Astral Projection	5.100.677		The true out-of-body experience!	Causes Isaac to turn into a ghost if he gets hit while in a room with enemies, giving him flight and spectral tears and blocking the next hit he takes.	2
Azazel's Rage	5.100.699		Ancient power	Isaac builds rage every time a room is cleared. After four rooms, fires a large Brimstone laser when entering the next room.	3
Battery Pack	5.100.603		Instant energy!	Recharges Isaac's currently held active item and drops 2-4 batteries.	1
Belly Jelly	5.100.690		Bounce away!	Causes enemies to bounce off of Isaac, dealing damage to them if they hit and enemy or obstacle. Also gives Isaac the chance to deflect enemy shots.	2
Binge Eater	5.100.664		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
Bird Cage	5.100.610		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 Dead Bird.	1
Bird's Eye	5.100.616		It burns	Gives Isaac the chance to shoot fires alongside his regular tears that block enemy shots and deal damage to enemies that touch them.	2
Birthright	5.100.619		???	Has a different effect for each character.	2
Blood Bombs	5.100.614		Bloody blast + HP up	Grants a Red Heart container and restore 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
Blood Oath	5.100.569		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
Blood Puppy	5.100.565		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
Bloody Gust	5.100.695		May your rage bring haste	When Isaac takes damage, he gains speed and tears for the rest of the floor.	3
Boiled Baby	5.100.607		Messy friend	Gives Isaac a familiar that fires chaotic bursts of tears in all directions.	1
Bone Spurs	5.100.683		Break your enemies	Enemies spawn floating bones on death, which block shots and damage/repel enemies that touch them.	2
Booster Pack	5.100.624		Collect them all!	Spawns 5 random cards.	1
Bot Fly	5.100.629		Defense drone	Spawns an orbiting fly familiar that fires shielded tears at incoming enemy projectiles.	3
Brimstone Bombs	5.100.646		Demon blast +5 bombs	Gives Isaac +5 bombs and causes his bombs to fire Brimstone lasers in the cardinal directions upon exploding.	3
C Section	5.100.678		Fetus shots	Switches control to a fetus that is attached via umbilical cord. The fetus has flight as well as all of Isaac's tear effects and stats.	4
Candy Heart	5.100.671		Power of love	Gives permanent stat boosts when Isaac heals with red heart pickups.	2
Card Reading	5.100.660		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
Consolation Prize	5.100.644		+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
Cracked Orb	5.100.675		Shards of knowledge	Unlocks doors and reveals a random room on the map when Isaac takes damage.	1
Cube Baby	5.100.652		Kick it!	Spawns an ice cube familiar that slides around when walked into. It slows and deals contact damage, freezing monsters it kills.	1
Dad's Note	5.100.668		...	Begins the sequence to access Home.	0
Dirty Mind	5.100.576		Filthy friends	Destroying poop spawns friendly Dips that follow Isaac and damage enemies. Destroying different types of poop spawns different Dips with special effects.	2
Divine Intervention	5.100.568		Double tap shield	Double tapping a fire key creates a shield that pushes away enemies and reflects enemy projectiles and lasers.	2
Dogma	5.100.633		Ascended	Grants flight, +0.1 speed, +2 damage, and the Holy Mantle effect. Grants enough health to have 6 full hearts, if possible. Automatically given to Isaac after defeating Dogma.	0
Dream Catcher	5.100.566		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
Echo Chamber	5.100.700		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
Empty Heart	5.100.676		It multiplies	If Isaac has an empty heart container, another one is added at the start of each floor.	2
Evil Charm	5.100.632		Luck up + you feel protected	Increases luck by 2.0.	1
Eye Drops	5.100.600		Tears up	Lowers the tear delay in Isaac's left eye, causing his eyes to fire at different rates.	3
Eye of the Occult	5.100.572		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
Eye Sore	5.100.558		More eyes	Causes Isaac to occasionally extra fire tears in random directions while shooting.	2
False PHD	5.100.654		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
Freezer Baby	5.100.608		Iced iced baby	Spawns a shooting familiar that has a chance to petrify enemies, and Freezes monsters upon killing them.	2
