Items

ltems 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.
• Repentance added 169 new items, for a total of 716 items. An update for Repentance, V1.7.5, added 3 new items, for a total of 719 items.

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

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

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

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

Activated Collectibles

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

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

Notes

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

Name	ID	Icon	Quote	Description	Quality
A Pony	5.100.130		Flight + dash attack	Passively grants flight and increases speed to 1.5. Upon use, Isaac charges in the direction the pony is facing, giving invulnerability during the charge and dealing damage to enemies hit.	2
Anarchist Cookbook	5.100.65		Summon bombs	Spawns six Troll Bombs around the room.	0
Best Friend	5.100.136		Friends 'till the end	Spawns a decoy Isaac that explodes after 5 seconds. Enemies will always target the decoy and ignore Isaac.	0
Blank Card	5.100.286		Card mimic	Copies the effect of the card or rune currently held by Isaac. Copies the effect of the card currently held by Isaac. The charge time is based on the power of the card.	2
Blood Rights	5.100.186		Mass enemy damage at a cost	Takes a full heart of health and deals 40 damage to all enemies in the room. Repeated uses in the same room only take half a heart.	0
Bob's Rotten Head	5.100.42		Reusable ranged bomb	Isaac holds a poison Bomb which can be thrown in the cardinal directions and explodes on impact.	1
Book of Revelations	5.100.78		Reusable soul protection	Increases the chance of a Devil Room / Angel Room appearing while held. Upon use, gives one Soul Heart, and replaces the boss of the current floor with a Harbinger if possible.	3
Book of Secrets	5.100.287		Tome of knowledge	Gives the effect of Treasure Map, The Compass, or Blue Map for the duration of the current floor. If all effects are active, X-Ray Vision is provided for the floor instead. Highlights any Tinted Rocks and rocks with Crawl Space in the room.	0
Book of Shadows	5.100.58		Temporary invincibility	Creates a protective shield, nullifying all types of damage in the current room for 10 seconds.	3
Box of Spiders	5.100.288		It's a box of spiders	Spawns 1-4 Blue Spiders that deal 2.5× Isaac's damage to enemies. Spawns 4-8 Blue Spiders that deal 2× Isaac's 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. Isaac begins taking damage if the item is held any longer. Isaac creates beams of light when touching enemies while invulnerable, and creates a powerful 4-way beam if blocking damage exactly as the invincibility starts.	1
Butter Bean	5.100.294		Reusable knock-back	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	Converts two Soul Hearts or Black Hearts into one filled Red Heart Container. Converts one Soul Heart or Black Heart into one filled Red Heart Container.	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.	1
Crystal Ball	5.100.158		I see my future	Reveals the map (except the Super Secret Room and Ultra Secret Room) and drops a Soul Heart or random card/rune. While held, increases the chance of finding a Planetarium.	3
D10	5.100.285		Reroll enemies	Re-rolls all monsters in the room. Replaces all monsters in the room with weaker monsters.	1
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.	1
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.	1
Dad's Key	5.100.175		Opens all doors...	Opens all doors in the current room in almost all circumstances, including doors which require a Key to open, entrances to Secret Rooms, and the door to Mega Satan.	2
Dead Sea Scrolls	5.100.124		It's a mystery	Triggers the effect of a random activated item from a list of possible options (not every activated item is included).	1
Deck of Cards	5.100.85		Reusable card generator	Gives Isaac a random card.	2
Doctor's Remote	5.100.47		Reusable air strike	Creates a crosshair on the ground that can be aimed with tear controls. A missile strikes the spot after 2 seconds, creating a heavy damage explosion.	1
Flush!	5.100.291		...	Turns all non-boss monsters in the room into Poop. Instantly kills poop-themed bosses. Floods the current room.	1
Forget Me Now	5.100.127		I don't remember...	Restarts 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.	2
Guppy's Paw	5.100.133		Soul converter	Converts one Red Heart Container into three Soul Hearts.	3
Head of Krampus	5.100.293		Krampus rage	Fires a powerful Brimstone beam in four cardinal directions, much like Krampus shoots. 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.	1
How to Jump	5.100.282		It's time you learned how	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 of his tears. Each tear shot by Isaac increases item charge by one. Tears from this item have a +5 flat damage bonus.	1
IV Bag	5.100.135		Portable blood bank	Damages Isaac and spawns a random amount of coins, similar to a Blood Donation Machine.	2
Kamikaze!	5.100.40		Become the bomb!	Creates an explosion around Isaac, damaging him and nearby enemies as well as destroying obstacles.	0
Lemon Mishap	5.100.56		Oops...	Creates a tiny pool of yellow creep, damaging enemies that cross it.	0
Magic Fingers	5.100.295		Pay to win	Uses 1 Penny to deal damage to all enemies in the room.	0
Mom's Bottle of Pills	5.100.102		Reusable pill generator	Gives Isaac a random pill.	1
Mom's Bra	5.100.39		Mass paralysis	Petrifies all enemies in the current room for 4 seconds.	0
Mom's Pad	5.100.41		Mass fear	Inflicts fear to all enemies in the room for 4 seconds. Spawns a blue fly.	0
Monster Manual	5.100.123		Temporary buddy generator	Spawns a familiar from a specific selection for the current room. Spawns a familiar from a specific selection for the current floor.	1
Monstro's Tooth	5.100.86		Summon Monstro	A friendly Monstro jumps on a random enemy, dealing 120 area damage. Targets Isaac if used in a room without enemies.	0
Mr. Boom	5.100.37		Reusable bomb buddy	Places a Mr. Mega Bomb that deals 110 damage. Places a Mr. Mega Bomb that deals 185 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 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.	1
Pandora's Box	5.100.297		? ?	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	Consumes 1 Penny and has a chance to drop a random pickup, like a Slot Machine.	0
Prayer Card	5.100.146		Reusable eternity	Gives Isaac an Eternal Heart.	3
Razor Blade	5.100.126		Feel my pain	Takes one Heart of health and grants +1.2 damage for the current room. Repeated uses in the same room only take half a heart.	0
Red Candle	5.100.289		Flame on	Throws out a flame that damages everything in its path, diminishing in size as it hits enemies or blocks shots.	1
Remote Detonator	5.100.137		Remote bomb detonation	Bombs placed by Isaac only explode when Remote Detonator is used. Gives 5 bombs.	0
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.	3
Scissors	5.100.325		Lose your head	Turns Isaac's head into a stationary familiar for the current room which fires tears automatically. Isaac's body also shoots a controllable fountain of blood shots for the room.	0
Shoop da Whoop!	5.100.49		BLLLARRRRGGG!	Fires a laser from Isaac's mouth that deals twice Isaac's tear damage.	2
Spider Butt	5.100.171		Mass enemy slowdown + damage	Deals 10 damage to all enemies in the room and slows them for 4 seconds. Enemies killed by Spider Butt spawn Blue Spiders.	1
Tammy's Head	5.100.38		Reusable tear burst	Shoots 10 tears in a circle around Isaac, which retain the damage, range, shot speed, and special effects (such as poison) of Isaac's tears. Tears from this item have a +25 flat damage bonus.	1
Telepathy For Dummies	5.100.192		Temporary psychic shot	Gives homing tears for the current room. Also gives +3 range.	1
Teleport!	5.100.44		Teleport!	Teleports Isaac to a random room on the current floor.	0
The Bean	5.100.111		Toot on command	Isaac farts, poisoning any enemy in close range.	0
The Bible	5.100.33		Temporary Flight	Grants flight for the current room. Instantly kills Mom, Mom's Heart, and It Lives when activated, but kills Isaac when used on Satan.	1
The Book of Belial	5.100.34		Temporary DMG up	+2 damage for the current room. Passively guarantees a Devil Room or Angel Room will appear while held. +2 damage for the current room. Passively increases the chance of finding a Devil Room or Angel Room while held.	2
The Book of Sin	5.100.97		Reusable item generator	Spawns a random coin, heart, bomb, key, battery, pill or card near Isaac.	1
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 flames	Throws out a flame that damages everything in its path, diminishing in size as it travels.	2
The D6	5.100.105		Reroll your destiny	Re-rolls all items in the current room into other items, depending on the current room's Item Pool.	4
The Gamekid	5.100.93		Temporary Man-Pac	Turns Isaac into a Pac-Man-like creature for 6.5 seconds, granting invulnerability, inflicting fear on all enemies, and has a chance of replenishing a Half Red Heart every time an enemy is killed.	1
The Hourglass	5.100.66		Temporary enemy slowdown	All enemies in the room are slowed for 8 seconds.	0
The Jar	5.100.290		Save your life	When at full health, up to 4 extra Red Hearts can be stored in The Jar. Activating drops the stored hearts on the ground.	0
The Nail	5.100.83		Temporary demon form	Gives one Soul Heart. For the current room; +0.7 damage, -0.18 speed, Isaac breaks rocks and deals contact damage. Gives half a Black Heart. For the current room; +2 damage, -0.18 speed, Isaac breaks rocks and deals contact damage.	2
The Necronomicon	5.100.35		Mass room damage	Deals 40 damage to every enemy in the room.	0
The Pinking Shears	5.100.107		Cut and run	Separates Isaac's head from his body for the current room, granting flight and turning the body into a familiar that chases enemies.	2
The Poop	5.100.36		Plop!	Spawns a pile of Poop where Isaac is standing and knocks back nearby enemies. May yield pickups like regular poop.	0
Undefined	5.100.324		Undefined	Teleports Isaac to the Secret Room, Super Secret Room, Treasure Room, or I AM ERROR.	1
Unicorn Stump	5.100.298		You feel stumped	Gives invulnerability and increased speed for six seconds, but removes the ability to shoot tears.	1
We Need To Go Deeper!	5.100.84		Reusable level skip	Creates a trapdoor to go to the next floor. Once per floor, using it on tiles with special graphics will instead create a Crawl Space.	2
White Pony	5.100.181		Flight + holy death	Passively grants flight and increases speed to 1.5. Upon use, Isaac charges in the direction the pony is facing, giving invulnerability during the charge while also creating damaging beams of light.	3
Yum Heart	5.100.45		Reusable regeneration	Restores one full Red Heart.	1
Box of Friends	5.100.357		Double your friends	Duplicates all of Isaac's familiars for the current room. If Isaac has no familiars, spawns a Demon Baby for the room instead.	1
D12	5.100.386		Rerolls rocks	Re-rolls all Rocks and Metal Blocks in the current room into other random obstacles. Re-rolls most types of Obstacles in the current room into other random obstacles.	1
D7	5.100.437		Roll again	Restarts the current room and brings back all enemies, allowing more rewards to be acquired by completing the room.	1
D8	5.100.406		Reroll stats	Re-rolls Isaac's damage, tears, range, and speed.	1
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 this, he takes extra damage and it becomes Broken Glass Cannon.	1
Glowing Hourglass	5.100.422		Turn back time	Rewinds time, putting Isaac back in the previous room and undoing anything that happened in the current room. Can only be used three times per floor, after which it functions like The Hourglass until the next floor.	3
Jar of Flies	5.100.434		Bug catcher	Killing an enemy adds a fly to the jar, up to a maximum of 20. On use, releases Blue Flies equal to the number of flies in the jar.	2
Kidney Bean	5.100.421		Love toots!	Isaac farts, charming all nearby enemies.	0
Mega Bean	5.100.351		Giga fart!	Petrifies all enemies in the current room for about 1.5 seconds, poisons any enemies near Isaac, and sends a rock wave across the room in the direction Isaac is facing.	1
Mega Blast	5.100.441		Laser breath	Isaac fires a giant laser for approximately 15 seconds. This laser deals massive damage, pushes Isaac backwards, and persists between rooms and floors.	4
Mine Crafter	5.100.427		Booom!	Places a Movable TNT barrel that can be pushed and used to destroy rocks or damage enemies. If used again in the same room while the previous TNT barrel is still intact, remotely detonates the TNT.	1
Mom's Box	5.100.439		What's inside?	Increases luck by 1 and doubles the effects of trinkets while held. When used, drops a random trinket on the ground.	2
Placebo	5.100.348		Pill mimic	Has the same effect as the Pill currently held by Isaac. The charge time is based on the power of the pill.	1
Tear Detonator	5.100.383		Remote tear detonation!	Splits all of Isaac's tears that are currently in the air into 6 tears that fire in all directions, which retain their damage and shot speed.	1
Teleport 2.0	5.100.419		I-Teleport!	Teleports Isaac to a room that has not been explored yet. Normal rooms are prioritized over special rooms, and common special rooms take priority over rarer ones.	3
Ventricle Razor	5.100.396		Short cutter	Creates up to two portals that remain even if Isaac leaves the room. Upon entering a portal, Isaac is teleported to the other portal.	1
Wooden Nickel	5.100.349		Flip a coin	Has a roughly 50% chance to drop a penny, nickel or dime, and a roughly 50% chance to do nothing.	1
Black Hole	5.100.512		Nothing can escape	Throws a black hole on the ground which sucks in and damages enemies and destroys nearby obstacles.	1
Book of the Dead	5.100.545		Rise from the grave	Creates a friendly Bony, Black Bony, or an orbital bone for each enemy killed in the current room. Creates a friendly Bony, Black Bony, Bone Fly, Revenant, or an orbital bone for each enemy killed in the current room.	2
Broken Shovel	5.100.550		It feels cursed	While held, causes Mom to continuously attempt to stomp on Isaac. Activating makes her stop for the current room or wave. One of two parts necessary to create Mom's Shovel.	4
Brown Nugget	5.100.504		Friendly fly	Spawns a stationary fly turret that lasts for the current room and 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.	0
Coupon	5.100.521		Allow 6 weeks for delivery	While held, guarantees one item in every Shop will be on sale. On use, makes a random item in the current room free.	2
Crooked Penny	5.100.485		50/50	Spawns a penny and has a 50% chance to double all items and pickups in the room. If the effect fails, the items and pickups disappear.	2
D infinity	5.100.489		Reroll forever	Grants a random die item that changes each use. Acts as any die item, and can by cycled by pressing the drop key.	4
D1	5.100.476		What will it be?	Duplicates a random pickup in the room. The new pickup may be different than the original (i.e. a different card, etc).	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.	0
Eden's Soul	5.100.490		...	Spawns two item pedestals then is consumed. Begins with no charges.	3
Mama Mega!	5.100.483		BOOOOOOOOOM!	Damages all enemies and destroys all obstacles. The effect occurs every time a new room is entered for the rest of the floor. Opens the doors to the floor's Secret Rooms and Super Secret Rooms.	3
Metronome	5.100.488		Waggles a finger	Grants a random item effect for the current room.	1
Mom's Shovel	5.100.552		Lost but not forgotten	Creates a trapdoor that leads to the next floor. 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 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. Can carry up to 10 items or pickups at once.	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!	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.	0
Plan C	5.100.475		My last resort	Kills all enemies in the room, then kills Isaac three seconds later.	0
Potato Peeler	5.100.487		A pound of flesh	Removes a Heart Container, increases damage and range, and grants a Cube of Meat.	2
Sacrificial Altar	5.100.536		He demands a sacrifice	Sacrifices up to 2 familiars and spawns an item for each familiar sacrificed. Converts all friendly spiders and flies into coins.	1
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. Damages all enemies in the room. Has a chance to drop a Half Red Heart if an enemy is hit.	2
Smelter	5.100.479		Trinket melter!	Consumes Isaac's currently held trinket and applies its effect permanently.	2
Sprinkler	5.100.516		Sprinkles.	Creates a stationary sprinkler for the current room that rotates and fires tears in 8 directions. The tears copy Isaac's stats and most tear effects.	1
Telekinesis	5.100.522		Power of the mind	Any enemy shots that come near Isaac for the next three seconds are held in place then fired back.	1
Void	5.100.477		Consume	Consumes all pedestal items in the room. Active items will have their effects added to Void, and passive items will grant random stat upgrades.	3
Wait What?	5.100.484		I can't believe it's not butter bean!	Isaac farts, sending out a circular rock wave that destroys obstacles and hurts enemies.	1
Abyss	5.100.706		Come forth from the depths	Destroys all items in the room and gives Isaac a unique locust familiar for each item destroyed. Some items generate locusts with special effects.	3
Alabaster Box	5.100.585		A sacred offering	Spawns three Soul Hearts and two Angel Room items and is consumed. Starts with no charges, and can only be charged by picking up 6 Soul Hearts.	1
Anima Sola	5.100.722		Repent	Chains down the nearest enemy for 5 seconds, preventing them from acting.	3
Bag of Crafting	5.100.710		Make your destiny	Collects and holds up to 8 pickups, which can then be used to craft an item. The power level of the item is based on the quality of pickups used.	3
Berserk!	5.100.704		Rip and tear	Isaac goes 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.	1
Book of Virtues	5.100.584		Spiritual companionship	Spawns a destroyable orbiting wisp familiar that fires tears and deals contact damage. Also acts as a passive item that causes other active items to spawn themed wisps.	3
Broken Glass Cannon	5.100.474		You broke it!	Begins with no charges and turns into Glass Cannon when used. Only acquired by taking damage while holding Glass Cannon.	0
Clear Rune	5.100.263		Rune mimic	Has the same effect as the rune or soul stone currently held by Isaac. The charge time is based on the power of the rune.	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.	3
Dark Arts	5.100.705		One with the shadows	Briefly grants +1 speed and makes Isaac invulnerable and intangible. When the effect ends, destroys all projectiles and damages all enemies Isaac ran through.	1
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.	1
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. Deals 15 damage to bosses, erasing that boss if fatal. Can only be used once per floor.	1
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.	1
Eternal D6	5.100.609		???	Rerolls all items in the room. Each item has a 25% chance to disappear instead.	3
Everything Jar	5.100.720		Anything is possible	Spawns certain pickups based on how many charges it has. If fully charged, instead has one of many unique effects.	2
Flip	5.100.711		Twist of fate	Item pedestals have a second uninteractable "ghostly" item behind them. Activating will flip the real and ghostly items around. If playing as Tainted Lazarus, also flips between them and Dead Tainted Lazarus.	4
Fortune Cookie	5.100.557		Reusable fortunes	Gives Isaac a fortune, Soul Heart, Card, Rune, or trinket, similar to a Fortune Telling Machine. Fortunes are much more likely to be given than anything else.	2
Free Lemonade	5.100.578		Party time!	Creates a large pool of yellow creep beneath Isaac.	0
Friend Finder	5.100.687		Best friends forever!	Spawns a random friendly monster that mimics Isaac's movements and attacks.	2
Gello	5.100.728		Demonic gestation	Spawns a demon familiar for the current room that's attached to Isaac and moves and fires in the direction Isaac shoots, using Isaac's damage, tears, range, shot speed, and special tear effects.	3
Genesis	5.100.622		In the beginning	Removes all of Isaac's items and pickups and takes him to a unique Bedroom with some pickups and Chests and a trapdoor to the next floor. For every item Isaac lost, he gets to take an item from a set of three.	2
Golden Razor	5.100.555		Pain from gain	Spends five Pennies to increase Isaac's damage by 1.2 for the current room.	0
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.	1
Keeper's Box	5.100.719		Portable shop	Spawns a random shop item or pickup which can be bought for its normal price.	1
Larynx	5.100.611		Hear my pain	Isaac shouts, damaging and pushing away nearby enemies. The shout gets stronger the more charges the item has. Larynx gains 1 charge whenever Isaac takes damage, in addition to charging normally.	2
Lemegeton	5.100.712		Item summoner	Spawns a wisp representing a random passive item, which orbits Isaac but can be destroyed. While the wisp is alive, Isaac gains that item's effects. Generation uses the current room's item pool 25% of the time, otherwise a random pool.	3
Magic Skin	5.100.642		All your desires fulfilled	Consumes one heart container or two Soul Hearts to spawn an item and give Isaac a broken heart container that can never be filled. If Magic Skin isn't being held after being used, it is very likely to replace any future items.	2
Meat Cleaver	5.100.631		Slice but no dice	Splits all enemies in the room into two smaller versions of themselves with much less health.	0
Mega Mush	5.100.625		I'm a big boy now!	Gigantifies Isaac for 30 seconds, increasing damage and range while lowering tears, granting invulnerability, and allowing Isaac to crush enemies and obstacles he walks on. The effect persists between rooms.	4
Mom's Bracelet	5.100.604		Mother's strength	Lets Isaac pick up and throw rocks, TNT, Poops, friendly Dips, Bombs, and other obstacles.	1
Plum Flute	5.100.650		Play time!	Summons the boss Baby Plum to fight for Isaac in the current room.	1
R Key	5.100.636		Time to start over	Brings Isaac back to the first floor of a new run, retaining all of his items.	4
Recall	5.100.714		Come back	Retrieves the Forgotten's body from any distance. Only available as the Birthright effect for Tainted Forgotten.	0
Red Key	5.100.580		Explore the other side	Creates a Red Room adjacent to a viable wall, indicated by the outline of a door. These rooms have a 10% chance to be a special room.	3
Sharp Key	5.100.623		Open your enemies	Adds 5 Keys on pickup. Allows Isaac to throw his keys to deal damage to enemies, destroy obstacles, and open doors.	1
Spin to Win	5.100.655		Let it rip!	Gives +0.5 speed and greatly increases the rotation speed and damage of orbitals for 3 seconds. Passively gives Isaac a spinning top orbital that blocks enemy shots and deals contact damage.	0
Spindown Dice	5.100.723		-1	Reduces the internal ID number of all items in the room by one, turning them into the item with that number.	4
Stitches	5.100.635		Bait and switch	Passively spawns a familiar that moves in the direction Isaac shoots. On use, Isaac swaps places with the familiar.	1
Sulfur	5.100.556		Temporary demon form	Grants Brimstone for the current room.	2
Sumptorium	5.100.713		Blood to blood	Removes half a heart and creates a Clot familiar that mimics Isaac's movements and tear effects. As Tainted Eve, passively converts health into Clots while firing. Activating returns all Clots to health.	3
Suplex!	5.100.709		Angel breaker	Isaac dashes forward and picks up the first enemy hit. After a moment, he slams them into the ground to deal damage and create a circular rock wave.	1
The Scooper	5.100.605		Plop!	Summons The Peeper for the current room, which leaves a trail of red creep.	0
Urn of Souls	5.100.640		Unleash their sorrow	Spews a stream of damaging flame. Gains Soul Charges each time an enemy dies, which are used to fuel the urn.	3
Vade Retro	5.100.653		Begone!	While held, enemies leave behind ghosts on death. Stronger enemies leave bigger ghosts. Using the item causes the ghosts to explode and damage nearby enemies, and instantly kills all ghost enemies with less than 50% HP.	1
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.	0
Yuck Heart	5.100.639		Gross!	Gives Isaac a Rotten Heart.	1

Passive Collectibles

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

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

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

• Removing a passive item is only possible in a few rare ways, and usually comes with severe drawbacks, such as D4 and Genesis rerolling all passive items, or Clicker removing the last passive item collected at the cost of changing the active character.