Fruity Plum	5.100.649		Bouncy friend	Gives Isaac a miniature Baby Plum familiar that propels itself diagonally around the room, firing tears behind itself as it travels.	1
Ghost Bombs	5.100.727		Spooky blast +5 bombs	Gives Isaac 5 bombs and causes his bombs to spawn ghosts that deal contact damage to enemies and explode after 10 seconds.	2
Giant Cell	5.100.658		Micro friends	Causes Isaac to spawn micro-Isaacs when he takes damage, which chase and shoot at nearby enemies.	1
Glitched Crown	5.100.689		?????	Before being picked up, item pedestals cycle between 5 random items.	4
Guppy's Eye	5.100.665		An eye for secrets	Shows the contents of Chests, Sacks, and Fire Places before they're opened.	2
Heartbreak	5.100.694		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
Hemoptysis	5.100.726		Double tap sneeze	Double-tapping a fire button causes Isaac to sneeze blood, dealing damage to enemies in front of him.	3
Hungry Soul	5.100.684		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
Hypercoagulation	5.100.724		Thick blooded	After taking damage from an enemy, launches a half or full red heart from Isaac that despawns after 1.5 seconds.	3
IBS	5.100.725		Your stomach rumbles	Causes Isaac to throw poop, create buffing creep, or drop bombs while fighting enemies.	2
Immaculate Heart	5.100.573		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
Inner Child	5.100.688		Let him free	Upon death, Isaac respawns in the current room with half a heart left, a massive size down, and +0.2 speed.	3
Isaac's Tomb	5.100.701		Buried memories	Spawns an Old Chest at the start of each floor.	3
It Hurts	5.100.560		No it doesn't...	Releases a ring of tears and increases tears for the current room when Isaac takes damage.	1
Jupiter	5.100.594		You're a gas giant!	+2 red Heart containers, -0.3 speed. Isaac builds speed while standing still, and releases poison gas clouds when he moves afterwards.	3
Keeper's Kin	5.100.717		Under a rock	Rocks and props spawn spiders over time while in a room with enemies, and spawn two blue spiders when destroyed.	2
Keeper's Sack	5.100.716		Spending power	Gives range, speed, or damage when buying things from a shop. Also spawns three coins and a key on pickup.	3
Knife Piece 1	5.100.626		???	Combined with Knife Piece 2, creates a knife familiar that damages enemies and can open the door to the Corpse.	0
Knife Piece 2	5.100.627		???	Combined with Knife Piece 1, creates a knife familiar that damages enemies and can open the door to the Corpse.	0
Knockout Drops	5.100.637		They pack a punch!	Adds a chance to shoot a fist tear that has extremely high knockback and confuses enemies.	3
Lil Abaddon	5.100.679		Abyssal friend	Spawns a familiar that charges a miniature Maw of the Void attack while Isaac shoots.	3
Lil Dumpy	5.100.615		Puffy buddy	Gives Isaac a Dumpy familiar that, when it takes damage, pushes/stuns/poisons nearby enemies and flies in a random direction.	0
Lil Portal	5.100.681		It hungers	A familiar that flies forward, consuming pickups in its path. Each one will increase its size and damage and spawn a Blue Fly. Every four pickups, it opens a portal that leads to an unexplored room.	1
Lodestone	5.100.617		Magnetizing tears	Gives Isaac the chance to fire tears that magnetize enemies they hit, causing them to attract nearby pickups and enemies, as well as tears/shots from all sources.	3
Lost Soul	5.100.612		Protect him	Gives Isaac a soul familiar that dies in one hit, respawning at the start of the next floor. If it survives an entire floor, it rewards Isaac with hearts or items.	2
Luna	5.100.589		The moon's blessing shines upon you	Adds an extra Secret Room and Super Secret Room to each floor. Secret Rooms contain a beam of light that increases tears for the current floor and give soul hearts.	2
Mars	5.100.593		Double tap dash	Dash by double-tapping the movement key, becoming invulnerable and damaging enemies. There's a short cooldown before Isaac can dash again.	2
Member Card	5.100.602		Exclusive access!	Adds a trapdoor to every shop that leads to a second shop with a unique stock and marked up prices.	1
Mercurius	5.100.590		Speed up + you feel elusive	+0.4 speed. Doors stay open after entering a room, even in rooms with enemies.	3