• Tainted Isaac is limited to 8 passive items (12 with Birthright) at a time, and can freely swap out old passive items once his inventory is full.

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

Name	ID	Icon	Quote	Description	Quality
The Sad Onion	5.100.1		Tears up	+0.7 tears.	3
The Inner Eye	5.100.2		Triple shot	Isaac shoots three tears at once with lower fire rate.	3
Spoon Bender	5.100.3		Homing shots	Grants Isaac homing tears.	3
Cricket's Head	5.100.4		DMG up	Increases Damage by 0.5, and increases damage multiplier by ×1.5.	4
My Reflection	5.100.5		Boomerang tears + DMG up + luck down	Gives Isaac's tears a boomerang effect. +1.5 range, +1 tear falling speed, x1.6 shot speed multiplier. 2x + 1.5 range, +1.5 damage, -1 luck, 1.6x shot speed multiplier.	2
Number One	5.100.6		Tears up + range down	Grants +1.5 tears, but severely reduces range.	2
Blood of the Martyr	5.100.7		DMG up	+1 damage. Isaac shoots blood tears.	3
Brother Bobby	5.100.8		Friends 'till the end	Spawns a familiar that follows Isaac around shooting tears that deal 3.5 damage. He shoots more frequently than most familiars.	1
Skatole	5.100.9		Fly love	Flies become harmless or less dangerous depending on the type.	0
Halo of Flies	5.100.10		Projectile protection	Spawns two Pretty Flies that block enemy shots and deal contact damage to flies.	2
1up!	5.100.11		Extra life	Gives Isaac an extra life. Upon death, he will respawn in the previous room with full health, after which 1up! will disappear.	2
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, +0.3 Speed, and restores all Health. Makes Isaac bigger. Adds one Red Heart Container, +0.3 Damage, x1.5 damage multiplier, +2.5 Range, +0.3 Speed, and restores all Health.	4
The Virus	5.100.13		Poison touch + speed up	Isaac poisons enemies on contact. -0.1 speed. +0.2 speed. Poisoned enemies have a chance to drop a black heart when killed.	2
Roid Rage	5.100.14		Speed and range up	+0.6 speed, +5.25 range, +0.5 tear falling speed. +0.3 speed, +2.5 range	2
<3	5.100.15		HP up	Grants Isaac one Red Heart container and fully restores Isaac's health.	2
Raw Liver	5.100.16		HP up	Grants 2 Red Heart containers and completely restores health.	2
Skeleton Key	5.100.17		99 keys	Gives Isaac 99 Keys.	2
A Dollar	5.100.18		$$$	Gives Isaac 100 Pennies.	3
Boom!	5.100.19		10 bombs	Grants 10 Bombs.	0
Transcendence	5.100.20		We all float down here...	Grants flight.	2
The Compass	5.100.21		The end is near	Reveals the locations and types of all special rooms on the map, except Secret Rooms and Super Secret Rooms.	1
Lunch	5.100.22		HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1
Dinner	5.100.23		HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1
Dessert	5.100.24		HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1
Breakfast	5.100.25		HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1
Rotten Meat	5.100.26		HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1
Wooden Spoon	5.100.27		Speed up	+0.3 speed.	1
The Belt	5.100.28		Speed up	+0.3 speed.	1
Mom's Underwear	5.100.29		Range up	+5.25 range, +0.5 tear falling speed. +2.5 range. Spawns 3-6 Blue Flies on pickup.	1
Mom's Heels	5.100.30		Range up	+5.25 range, +0.5 tear falling speed. +2.5 range, enemies that touch Isaac take 12 damage.	1
Mom's Lipstick	5.100.31		Range up	+5.25 range, +0.5 tear falling speed. +3.75 range. Spawns a Heart on pickup.	1
Wire Coat Hanger	5.100.32		Tears up	+0.7 tears.	3
Lucky Foot	5.100.46		Luck up	+1 luck. Improves Isaac's chances at various random events (independent from the luck stat). Converts all bad pills into good pills, without identifying them.	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.	2
Steven	5.100.50		DMG up	+1 damage.	3
Pentagram	5.100.51		DMG up	+1 damage, increases Devil Room / Angel Room chance by 10%.	3
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
Magneto	5.100.53		Item snatcher	Pulls pickups towards Isaac.	1
Treasure Map	5.100.54		Full visible map	Reveals the map of each floor. It does not identify special rooms and does not reveal the locations of Secret Rooms / Super Secret Rooms.	1
Mom's Eye	5.100.55		Eye in the back of your head	Gives Isaac a chance to fire tears from the back of his head.	1
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
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
Charm of the Vampire	5.100.62		DMG up + kills heal	Heals Isaac for a Half Red Heart for every 13 enemies killed. +0.3 damage.	2
The Battery	5.100.63		Stores energy	Activated items can be overcharged, allowing them to store up to one extra use.	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
Sister Maggy	5.100.67		Friends 'till the end	Spawns a familiar that follows Isaac around shooting tears that deal 3.5 damage. Spawns a familiar that follows Isaac around shooting tears that deal 6 damage.	1
Technology	5.100.68		Laser tears	Replaces tears with a piercing laser with unlimited range.	3
Chocolate Milk	5.100.69		Charge shots	Grants charged tears that deal greater damage when fully charged.	3
Growth Hormones	5.100.70		Speed + DMG up	+1 damage, +0.4 speed. +1 damage, +0.2 speed.	3
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 falling speed, -4.25 range (effective range is increased). +0.3 speed, +2.5 range.	2
Rosary	5.100.72		Tears + faith up	Grants 3 Soul Hearts. Causes The Bible to appear in any item pool. +0.5 tears.	2
Cube of Meat	5.100.73		Gotta meat 'em all!	Creates an orbital familiar. Collecting additional copies gives it the ability to shoot tears, then chase enemies to deal contact damage, then deal even more contact damage.	1
A Quarter	5.100.74		+25 coins	Gives Isaac 25 coins.	0
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
X-Ray Vision	5.100.76		I've seen everything	Reveals and opens all Secret Room and Super Secret Room entrances.	2
The Mark	5.100.79		DMG + speed up	Grants one Soul Heart, +1 damage, and +0.2 speed. Grants one Black Heart, +1 damage, and +0.2 speed.	3
The Pact	5.100.80		DMG + tears up	Grants two Soul Hearts, +0.5 damage, and +0.7 tears. Grants two Black Hearts, +0.5 damage, and +0.7 tears.	3
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
Lord of the Pit	5.100.82		Demon wings	Grants flight and +0.3 speed.	3
Loki's Horns	5.100.87		Cross tears	Gives a random chance for projectiles to fire in all 4 cardinal directions.	1
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
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
The Small Rock	5.100.90		DMG up + speed down	+1 damage, +0.2 tears, -0.2 speed.	3
Spelunker Hat	5.100.91		See-through doors	Reveals type of adjacent rooms, including location for Secret Rooms and Super Secret Rooms. Reveals rooms up to 2 rooms away and blocks projectiles falling from above.	2
Super Bandage	5.100.92		+2 hearts	Grants one full Red Heart container and 2 Soul Hearts.	2
Sack of Pennies	5.100.94		Gives money	Spawns a familiar that drops a coin every 2 rooms.	1
Robo-Baby	5.100.95		Friends 'till the bbbbzzzt	Spawns a familiar that shoots Technology lasers.	1
Little C.H.A.D.	5.100.96		Gives kisses	Spawns a familiar who drops a Half Red Heart every 3 rooms.	2
The Relic	5.100.98		Soul generator	Spawns a cross familiar that drops a Soul Heart after clearing enough rooms.	3
Little Gish	5.100.99		Sticky friend	Spawns a familiar that follows Isaac around and fires slowing tears, impeding enemies' speed.	1
Little Steven	5.100.100		Psychic friend	Spawns a familiar who follows Isaac around and fires homing tears.	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 falling speed. Grants one full Red Heart container, +0.3 damage, +0.2 tears, +1.5 range, and +0.3 speed. Heals 1 additional Red Heart.	3
The Common Cold	5.100.103		Poison damage	Adds a chance to shoot poison tears, dealing damage over time when inflicted.	1
The Parasite	5.100.104		Split shot	Isaac's tears split in two when they hit something.	3
Mr. Mega	5.100.106		Bigger boom	+5 Bombs. Increases the size, blast radius, and damage of Isaac's bombs.	2
The Wafer	5.100.108		Damage resistance	Most sources of damage that would cause more than one-half heart of damage are reduced to one-half heart instead.	4
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
Mom's Contacts	5.100.110		Freeze effect	Adds a chance to shoot petrifying tears, which stop enemies in place and prevent them from moving or attacking. +0.25 range. +1.5 range.	3
Guardian Angel	5.100.112		Extra protection	Spawns an orbital familiar that blocks enemy shots, deals 7 damage per tick on contact, and increases the speed of all orbital familiars.	1
Demon Baby	5.100.113		Auto-turret friend	Spawns a familiar that follows Isaac and automatically fires at enemies in its reach.	1
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
Ouija Board	5.100.115		Spectral tears + tears up	Grants spectral tears that travel through obstacles (but not enemies). +0.5 tears.	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
Dead Bird	5.100.117		Protective buddy	After Isaac takes damage, spawns a flying familiar that chases enemies for the current room, dealing ~4 damage per second.	0
Brimstone	5.100.118		Blood laser barrage	Tears are replaced with a blood 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
Blood Bag	5.100.119		HP up	Grants one filled Red Heart container, restores 4 Red Hearts, and increases speed by 0.3.	2
Odd Mushroom	5.100.120		Tears + speed up, DMG down	+1.7 tears, +0.3 speed, slightly reduces damage.	2
Odd Mushroom	5.100.121		HP + DMG up, speed down	Grants one empty Heart container, +0.3 damage, +0.25 range, +0.5 tear falling speed, and -0.1 speed. Grants one full Heart container, +1 damage, +1.5 range, and -0.2 speed	2
Whore of Babylon	5.100.122		Curse up	Grants +1.5 Damage and +0.3 Speed whenever Isaac has a Half Red Heart or less.	2
Bobby-Bomb	5.100.125		Homing bombs!	+5 Bombs. Bombs gain a homing effect, slowly moving towards the nearest enemy.	1
Forever alone	5.100.128		Attack fly	Spawns an attack fly that orbits a long distance from Isaac, dealing 30 damage per second.	1
Bucket of Lard	5.100.129		HP up	Grants two empty Red Heart containers, heals Isaac for a Half Red Heart, -0.2 speed. Grants two Red Heart containers, -0.2 speed.	1
Bomb Bag	5.100.131		Gives bombs	Spawns a familiar that drops a Bomb every 3 rooms.	1
A Lump of Coal	5.100.132		My Xmas present	The more distance tears travel, the more damage they will do.	3
Guppy's Tail	5.100.134		Cursed?	Room Clear Awards have a 1/3 chance of being replaced with a Chest and a 2/9 chance being replaced with nothing.	2
Stigmata	5.100.138		DMG + HP up	+0.3 damage, grants one full Red Heart container. Heals 1 additional Red Heart.	2
Mom's Purse	5.100.139		More trinket room	Allows Isaac to hold one additional trinket. Drops a random trinket.	2
Bob's Curse	5.100.140		+5 poison bombs	+5 Bombs. Grants Isaac's bombs a poison effect. They also leave a lingering poison cloud, and Isaac becomes immune to poison.	1
Pageant Boy	5.100.141		Ultimate grand supreme	Spawns seven random coins around Isaac.	0
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
Speed Ball	5.100.143		Speed + shot speed up	+0.3 speed, +0.2 shot speed.	2
Bum Friend	5.100.144		He's greedy	Spawns a familiar that picks up coins for himself, giving random pickups in return. Can spawn Items from the Beggar Item Pool.	1
Infestation	5.100.148		Fly revenge	1-3 Blue Flies randomly spawn every time Isaac gets hit. 2-6 Blue Flies randomly spawn every time Isaac gets hit.	0
Ipecac	5.100.149		Explosive shots	Replaces tears with explosive and poisoning projectiles fired in an arc from the mouth.	4
Tough Love	5.100.150		Tooth shot	Adds a chance to shoot a tooth instead of a tear, which deals x3.2 Isaac's damage.	3
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
Technology 2	5.100.152		Extra laser	Replaces the tears fired from Isaac's right eye with a rapid-firing low damage piercing laser. Damage down.	2
Mutant Spider	5.100.153		Quad shot	Isaac shoots four tears at once with lower fire rate.	3
Chemical Peel	5.100.154		DMG up	Tears fired from the left eye have +2 flat damage.	2
The Peeper	5.100.155		Plop!	Spawns a familiar that slowly floats around the room in a zig-zag pattern, damaging enemies it passes through. Increases the damage of tears from Isaac's left eye by 35%.	2
Habit	5.100.156		Item martyr	When Isaac is hit, his active item gains 1 room's worth of charge.	2
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.	2
Spirit of the Night	5.100.159		Scary	Grants spectral tears and flight.	3
Ankh	5.100.161		Eternal life?	Upon death, Isaac will respawn as ??? in the previous room, with 3 Soul Hearts.	0
Celtic Cross	5.100.162		Blessing of protection	Grants a chance to trigger the Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 7 seconds.	1
Ghost Baby	5.100.163		Spectral buddy	Spawns a familiar that follows Isaac around and fires spectral tears.	1
Cat-o-nine-tails	5.100.165		Shot speed + damage up	+1 damage, +0.23 shot speed.	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
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
Polyphemus	5.100.169		Mega tears	Isaac fires huge tears that deal massive damage, but fire rate is greatly decreased. If a tear kills an enemy, it travels on with any leftover damage.	4
Daddy Longlegs	5.100.170		Daddy's love	Daddy Long Legs' shadow follows Isaac and occasionally stomps enemies for 40 damage total.	3
Sacrificial Dagger	5.100.172		My fate protects me	Spawns a dagger orbital familiar, blocking enemy shots and dealing a high amount of damage to enemies in contact.	2
Mitre	5.100.173		Blessing of purity	Grants a chance of converting any Red Heart pickups that spawn into Soul Hearts instead.	3
Rainbow Baby	5.100.174		Random buddy	Spawns a familiar that follows Isaac around and fires tears with random effects.	1
Stem Cells	5.100.176		HP + shot speed up	Grants one full Red Heart container and +0.16 shot speed. Heals 1 additional Red Heart	1
Holy Water	5.100.178		Splash!	Spawns a bottle familiar that breaks when Isaac takes damage, leaving a puddle of blue creep. A bottle familiar that flies forward when Isaac shoots. It breaks upon hitting an enemy, leaving a puddle of blue creep that petrifies enemies.	3
Fate	5.100.179		Flight eternal	Grants flight and one Eternal Heart.	3
The Black Bean	5.100.180		Toot on touch	When taking damage, Isaac farts, poisoning enemies in range. When taking damage, Isaac farts five times, poisoning and knocking back nearby enemies and leaving lingering poison clouds.	0
Sacred Heart	5.100.182		Homing shots + DMG up	Adds a Red Heart Container. Grants homing tears, a x2.3 Damage multiplier, +1 flat Damage, -0.4 Tears, -0.25 Shot Speed, and +4.125 Range. Adds a Red Heart Container. Grants homing tears, a x2.3 Damage multiplier, +1 flat Damage, -0.4 Tears, and -0.25 Shot Speed.	4
Tooth Picks	5.100.183		Tears + shot speed up	+0.7 tears, +0.16 shot speed.	3
Holy Grail	5.100.184		Flight + HP up	Grants flight and one Red Heart container. Heals 1 additional Red Heart.	3
Dead Dove	5.100.185		Flight + spectral tears	Grants spectral tears and flight.	3
Guppy's Hairball	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
Abel	5.100.188		Mirrored buddy	Spawns a familiar that mirrors Isaac's movements and shoots in the opposite direction. Spawns a familiar that mirrors Isaac's movements and shoots towards him.	0
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 falling speed. Fully restores all red hearts. +1 Red Heart container, +0.3 damage, +0.2 tears, +0.2 speed, +2.5 range. Fully restores all red hearts.	3
Pyro	5.100.190		99 bombs	Grants 99 Bombs.	3
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
MEAT!	5.100.193		DMG + HP up	Grants one full Red Heart container, +0.3 damage. Heals 1 additional Red Heart	2
Magic 8 Ball	5.100.194		Shot speed up	+0.16 shot speed, spawns a random tarot card. Increases the chance of finding a Planetarium.	1
Mom's Coin Purse	5.100.195		What's all this...?	Spawns 4 random pills near Isaac.	0
Squeezy	5.100.196		Tears up	+0.4 tears, spawns 2 Soul Hearts.	3
Jesus Juice	5.100.197		Damage + range up	+0.5 damage, +0.25 range, +0.5 tear falling speed. +0.5 damage, +1.5 range.	2
Box	5.100.198		Stuff	Spawns various pickups: 1 coin, 1 Key, 1 Bomb, 1 Heart, 1 card/rune, 1 pill and 1 trinket.	0
Mom's Key	5.100.199		Better chest loot +2 keys	Adds 2 keys. Chests will drop additional pickups.	3
Mom's Eyeshadow	5.100.200		Charm tears	Tears have a chance to charm enemies.	1
Iron Bar	5.100.201		DMG up + concussive tears	+0.3 damage. Adds a chance to shoot concussive tears, causing enemies to walk around randomly.	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 Pennies.	1
Humbleing Bundle	5.100.203		1+1 free 4Evar	Transforms Bombs, Keys, Pennies, and Red Hearts into their respective Double versions. This will occur 50% of the time.	3
Fanny Pack	5.100.204		Filled with goodies	Has a chance to drop a random pickup when Isaac takes damage.	1
Sharp Plug	5.100.205		Infinite charge... at a cost	Damages Isaac in exchange for fully recharging Isaac's current activated item.	2
Guillotine	5.100.206		DMG + tears up. An out-of-body experience!	Isaac's head becomes an orbital familiar that blocks shots and deals contact damage. Tears are still fired from the rotating head. +1 damage, -1 tear delay. +1 damage, +0.5 fire rate.	0
Ball of Bandages	5.100.207		Gotta lick 'em all!	Creates an orbital familiar. Collecting additional copies gives it the ability to shoot Charm tears, then chase enemies to deal contact damage, then deal even more contact damage.	1
Champion Belt	5.100.208		DMG + challenge up	+1 damage. Increases the chance of champion enemies appearing by 15%.	3
Butt Bombs	5.100.209		Toxic blast +5 bombs	+5 Bombs. Bombs now cloud up the screen, briefly damaging and confusing all enemies.	1
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
Spiderbaby	5.100.211		Spider revenge	Spawns 1-2 Blue Spiders when Isaac takes damage. Spawns 3-5 Blue Spiders when Isaac takes damage.	0
Guppy's Collar	5.100.212		Eternal life?	Grants a permanent 50% chance to respawn with 1/2 of a Red Heart after death.	1
Lost Contact	5.100.213		Shielded tears	Isaac's tears can hit and destroy enemy projectiles. -0.15 shot speed.	2
Anemic	5.100.214		Toxic blood	After Isaac is damaged, a trail of red creep will be left behind him until he leaves the current room. +5 range. +1.5 range.	1
Goat Head	5.100.215		He accepts your offering	A Devil Room / Angel Room will always spawn after every boss fight, excluding the first floor and floors after Chapter 4.	3
Ceremonial Robes	5.100.216		DMG + evil up	Grants 3 Black Hearts and +1 damage.	3
Mom's Wig	5.100.217		You feel itchy...	Adds a chance to spawn Blue Spiders when firing tears. Restores 1 Red Heart.	2
Placenta	5.100.218		Regeneration + HP up	Grants one full Red Heart container, and a chance to regenerate a Half Red Heart of health every minute of gameplay.	2
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
Sad Bombs	5.100.220		Tear blasts +5 bombs	+5 Bombs. Upon exploding, bombs shoot 10 tears around them, affected by tear modifiers.	2
Rubber Cement	5.100.221		Bouncing tears	Tears bounce off walls, enemies, and environmental objects.	3
Anti-Gravity	5.100.222		Anti-gravity tears + tears up	Tears float in position until firing ceases, after which they will fly off in the direction they were shot in. -2 Tear Delay. +1 Fire Rate.	1
Pyromaniac	5.100.223		It hurts so good +5 bombs	+5 bombs. Grants immunity to explosion damage and causes explosions to heal Isaac. Also grants immunity to fire.	4
Cricket's Body	5.100.224		Bursting shots + tears up	When tears hit an object or deplete their range, they spawn 4 smaller tears, whose range and damage scale with Isaac's. Grants -1 tear delay and reduces range. Grants +0.5 fire rate and reduces range.	3
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
Black Lotus	5.100.226		HP up x3!	Grants one Red Heart Container, one Soul Heart, and one Black Heart.	2
Piggy Bank	5.100.227		My life savings	Gives 3 Pennies on pick-up. Every time Isaac is damaged, he will drop one or two additional pennies.	1
Mom's Perfume	5.100.228		Fear shot + tears up	Adds a chance to shoot fear tears. Decreases tear delay by 1. +0.5 fire rate.	2
Monstro's Lung	5.100.229		Charged burst attack	Replaces normal tears with a charged shot that fires 14 tears in the same fashion as Monstro.	2
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.	3
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
Stop Watch	5.100.232		Let's slow this down a bit...	+0.3 speed. Automatically inflicts slow to all enemies in every room. +0.3 speed. Upon taking damage, inflicts slow to all enemies for the current room. +0.3 speed. Slows all enemies in every room to 80% speed.	4
Tiny Planet	5.100.233		Orbiting tears + range up	Massively increases Range and grants spectral tears. Tears orbit around Isaac at a fixed distance until they hit the ground.	0
Infestation 2	5.100.234		Infestation shot	Spawns allied Blue Spiders from killed enemies.	3
E. Coli	5.100.236		Turdy touch	Enemies that touch Isaac are transformed into Poop.	0
Death's Touch	5.100.237		Piercing shots + DMG up	+1.5 damage, -0.3 tears. Tears are replaced with large piercing scythes.	3
Key Piece 1	5.100.238		???	Combined with Key Piece 2, unlocks the golden gate in the starting room of Chest and Dark Room to fight Mega Satan.	0
Key Piece 2	5.100.239		???	Combined with Key Piece 1, unlocks the golden gate in the starting room of Chest and Dark Room to fight Mega Satan.	0
Experimental Treatment	5.100.240		Some stats up, some stats down	Randomly increases and decreases some of Isaac's stats. Increases four random stats and decreases the other two.	1
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.	2
Infamy	5.100.242		Blocks damage... sometimes	Gives Isaac a 50% chance to block projectiles coming from any direction.	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.	2
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
20/20	5.100.245		Double shot	Isaac fires two tears at once, one from each eye. 0.8× damage multiplier.	4
Blue Map	5.100.246		Secrets	Reveals the locations of Secret Rooms and Super Secret Rooms on the map.	1
BFFS!	5.100.247		Your friends rule!	Increases the size and effectiveness of most familiars.	2
Hive Mind	5.100.248		Giant spiders and flies	Increases the size of Blue Spiders and Blue Flies and doubles the amount of damage they deal. Also increases the effectiveness of fly and spider familiars.	2
There's Options	5.100.249		More options	Two items appear after defeating a Boss. Only one can be taken; the other will disappear.	3
BOGO Bombs	5.100.250		1+1 BOOM!	All normal Bombs become Double Bombs.	1
Starter Deck	5.100.251		Extra card room	Isaac can hold 2 cards at once and all pills are replaced by cards.	2
Little Baggy	5.100.252		Extra pill room	Isaac can hold 2 pills at once and all cards and runes are replaced by pills.	0
Magic Scab	5.100.253		HP + luck up	Grants one full Red Heart container, +1 luck. Heals 1 additional Red Heart.	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 falling speed. Tears fired from the left eye have +1 flat damage and +2.75 range.	2
Screw	5.100.255		Tears + shot speed up	+0.5 tears, +0.2 shot speed.	2
Hot Bombs	5.100.256		Burning blast +5 bombs	+5 Bombs. Isaac's bombs leave behind fire that damages enemies upon contact.	1
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
Missing No.	5.100.258		Syntax error	Randomizes all passive items and stats upon pickup and at the start of each succeeding floor.	0
Dark Matter	5.100.259		DMG up + fear shot	+1 damage, adds a chance to shoot fear tears.	3
Black Candle	5.100.260		Curse immunity + evil up	Prevents curses. Grants one Black Heart. Increases the chance for a Devil Room or Angel Room to appear.	3
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.	3
Missing Page 2	5.100.262		Evil up. Your enemies will pay!	Grants one . 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 s and The Necronomicon-like effects by 40.	0
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.	1
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
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
Robo-Baby 2.0	5.100.267		We worked out all the kinks	Spawns a familiar that fires lasers at any enemy in its line of sight and moves based on the direction Isaac is firing tears.	1
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
Headless Baby	5.100.269		Bloody friend	Spawns a familiar that follows Isaac, leaving blood creep on the ground.	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.	2
Mystery Sack	5.100.271		?	Spawns a familiar that drops a Heart, coin, Bomb, or Key every 5-6 rooms.	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.	0
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.	0
Best Bud	5.100.274		Sworn protector	When hit, spawns a quickly orbiting attack fly similar to Forever alone for the current room that deals high damage.	0
Lil Brimstone	5.100.275		Evil friend	Grants a familiar that charges a thin Brimstone laser while Isaac is shooting.	2
Isaac's Heart	5.100.276		Protect it	Isaac himself is now immune to all damage, and a heart familiar follows him. If the heart is hurt, Isaac is hurt. The heart charges up as Isaac shoots, firing 8 blood shots, knocking back enemies, and leaving a puddle of creep when released.	0
Lil Haunt	5.100.277		Fear him	Spawns a familiar that chases down enemies, dealing 4 damage per second and inflicting fear.	1
Dark Bum	5.100.278		He wants to take your life	Spawns a familiar that follows Isaac around and collects Red Hearts. For every 1½ Red Hearts collected, Dark Bum will give a reward.	3
Big Fan	5.100.279		Fat protector	Spawns a large, slow-moving orbital familiar that blocks enemy shots and deals 30 damage per second to enemies. Reduces the speed other orbitals rotate at.	1
Sissy Longlegs	5.100.280		She loves you	Spawns a familiar that wanders randomly, occasionally spawning Blue Spiders. Briefly charms enemies on contact.	1
Punching Bag	5.100.281		Scape goat	Spawns a Mulligan familiar that wanders randomly. Enemies will attack the Mulligan if it's closer.	1