Monstrance	5.100.574		Purifying light	Isaac gains an aura that deals damage to enemies inside it.	2
Montezuma's Revenge	5.100.680		Oh no...	While firing, Isaac charges up a short-ranged Brimstone-like diarrhea beam that shoots behind him.	3
Mucormycosis	5.100.553		Spore shot	Gives Isaac the chance to fire spore tears that stick to enemies and blow up after a few seconds, dealing damage and poisoning nearby enemies and releasing more spores.	3
Nancy Bombs	5.100.563		Random blast +5 bombs	+5 bombs. Bombs explode with a random bomb effect.	1
Neptunus	5.100.597		Open the floodgates	Isaac's mouth fills with tears over time while not firing, up to a cap. Holding the fire button will release all stored tears in rapid succession.	3
Ocular Rift	5.100.606		Stare into the abyss	Gives Isaac the chance to fire tears that create rifts where they land, which damage nearby enemies and pull in enemies, pickups, and tears/shots from all sources.	3
Options?	5.100.670		There might be options	If a room gives a reward when cleared, there will be two different rewards to chose from. Taking one causes the other to disappear.	2
Orphan Socks	5.100.571		Speed up + your feet feel stronger	Prevents creep and floor spikes from damaging Isaac. Also gives Isaac +0.3 speed and 2 soul hearts.	1
Paschal Candle	5.100.567		Keep the flame burning	Gives Isaac a tears bonus based on how many consecutive rooms he's cleared without taking damage.	3
Playdough Cookie	5.100.570		Tasty rainbow	Grants multicolored tears. Each color comes with a different status or tear effect.	3
Pluto	5.100.598		Size down	Significantly shrinks Isaac, allowing him to squeeze between objects and makes some enemy shots pass over him. Also gives +0.7 tears.	3
Psy Fly	5.100.581		Flamboyant protector	Spawns a fly orbital familiar that chases and deflects enemy shots and converts them into homing tears.	3
Purgatory	5.100.634		Help from beyond	While in a room with enemies, spawns cracks on the ground. Walking over these cracks summons ghosts that launch themselves at enemies and explode.	2
Quints	5.100.661		They lurk inside	Killing enemies spawns a stationary shooting familiar where they died for the current room.	1
Red Stew	5.100.621		Full HP + temporary DMG up	Refills all heart containers. Grants an enormous damage boost that wears off over time.	0
Redemption	5.100.673		Deliver me from evil	Gives Isaac a soul heart and +1 damage if he goes into a Devil Room but doesn't take anything from it.	2
Revelation	5.100.643		Awaken your faith	Allows Isaac to charge a holy laser by continuously firing for 2.5 seconds, then releasing the fire buttons. Also gives Isaac flight and 2 soul hearts.	4
Rock Bottom	5.100.562		It's only up from there	Locks Isaac's attributes to their highest values reached.	2
Rocket in a Jar	5.100.583		Rocket propulsion +5 bombs	+5 bombs. If Isaac is currently moving, placing a bomb will instead shoot a fast-moving, explosive rocket in the direction he's facing.	2
Rotten Tomato	5.100.618		Delicious!	Adds a chance to fire tears that Mark enemies. Marked enemies are attacked by other enemies.	1
Sacred Orb	5.100.691		Destined for greatness	Prevents low-quality items from spawning, greatly increasing the quality of items received from all items pools.	4
Salvation	5.100.696		Divine protection	Gives Isaac a halo that summons beams of light on enemies inside it. The halo grows larger the more times Isaac has taken damage this floor.	2
Sanguine Bond	5.100.692		He awaits your offering	Spawns a special set of spikes in the Devil Room. Taking damage from the spikes has a chance to grant a reward.	1
Saturnus	5.100.595		Ring of tears	Upon entering a room, a circle of tears orbits Isaac. Enemy tears have a chance to be caught in orbit, turning them friendly.	1
Sausage	5.100.669		All stats up	Adds a Red Heart container, and increases speed, damage, tears, range, shot speed, and luck.	3
Sol	5.100.588		Radiant victory	Reveals the location of the Boss room. Upon defeating a boss, activates XIX - The Sun, fully recharges Isaac's active item, and grants bonus damage and luck for the rest of the floor.	2
Soul Locket	5.100.686		Power of faith	Gives Isaac a permanent stat boost whenever he picks up a soul heart.	2