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
Aries	5.100.300		Ramming speed	+0.25 Speed. Running into enemies while at a high speed will deal damage. Prevents Isaac from taking contact damage while moving at high speed.	2
Cancer	5.100.301		HP up + you feel protected	Adds 3 Soul Hearts. Grants The Wafer effect for the current room after taking damage.	3
Leo	5.100.302		Stompy	Isaac can destroy rocks by walking into them.	1
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
Libra	5.100.304		You feel balanced	Gives 6 Coins, 6 Bombs, and 6 Keys and balances out all attributes.	1
Scorpio	5.100.305		Poison tears	Grants poison tears, which deal damage over time when inflicted.	3
Sagittarius	5.100.306		Piercing shots + speed up	Increases speed by +0.2 and grants piercing tears.	3
Capricorn	5.100.307		All stats up	Adds 1 Red Heart Container, gives +0.5 Damage, +0.1 Speed, +1.5 Range, and -1.0 Tear Delay, and gives 1 Bomb, Penny, and Key. Adds 1 Red Heart Container, gives +0.5 Damage, +0.1 Speed, +0.75 Range, and +0.5 Fire Rate, and gives 1 Bomb, Penny, and Key.	3
Aquarius	5.100.308		Trail of tears	A trail of blue creep is left behind Isaac, which damages enemies. The creep scales with damage and inherits most tear effects.	2
Pisces	5.100.309		Tears up + knock-back shots	-1 Tear Delay, adds knock-back shots and increases tear size. +0.5 Fire Rate, adds knock-back shots and increases tear size.	2
Eve's Mascara	5.100.310		DMG up, tears + shot speed down	Doubles damage, halves tears stat, and greatly reduces shot speed. Doubles damage, 0.66x tears multiplier, and greatly reduces shot speed.	3
Judas' Shadow	5.100.311		Sweet revenge	Upon death, respawns Isaac as Dark Judas with two Black Hearts in the previous room.	3
Maggy's Bow	5.100.312		HP up + you feel healthy	Gives one Red Heart Container and doubles the healing provided by Red Hearts. Also heals 1 Red Heart when obtained.	2
Holy Mantle	5.100.313		Holy shield	Grants a shield that negates the first instance of damage taken from a hostile source once per room.	4
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
Strange Attractor	5.100.315		Magnetic tears	Pickups, trinkets, and monsters are magnetically attracted to Isaac's tears.	0
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
Mysterious Liquid	5.100.317		Toxic splash damage	Tears leave a small, short lasting pool of creep on impact or when their range is depleted.	3
Gemini	5.100.318		Conjoined friend	Spawns a conjoined familiar which chases enemies close to Isaac, dealing ~6.43 damage per second.	1
Cain's Other Eye	5.100.319		Near-sighted friend	Spawns a familiar that slowly floats around the room on a zig-zag pattern and shoots normal tears in the same direction as Isaac. Spawns a familiar that follows Isaac and fires tears in random cardinal directions that copy Isaac's tears and tear effects and scale with damage.	2
???'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	1
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
Mongo Baby	5.100.322		Mongo friend	Spawns a familiar that copies the tears of Isaac's other familiars.	2
The Polaroid	5.100.327		Fate chosen	If Isaac has half a red heart or no red hearts after taking damage, he gains a shield that nullifies all types of damage for 5 seconds. Allows entrance into Chest. Also allows access to Home.	2
The 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. +1 Damage and also allows access to Home.	2
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.	1
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
Godhead	5.100.331		God tears	Grants homing tears with a damaging halo. +0.5 Damage, -0.3 Tears -0.3 Shot Speed, +0.8 Tear Falling Speed, and +1.2 Range. Grants homing tears with a damaging halo. +0.5 Damage, -0.3 Tears, and -0.3 Shot Speed.	4
Lazarus' Rags	5.100.332		Eternal life?	Upon dying, resurrect as Lazarus Risen in the current room with one Red Heart container and Anemic. Upon dying, resurrect as Lazarus Risen in the current room with one less Red Heart container, Anemic, and +0.5 Damage. Transform into Lazarus when reaching the next floor.	1
The Mind	5.100.333		I know all	Reveals the entire map, including all special rooms and Secret Rooms.	3
The Body	5.100.334		I feel all	Adds 3 Red Heart Containers.	3
The Soul	5.100.335		I am all	Grants two Soul Hearts. Isaac gains a pulsing aura that repels enemies and projectiles.	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.	2
Broken Watch	5.100.337		I think it's broken	Slows all enemies in every fourth newly-discovered room, with a small chance to speed them up instead.	1
Safety Pin	5.100.339		Evil + range + shot speed up	Grants one Black Heart, +5.25 range, +0.5 tear falling speed, +0.16 shot speed. Grants one Black Heart, +2.5 range, +0.16 shot speed.	1
Caffeine Pill	5.100.340		Speed up + size down	Grants +0.3 speed, reduces Isaac's size, and gives a random pill.	1
Torn Photo	5.100.341		Tears + shot speed up	+0.7 tears, +0.16 shot speed.	3
Blue Cap	5.100.342		HP + tears up + shot speed down	Gives one full Red Heart container, +0.7 tears, and -0.16 shot speed. Heals 1 additional Red Heart.	3
Latch Key	5.100.343		Luck up	Grants 1 Soul Heart and +1 luck. Spawns 2 Keys.	1
Match Book	5.100.344		Evil up	Grants Isaac one Black Heart, spawns two or three Bombs. Also spawns Match Stick if it hasn't been encountered yet.	1
Synthoil	5.100.345		DMG + range up	+1 damage, +5.25 range, +0.5 tear falling speed. +1 damage, +2.5 range.	3
A Snack	5.100.346		HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	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
Bomber Boy	5.100.353		Cross blast + 5 bombs	+5 Bombs. Isaac's bombs will now explode in a large cross-shaped pattern (roughly 5 bombs explosions wide). This also affects player-spawned Troll Bombs.	2
Crack Jacks	5.100.354		HP up. Don't swallow the prize!	Grants one full Red Heart container and drops a random trinket. Heals 1 additional Red Heart.	2
Mom's Pearls	5.100.355		Range + luck up	+1.25 range, +0.5 tear falling speed, +1 luck. +2.5 range, +1 luck. Grants one Soul Heart.	2
Car Battery	5.100.356		Active power up	Causes Isaac's activated item to activate twice on each use.	3
The Wiz	5.100.358		Double wiz shot!	Grants spectral tears. Tears simultaneously fire out of both eyes diagonally, similar to the effect of the R U a Wizard? pill.	0
8 Inch Nails	5.100.359		Stick it to 'em!	+1.5 damage. Replaces Isaac's tears with nails, which have increased knockback.	3
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
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
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
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.	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
Lost Fly	5.100.365		Lost protector	Spawns a fly familiar that moves in a straight line and circles around the first wall or obstacle it hits. It deals 105 damage per second on contact. It deals 56 damage per second and forces nearby enemies to attack it.	2
Scatter Bombs	5.100.366		We put bombs in your bombs!	+5 Bombs. Isaac's bombs explode into 2-4 tiny bombs.	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. They also leave a long-lasting puddle of slowing white creep.	1
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
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
Mr. Dolly	5.100.370		Range + tears up	+0.7 tears, +5.25 range, +0.5 tear falling speed, Spawns a combination of 3 Red Hearts, Soul Hearts or Black Hearts on the floor when picked up. +0.7 tears, +2.5 range, spawns 3 random types of Hearts on the floor when picked up.	3
Curse of the Tower	5.100.371		Embrace chaos	Upon taking damage, spawns six Troll Bombs around the room, similar to the effect of XVI - The Tower.	0
Charged Baby	5.100.372		Bbbzzzzzt!	Spawns a familiar that occasionally drops a Lil' Battery, gives an active item charge, or petrifies all enemies in the room.	2
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
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
Restock	5.100.376		Never ending stores!	Causes Shops to instantly restock their items when they are bought. Outside of Greed Mode, the restocked item's cost is increased after each purchase.	2
Bursting Sack	5.100.377		Spider love	Spider enemies no longer target or deal contact damage to Isaac.	1
Number Two	5.100.378		Uh oh...	Continuously firing tears for three seconds causes Isaac to drop a Butt Bomb, which damages and confuses all enemies in the room when it explodes.	2
Pupula Duplex	5.100.379		Wide shot	Gives Isaac spectral tears and gives his tears a wide arc shape, increasing their size.	2
Pay To Play	5.100.380		Money talks	+5 Coins. Most doors require one Penny to open instead of a Key. +5 Coins. All locked doors, Locked Chests, and Key Blocks must be opened with one Penny instead of Keys.	2
Eden's Blessing	5.100.381		Tears up + your future shines brighter	+0.7 tears up. Grants a random item at the start of the next run.	3
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
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
Censer	5.100.387		Peace be with you	Spawns a familiar which creates a circular aura that slows down enemies and enemy shots inside.	2
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
Rune Bag	5.100.389		Rune generator	Spawns a familiar that drops a random rune after clearing enough rooms.	3
Seraphim	5.100.390		Sworn friend	Spawns an angel familiar who follows Isaac and fires homing tears which deal 10 damage and have 75% shot speed.	3
Betrayal	5.100.391		Turn your enemy	Charms all enemies in the room when Isaac takes damage. Enemies are able to damage each other. If an enemy is damaged by another enemy, they will attack that enemy instead of Isaac.	1
Zodiac	5.100.392		The heavens will change you	Gives Isaac a random zodiac item effect that changes every floor.	1
Serpent's Kiss	5.100.393		The kiss of death	Tears have a chance to apply a poison effect to enemies. Isaac poisons enemies on contact. Poisoned enemies have a chance to drop a Black Heart when killed.	2
Marked	5.100.394		Directed tears	Isaac will automatically fire tears directed at a red target on the ground. The target can be moved with tear controls. +0.7 tears, increases range.	0
Tech X	5.100.395		Laser ring tears	Tears are replaced with laser rings that pierce through enemies and deal damage to enemies within them. Can be charged to increase the effectiveness of the ring.	4
Tractor Beam	5.100.397		Controlled tears	Isaac's tears are bound to a beam emitting in the direction he's firing. +0.5 Tears, +5.25 Range, +0.16 Shot Speed. +1 Fire Rate, +2.5 Range, +0.16 Shot Speed.	3
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
Maw Of The Void	5.100.399		Consume thy enemy!	Isaac can charge and unleash a black ring that rapidly deals damage around him. The ring can cause enemies to drop Black Hearts. +1 damage.	3
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 2× his tear damage, and occasionally inflicts fear.	1
Explosivo	5.100.401		Sticky bomb shot!	Isaac's tears have a chance to stick to enemies and explode.	3
Chaos	5.100.402		!!!	Drops 1-6 random pickups on the floor. Causes items to be chosen from random item pools.	3
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
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
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.	1
Purity	5.100.407		Aura stat boost	Boosts one of Isaac's stats depending on the color of the aura around him. The aura disappears upon taking damage and reappears with a random color upon entering a new room. Red boosts damage, blue boosts tears, yellow boosts speed, and orange boosts range.	3
Athame	5.100.408		Call to the void	When Isaac takes damage, a damaging black ring briefly appears around him. This ring can cause enemies to drop Black Hearts. After Isaac kills an enemy, adds a luck-based chance to spawn a damaging black ring around them.	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
Evil Eye	5.100.410		Eye shot!	Adds a chance to fire a slow-moving eye that fires tears in the same direction as Isaac. The eye is destroyed when it hits an enemy or obstacle.	2
Lusty Blood	5.100.411		Their blood brings rage!	Isaac's damage increases for the current room each time he kills an enemy.	3
Cambion Conception	5.100.412		Feed them hate	After taking damage a certain amount of times, a permanent demonic familiar spawns.	1
Immaculate Conception	5.100.413		Feed them love	Upon picking up a certain amount of health, spawn a permanent angelic familiar.	1
More Options	5.100.414		There's options	Two item pedestals are presented in every Treasure Room. Only one can be taken; the other will disappear.	3
Crown Of Light	5.100.415		The untainted gain power	+2 Soul Hearts. While Isaac has no empty red hearts, grants 2x damage, increased range, and -0.3 shot speed. Regardless of health, the crown deactivates for the current room when Isaac takes damage.	4
Deep Pockets	5.100.416		More money!	Allows Isaac to carry two cards or pills (or a combination of both) at the same time. Increases the coin cap to 999. If a room would otherwise yield no reward, 1-3 coins will spawn.	2
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 1.5× tear damage multiplier.	3
Fruit Cake	5.100.418		Rainbow effects!	Isaac's tears gain a random effect that changes every shot.	2
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.	0
Circle of Protection	5.100.423		Protect me from myself	Surrounds Isaac with a large white halo that occasionally deals Isaac's tear damage to enemies inside it, and can convert enemy shots into friendly homing tears.	2
Sack Head	5.100.424		More sacks!	Spawns a Grab Bag on pickup. Coins, Bombs, Keys, cards, runes and batteries have a chance to become Grab Bags.	3
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.	1
Obsessed Fan	5.100.426		Follows my every move...	Spawns a familiar that follows Isaac's movements on a delay and deals 30 contact damage per second to enemies.	0
PJs	5.100.428		You feel cozy	Grants 4 Soul Hearts and fully restores Isaac's health.	2
Head of the Keeper	5.100.429		Penny tears!	Isaac's tears become coins. Hitting an enemy has a 5% chance to drop a Penny.	2
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
Multidimensional Baby	5.100.431		ydduB Buddy	Spawns a familiar that will follow Isaac's movements on a 2.5-second delay. Tears that pass through the baby will be doubled and increase in speed.	2
Glitter Bombs	5.100.432		Prize bombs!	+5 Bombs. Bombs have a chance to drop random pickups or charm enemies when they explode.	2
My Shadow	5.100.433		Me! And my shaaaadow!	Inflicts fear on all enemies in the room upon taking damage and spawns black friendly Chargers that attack enemies. Spawns a shadow familiar that closely follows behind Isaac. It spawns a black friendly Charger whenever an enemy touches it.	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
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. After the milk spills, Isaac's fire rate is increased by 1 for the current room.	1
Binky	5.100.438		Tears up	Grants one Soul Heart, +0.75 tears and decreases Isaac's size.	3
Kidney Stone	5.100.440		Matt's kidney stone	Isaac is occasionally forced to stop firing and charge an attack that launches a massive piercing, spectral kidney stone and a barrage of tears. -0.2 speed, decreases range.	2
Dark Prince's Crown	5.100.442		Loss is power	When at exactly one Red Heart, +0.75 tears, +1.5 range, and +0.2 shot speed. When at exactly one Red Heart, +2 fire rate, +1.5 range, and +0.2 shot speed.	1
Apple!	5.100.443		Trick or treat?	+0.3 tears. Adds a chance to fire a razor blade that deals 4× Isaac's damage.	3
Lead Pencil	5.100.444		He's a bleeder!	After every 15 tears fired, Isaac will fire a high-damage cluster of tears.	3
Dog Tooth	5.100.445		Bark at the moon!	+0.3 damage, +0.1 speed. Plays a howl or bark sound when entering a room with undiscovered Secret Rooms or Crawl Spaces.	2
Dead Tooth	5.100.446		Toxic breath	While firing, Isaac gains a green aura that poisons nearby enemies.	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
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.	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
Eye of Greed	5.100.450		Gold tears!	Every 20 tears, Isaac loses 1 Penny 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
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.	2
Varicose Veins	5.100.452		I'm leaking...	Taking damage releases a ring of 10 high damage tears.	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.	3
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
Dad's Lost Coin	5.100.455		I remember this...	+1.5 range, +1 tear falling speed. Drops a Lucky Penny. +2.5 range. Drops a Lucky Penny.	1
Midnight Snack	5.100.456		HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1
Cone Head	5.100.457		Hard headed!	Grants a Soul Heart. Gives Isaac a chance to ignore any damage taken.	2
Belly Button	5.100.458		What's in there?	Drops a random trinket. Grants a second trinket slot.	2
Sinus Infection	5.100.459		Booger tears!	Adds a chance to fire a booger that sticks to enemies and deals damage over time.	3
Glaucoma	5.100.460		Blind tears!	Adds a chance to shoot tears that confuse enemies for an extremely long time.	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
Eye of Belial	5.100.462		Possessed tears!	Grants piercing tears. After piercing one enemy, tears start homing and deal double damage.	3
Sulfuric Acid	5.100.463		Acid tears!	+0.3 damage. Adds a chance to fire acidic tears which can destroy obstacles and open doors.	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.	2
Analog Stick	5.100.465		360 tears!	+0.35 tears up. Allows Isaac to fire tears diagonally.	2
Contagion	5.100.466		Outbreak!	The first enemy killed in a room releases a gas cloud that poisons nearby enemies. Affected enemies will also release gas upon death, spreading the effect.	2
Finger!	5.100.467		Watch where you point that!	Spawns a finger familiar that faces in the same direction as Isaac, rapidly damaging enemies it points at for 10% of Isaac's damage.	1
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
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
Hushy	5.100.470		Lil hush!	Spawns a familiar that bounces diagonally around the room and deals contact damage. While firing tears, it stops moving.	0
Lil Monstro	5.100.471		Ain't he cute?	Spawns a familiar that fires clusters of tears. Must be charged before shooting.	2
King Baby	5.100.472		Hail to the king baby	Spawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, other familiars stop moving.	1
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
Tonsil	5.100.474		Gross...	Grants a familiar that follows Isaac and blocks enemy shots.
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
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
Adrenaline	5.100.493		Panic = power	Increases damage based on how many empty Red Heart containers Isaac has.	1
Jacob's Ladder	5.100.494		Electric tears	Tears fire sparks of electricity in random directions upon hitting an obstacle or enemy.	3
Ghost Pepper	5.100.495		Flame tears	Gives a chance to shoot fires alongside tears that block enemy shots and deal damage to enemies that touch them. Gives a chance to shoot blue fires alongside tears that become smaller as they travel.	3
Euthanasia	5.100.496		Needle shot	Adds a luck-based 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
Camo Undies	5.100.497		Camo kid	Isaac becomes camouflaged at the beginning of each room. Until he shoots, all non-boss enemies will be confused. Isaac gains +0.5 Speed while camouflaged, and gains Tears and Damage upon breaking it.	3
Duality	5.100.498		You feel very balanced	Whenever a Devil Room 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 will always spawn after every boss fight, excluding the first floor and floors after Chapter 4.	3
Sack of Sacks	5.100.500		Gives sacks	Spawns a familiar that drops a Grab Bag every 5-6 rooms cleared.	2
Greed's Gullet	5.100.501		Money = health!	Grants a Red Heart container for every 25 Coins Isaac has.	1
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
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
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.	2
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.	3
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
Bloodshot Eye	5.100.509		Bloody friend	Spawns an orbital familiar that deals contact damage and fires a tear every 2 seconds. Spawns an orbital familiar that deals contact damage, blocks shots, and fires tears at enemies in its line of sight.	1
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
Bozo	5.100.513		Party time!	+0.1 flat damage, grants a Soul Heart. Enemies can randomly become briefly charmed or feared. Taking damage has a chance to spawn a Rainbow Poop.	2
Broken Modem	5.100.514		Lag!	Enemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals. The reward from clearing a room will sometimes be duplicated.	3
Fast Bombs	5.100.517		Rapid bomb drops	+7 Bombs. Removes the delay between bomb placements, allowing them to be placed rapidly. Bombs will no longer knock each other away.	1
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
Lil Delirium	5.100.519		Delirious friend	Grants a familiar that transforms into another random familiar every 10 seconds.	1
Jumper Cables	5.100.520		Bloody recharge	Grants an active item charge every 15 enemies killed.	3
Technology Zero	5.100.524		Static tears!	Connects Isaac's tears with electricity that can damage enemies.	3
Leprosy	5.100.525		You're tearing me apart!	Taking damage grants a body part orbital that blocks shots and deals contact damage, up to a maximum of three. The body parts are destroyed after blocking enough damage.	0
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
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
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.	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.	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.	4
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.	3
Trisagion	5.100.533		Smite thy enemy	Tears are replaced with piercing white blasts of light that deal less damage but can damage the same enemy multiple times.	3
Schoolbag	5.100.534		Extra active item room	Allows Isaac to hold two active items.	3
Blanket	5.100.535		You feel Safe	Grants one Soul Heart. Upon entering a boss room, grants a shield that blocks one hit, then disappears.	2
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
Marbles	5.100.538		Choking hazard	Spawns 3 random trinkets. Taking damage has a 5% chance to swallow Isaac's currently held trinket, gaining its effect permanently.	2
Mystery Egg	5.100.539		Sacrificial insemination	Spawns an egg familiar, which hatches a random friendly monster when Isaac is hurt once per room. The power of the monster improves for each consecutive room cleared without taking damage.	0
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
Marrow	5.100.541		HP up?	Grants one Bone Heart and spawns three Red Hearts.	1
Slipped Rib	5.100.542		Projectile shield	Spawns a bone familiar that circles around Isaac and reflects enemy shots.	1
Hallowed Ground	5.100.543		Portable sanctuary	Spawns a white poop familiar, which turns into a White Poop when Isaac is hurt. White poop has an aura that increases tear fire rate and can block enemy shots. The aura also increases damage by 20% and gives homing.	1
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.	1
Dad's Ring	5.100.546		Father's blessing	Creates a ring of light around Isaac that petrifies enemies in contact.	2
Divorce Papers	5.100.547		Tears up + you feel empty	Grants one Bone Heart, +0.7 tears, spawns a Mysterious Paper.	3
Jaw Bone	5.100.548		Fetch!	Spawns a familiar that flies through the room while firing, dealing a flat 7 contact damage to enemies and retrieving pickups.	1
Brittle Bones	5.100.549		Everything hurts	Replaces all Red Heart Containers with 6 empty Bone Hearts. Upon losing a Bone Heart, Isaac fires bones in 8 directions and permanently gains a tears up. Upon losing a Bone Heart, Isaac fires bones in 8 directions and permanently gains a fire rate up.	3
Broken Shovel	5.100.551		It feels cursed	One of two parts necessary to create Mom's Shovel. No effect if somehow obtained on its own.	4
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
2Spooky	5.100.554		4me	Enemies near Isaac are afflicted with fear.	1
Eye Sore	5.100.558		More eyes	Causes Isaac to occasionally fire extra tears in random directions while shooting.	1
120 Volt	5.100.559		Zap!	Repeatedly zaps enemies that are close to Isaac.	2
It Hurts	5.100.560		No it doesn't...	Releases a ring of tears and increases fire rate for the current room when Isaac takes damage.	1
Almond Milk	5.100.561		DMG down + tears up + you feel nutty	Quadruples fire rate, with ×0.3 damage multiplier. Each tear is given a random effect that alters its movement.	1
Rock Bottom	5.100.562		It's only up from there	Locks Isaac's attributes to their highest values reached.	4
Nancy Bombs	5.100.563		Random blast +5 bombs	+5 Bombs. Each bomb gains 1-4 random bomb synergies.	1
A Bar of Soap	5.100.564		Tears + shot speed up	+0.5 Tears, +0.2 Shot Speed.	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 but will also try to hurt Isaac, it will also generate Half Red Hearts on enemy kills. It can increase in power one more stage after killing even more enemies. Dealing enough damage to it returns it to normal.	1
Dream Catcher	5.100.566		Sweet dreams	During the transition between floors, Isaac's nightmare shows the contents of the upcoming floor's Treasure Room, as well as the floor's boss. Grants a Half Soul Heart when entering a new floor.	2
Paschal Candle	5.100.567		Keep the flame burning	Gives Isaac a familiar that grants +0.4 Fire Rate for each consecutive room he's cleared without taking damage. The bonus stacks up to five times.	3