Spirit Shackles	5.100.674		Unfinished business	On death, Isaac's ghost is chained to his dead body and he can continue to fight with 1/2 of a heart, returning to life after 10 seconds. Must be recharged by picking up a soul heart.	3
Spirit Sword	5.100.579		Divine blade	Instead of tears, Isaac swings a sword. Charging does a spin attack and fires a projectile, and a projectile is sometimes fired with normal swings if Isaac has no empty red hearts.	3
Stapler	5.100.708		DMG up	+1 damage. Prevents Isaac from firing tears from one eye, like Cain.	3
Star of Bethlehem	5.100.651		Follow the light	Spawns a star familiar that slowly travels towards the Boss Room, giving an aura that increases damage and tears and grants homing.	2
Strawman	5.100.667		A helping hand	Spawns Keeper to fight enemies alongside Isaac. If Keeper dies, he spawns blue spiders and Strawman is removed from Isaac's inventory.	2
Supper	5.100.707		HP up	Grants one Red Heart container and heals for one extra heart.	1
Terra	5.100.592		Born to rock	Replaces tears with rocks that deal variable damage, have increased knockback, and can destroy obstacles.	3
The Intruder	5.100.575		Invasive friend	A familiar burrows in Isaac's head, firing 4 slowing tears. Upon taking damage, there's a chance it will burst out of Isaac's head, spawning blue spiders and chasing enemies for the current room.	3
The Stairway	5.100.586		May you get what you came for	Generates a ladder at the start of every floor that leads to a unique Angel Room shop.	3
The Swarm	5.100.693		Infest	Spawns nine orbital flies, which turn into Blue Flies after they block a shot. Each time a room is cleared, spawns another orbital fly.	2
Tinytoma	5.100.645		Itching for revenge	Gives Isaac a Teratoma orbital that blocks shots, deals contact damage, and splits into smaller versions of itself upon taking damage. The smaller versions break into blue spiders.	1
TMTRAINER	5.100.721		ZZaZZ ZZdZZiZZmZZhZZ ZZvZZ ZZoZZ ZZ ZZsZZlZZhZZsZZoZZaZZiZZ	Causes all future items to be "glitched", granting them completely random effects.	2
Tooth and Nail	5.100.663		You feel prickly	Isaac periodically turns into a spiked statue, briefly becoming invulnerable and dealing contact damage.	2
Tropicamide	5.100.659		Tear size + range up	+1.5 range, Increases tear size.	1
Twisted Pair	5.100.698		Double trouble!	Gives Isaac two familiars that stand by Isaac's side and fire tears that use Isaac's tears, range, shot speed, and tear effects and scale with Isaac's damage.	4
Uranus	5.100.596		Ice tears	Isaac shoots ice tears, which slow enemies and freeze monsters they kill. Frozen enemies slide away and explode into ice shards when touched.	3
Vanishing Twin	5.100.697		He wants revenge	Spawns a familiar that becomes a clone of the floor's boss when entering the boss room. Defeating it drops an extra item.	3
Vasculitis	5.100.657		Clogged enemies	Enemies explode into tears upon death, which inherit the effects of Isaac's tears.	2
Vengeful Spirit	5.100.702		Hot blooded	After taking damage, spawns an orbital wisp that lasts for the entire floor, up to a maximum of six. They fire tears but do not block shots.	2
Venus	5.100.591		HP up + you feel pretty	Adds one red Heart container. Enemies near Isaac become charmed.	1
Voodoo Head	5.100.599		Extra curse rooms	Spawns an additional curse room on each floor.	1
Worm Friend	5.100.682		Clingy buddy	Gives Isaac a nerve ending familiar that burrows out of the ground to grab and deal damage to enemies over time.	2
Tonsil	5.100.474		Gross...	Grants a familiar that can block enemy shots.

Trivia

• Wiggle Worm was an item in the original The Binding of Isaac; however, in Rebirth, it was changed into a trinket.
  • The Polaroid was a trinket in the original The Binding of Isaac, but it was changed into an item. Interestingly, these changes keep the count of items and trinkets from the original game the same.
• There are a total of 123 active items, with 74 in Rebirth, 19 in Afterbirth, and 30 in Afterbirth+. Of those, 101 items utilize a charge bar, with 61 items in Rebirth, 16 in Afterbirth, and 24 in Afterbirth+.
• There are a total of 424 passive items, with 267 in Rebirth, 76 in Afterbirth, and 81 in Afterbirth+.
  • From Rebirth to Afterbirth+, there has been about a 1:4 ratio of active items to passive items.
• Afterbirth+'s original item count was 89. The Booster Packs added 42 items.