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.	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.	1
Playdough Cookie	5.100.570		Tasty rainbow	Grants multicolored tears. Each color comes with a different status or tear effect.	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.	2
Eye of the Occult	5.100.572		DMG up + range up + controlled tears	+1 damage, +2 range, -0.16 shot speed. Isaac's tears can be controlled mid-flight with tear controls.	3
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
Monstrance	5.100.574		Purifying light	Isaac gains an aura that deals damage to enemies inside it.	1
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.	2
Dirty Mind	5.100.576		Filthy friends	Destroying poop spawns Dip Familiars that follow Isaac and damage enemies. Destroying different types of poop spawns different Dips with special effects.	1
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 Heart Containers.	3
Psy Fly	5.100.581		Flamboyant protector	Spawns a fly orbital familiar that seeks out incoming enemy shots and destroys them.	4
Rocket in a Jar	5.100.583		Rocket propulsion +5 bombs	+5 Bombs. If Isaac is currently firing, placing a bomb will instead shoot a fast-moving, explosive rocket in the direction he's facing.	1
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
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, grants bonus damage and luck for the rest of the floor, and removes curses.	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 Fire Rate for the current floor and gives a Half Soul Heart.	3
Mercurius	5.100.590		Speed up + you feel elusive	+0.4 speed. Doors stay open after entering a room, even in rooms with enemies.	2
Venus	5.100.591		HP up + you feel pretty	Adds one red Heart container. Heals 1 additional Red Heart. Enemies near Isaac become charmed.	2
Terra	5.100.592		Born to rock	+1 Damage. Replaces tears with rocks that deal variable damage, have increased knockback, and can destroy obstacles.	3
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.	0
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.	2
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.	2
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
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
Pluto	5.100.598		Size down	+0.7 tears. Significantly shrinks Isaac, allowing him to squeeze between objects and makes some enemy shots pass over him.	3
Voodoo Head	5.100.599		Extra curse rooms	Spawns an additional Curse Room on each floor. Curse Rooms have improved layouts.	2
Eye Drops	5.100.600		Tears up	Increases the fire rate in Isaac's left eye, causing his eyes to fire at different rates.	3
Act of Contrition	5.100.601		Tears up, you feel forgiven	+0.7 tears, grants an Eternal Heart. Allows Angel Rooms to appear even if a Devil Deal has been taken before. Reduces the Devil/Angel room chance penalty for taking Red heart damage.	3
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.	2
Battery Pack	5.100.603		Instant energy!	Recharges Isaac's currently held active item and drops 2-4 batteries.	0
Ocular Rift	5.100.606		Stare into the abyss	Adds a chance to fire tears that create rifts where they land, which suck enemies, pickups, and shots towards them and damage enemies in the area.	2
Boiled Baby	5.100.607		Messy friend	Gives Isaac a familiar that fires chaotic bursts of tears in all directions.	1
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
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.	0
Lost Soul	5.100.612		Protect him	Creates a ghostly familiar that closely follows behind Isaac. It dies in one hit, but respawns at the start of the next floor. Each time it survives until the next floor, it rewards Isaac with Soul Hearts, Eternal Hearts, or an Item.	1
Blood Bombs	5.100.614		Bloody blast + HP up	Grants a Red Heart container and restores 5 hearts. Bombs leave behind damaging red creep. Isaac can place Bombs at the cost of half a heart if he doesn't have any.	2
Lil Dumpy	5.100.615		Puffy buddy	Spawns a Dumpy familiar that pushes away nearby enemies and projectiles just before Isaac is about to be hit, then falls asleep. He can be awoken by walking to him.	3
Bird's Eye	5.100.616		It burns	Gives a chance to shoot fires alongside tears that block enemy shots and deal damage to enemies that touch them.	3
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.	2
Rotten Tomato	5.100.618		Delicious!	Adds a chance to fire tears that mark enemies with the Bait status effect. Enemies marked as bait are attacked by other enemies.	2
Birthright	5.100.619		???	Grants a character-specific effect that enhances their special abilities.	3
Red Stew	5.100.621		Full HP + temporary DMG up	Refills all heart containers. Grants an enormous damage boost that wears off over time.	2
Booster Pack	5.100.624		Collect them all!	Drops 5 random cards.	1
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
Bot Fly	5.100.629		Defense drone	Spawns an orbiting fly familiar that fires shielded tears at incoming enemy projectiles.	3
Evil Charm	5.100.632		Luck up + you feel protected	+2 luck. Provides immunity to burn, confusion, fear, and poison.	1
Dogma	5.100.633		Ascended	Grants flight, +2 damage, and increases speed to 1.1. Grants enough health to have 6 full hearts, if possible. Grants the Holy Mantle effect for the room it was obtained in. Automatically given to Isaac after defeating Dogma.	3
Purgatory	5.100.634		Help from beyond	While in a room with enemies, spawns red cracks in the ground. Walking over these cracks summons ghosts that launch themselves at enemies and explode.	1
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.	2
Akeldama	5.100.641		Spill your guts	While in an uncleared room, Isaac forms a trail of bloody tears that drags behind him, bursting and dealing damage upon contact with enemies.	1
Revelation	5.100.643		Awaken your faith	Grants flight and two Soul Hearts. In addition to tears, Isaac can charge up and fire a powerful holy laser.	4
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
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
Brimstone Bombs	5.100.646		Demon blast +5 bombs	+5 Bombs. Bombs fire four Brimstone lasers in the cardinal directions upon exploding.	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
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
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 tears.	3
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
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
Vasculitis	5.100.657		Clogged enemies	Enemies explode into tears upon death, which inherit the effects of Isaac's tears.	1
Giant Cell	5.100.658		Micro friends	Causes Isaac to spawn Minisaac familiars when he takes damage, which chase and shoot at nearby enemies.	1
Tropicamide	5.100.659		Tear size + range up	+2.5 Range, Increases tear size.	1
Card Reading	5.100.660		A link to your future	Spawns two portals at the beginning of each floor that each lead to either the Boss Room, Treasure Room, Secret Room, or the Shop.	3
Quints	5.100.661		They lurk inside	The first five enemies killed in a room will spawn stationary shooting familiars where they died.	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
Binge Eater	5.100.664		All you can eat	+1 Red Heart Container and fully heals Isaac. Item pedestals also offer a random food item. Picking up a food item temporarily grants +3.6 damage and permanently boosts 2 stats.	4
Guppy's Eye	5.100.665		An eye for secrets	Shows the contents of Chests, Fire Places, Grab Bags, and Shopkeepers before they're opened/destroyed.	2
Strawman	5.100.667		A helping hand	Spawns a controllable Keeper to fight enemies alongside Isaac, functioning similarly to Jacob and Esau. If Keeper dies, he spawns 5 blue spiders and Strawman is removed from Isaac's inventory.	1
Dad's Note	5.100.668		...	Sends Isaac on an Ascent toward Home.	0
Sausage	5.100.669		All stats up	Adds a Red Heart Container, fully heals Isaac, and gives +0.2 Speed, +0.5 Damage, +0.5 Tears, +2.5 Range, +0.2 Shot Speed, and +1.0 Luck. Increases the chance of encountering a Devil Room, Angel Room, and/or Planetarium each by 6.9%.	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
Candy Heart	5.100.671		Power of love	Gives Isaac a permanent stat boost whenever he heals with Red Heart pickups.	1
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.	0
Redemption	5.100.673		Deliver me from evil	If Isaac enters a Devil Room but leaves without taking/opening anything in it, he gets +1 Damage and a Soul Heart at the start of the next floor.	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. After it activates, it must be recharged by picking up a Soul Heart.	1
Cracked Orb	5.100.675		Shards of knowledge	Unlocks doors and reveals a random room on the map when Isaac takes damage.	1
Empty Heart	5.100.676		It multiplies	If Isaac has one red heart or fewer at the beginning of a floor, he gains an empty red heart container.	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 an uncleared room, giving him flight and spectral tears and blocking the next hit he takes.	1
C Section	5.100.678		Fetus shots	Replaces tears with fetuses that chase down enemies and deal contact damage. Each shot requires a brief charge up.	4
Lil Abaddon	5.100.679		Abyssal friend	Spawns a familiar that charges a miniature Maw Of The Void attack while Isaac shoots.	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.	2
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.	0
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.	3
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
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.	2
Soul Locket	5.100.686		Power of faith	Gives Isaac a permanent stat boost whenever he picks up a Soul Heart.	1
Inner Child	5.100.688		Let him free	Upon death, Isaac respawns in the current room with half of a Red Heart, a massive size down, and +0.2 Speed.	2
Glitched Crown	5.100.689		?????	Item pedestals cycle between 5 random items before being picked up.	4
Belly Jelly	5.100.690		Bounce away!	Causes enemies to bounce off of Isaac, dealing damage to them if they hit an enemy or obstacle. Also gives Isaac the chance to deflect enemy shots.	3
Sacred Orb	5.100.691		Destined for greatness	Prevents items of quality 0-1 from appearing, and items of quality 2 from appearing 33% of the time. Quest items are unaffected.	4
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
The Swarm	5.100.693		Infest	Spawns eight orbital flies, which turn into Blue Flies after they block a shot. Each time a room is cleared, spawns another orbital fly.	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
Bloody Gust	5.100.695		May your rage bring haste	The first 6 times Isaac takes damage on a given floor, he gains Speed and Fire Rate for the rest of the floor, up to a maximum of +1.02 and +3.00, respectively.	2
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.	3
Vanishing Twin	5.100.697		He wants revenge	Spawns a familiar that becomes a weaker clone of the floor's boss when entering the Boss Room. Defeating it drops an extra item.	1
Twisted Pair	5.100.698		Double trouble!	Spawns two familiars that float on either side of Isaac and fire tears that use his tears, range, shot speed, and tear effects, and scale with damage.	4
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.	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 the previous three Cards/Pills/Runes he used after picking up Echo Chamber.	3
Isaac's Tomb	5.100.701		Buried memories	Spawns an Old Chest at the start of each floor.	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.	1
Supper	5.100.707		HP up	Grants one full Red Heart container. Heals 1 additional Red Heart.	1
Stapler	5.100.708		DMG up	+1 Damage. Prevents Isaac from firing tears from his left eye, like Cain.	3
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
Keeper's Kin	5.100.717		Under a rock	Rocks and other Obstacles spawn blue spiders over time while in a room with enemies, and spawn two blue spiders when destroyed.	2
TMTRAINER	5.100.721		ZZaZZ ZZdZZiZZmZZhZZ ZZvZZ ZZoZZ ZZ ZZsZZlZZhZZsZZoZZaZZiZZ	Causes all future items to be "glitched", granting them completely random effects.	0
Hypercoagulation	5.100.724		Thick blooded	After Isaac takes damage from an enemy or donates health, launches Red Hearts from Isaac that despawn after 1.5 seconds.	2
IBS	5.100.725		Your stomach rumbles	Causes Isaac to throw poop, create buffing creep, or drop bombs while fighting enemies.	0
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. Affected enemies are cursed and take more damage from Brimstone-like attacks.	1
Ghost Bombs	5.100.727		Spooky blast +5 bombs	+5 Bombs. Bombs become spectral and spawn ghosts that deal contact damage to enemies and explode after 10 seconds.	1
Glass Eye	5.100.730		DMG + luck up	+0.75 damage, +1 luck.	3
Stye	5.100.731		DMG + range up	Tears fired from Isaac's right eye have +28% Damage, +6.5 Range, and -0.3 Shot Speed.	2
Mom's Ring	5.100.732		DMG up	+1 Damage. Drops a random Rune or Soul Stone upon pickup.	3

Collectible ID Gaps

All of the collectibles in the game have contiguous IDs, with the following exceptions:

ID	Description	Item Before	Item After
43	Has a placeholder name of "Pills here!" in the "items.xml" file, a leftover from the original The Binding of Isaac.	Bob's Rotten Head (42)	Teleport! (44)
59	The passive version of The Book of Belial granted when obtaining Birthright as Judas or Dark Judas.	Book of Shadows (58)	The Ladder (60)
61	Has a placeholder name of "Tarot Card" in the "items.xml" file, a leftover from the original The Binding of Isaac.	The Ladder (60)	Charm of the Vampire (62)
235	n/a	Infestation 2 (234)	E. Coli (236)
263	Clear Rune was reallocated to this ID in Repentance.	Missing Page 2 (262)	Smart Fly (264)
587	Used to be the ID for Menorah before it was cut from Repentance.	The Stairway (586)	Sol (588)
613	Used to be the ID for Salt Shaker before it was cut from Repentance.	Lost Soul (612)	Blood Bombs (614)
620	Used to be the ID for Voodoo Pin before it was cut from Repentance.	Birthright (619)	Red Stew (621)
630	Used to be the ID for Lucky Seven before it was cut from Repentance.	Bot Fly (629)	Meat Cleaver (631)
648	Used to be the ID for Pill Crusher before it was cut from Repentance.	4.5 Volt (647)	Fruity Plum (649)
656	A passive collectible granted when you use the Damocles active item. Since it is not a "real" item, it is included in this list of missing IDs.	Spin to Win (655)	Vasculitis (657)
662	n/a	Quints (661)	Tooth and Nail (663)
666	n/a	Guppy's Eye (665)	Strawman (667)
718	n/a	Keeper's Kin (717)	Keeper's Box (719)

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 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 170 active items, with 74 in Rebirth, 19 in Afterbirth, 30 in Afterbirth+, and 47 in Repentance. Of those, 138 items utilize a charge bar, with 61 items in Rebirth, 16 in Afterbirth, 24 in Afterbirth+, and 37 in Repentance.
• There are a total of 547 passive items, with 267 in Rebirth, 76 in Afterbirth, 81 in Afterbirth+, and 123 in Repentance.
  • 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.

The Binding of Isaac: Rebirth
Achievements Challenges Completion Marks Items Trinkets Characters Chapters Rooms Transformations Attributes Bosses Monsters Pickups Modes Curses Objects Seeds Effects Endings
Collection Item Pools Version History Modding Music