Binding of Isaac: Rebirth Wiki

This article is about the item. For the monster, see Leech (Enemy).

Leech is a passive item.

Effect[ | ]

  • Spawns a crawling Leech familiar that follows Isaac. If an enemy comes near, the Leech will attack and chase it, doing 1.5 damage per tick or about 3.2 damage per second. If an enemy is killed by the Leech, Isaac will be healed by a Half Red HeartHalf Red Heart.

Notes[ | ]

  • The Leech's healing effect does not affect characters that do not have Heart containers.
  • Enemies that turn into flesh piles and regenerate when killed such as GlobinGlobins and some dark red champions regenerate quicker than the Leech can kill them. Isaac will gain half a heart each time the enemies collapse, granting an easy way to regenerate all Red Hearts. This can also open up many powerful synergies with any item that provides a benefit or resource when Isaac takes damage.
  • (in Repentance) Like with Collectible Ghost Baby iconGhost Baby having a chance to drop from skulls, Leech can rarely drop from the buckets in DownpourDownpour.

Synergies[ | ]

  • ArcadeArcades: The player can let the Leech eat FlyFlies from the Shell GameShell Game and use the resulting health to gamble on the Blood Donation MachineBlood Donation Machine.
  • Collectible BFFS! iconBFFS!: Leech grows bigger and does double damage. Still only heals for a Half Red Heart.
  • (except in Repentance)Collectible E. Coli iconE. Coli: Enemies can be turned into PoopPoop at the cost of a Half Red Heart, then consumed by the leech to regain health. Utilization of temporary immunity when hit can allow multiple enemies to be turned into poop, resulting in a net gain of health. However, when combined with Gnawed Leaf (see below), the player can simply stand still and let Leech do the dirty work.
  • (except in Repentance)Collectible Flush! iconFlush!: The leech still can attack the enemies turned into poop and gain health.
  • Collectible Gnawed Leaf iconGnawed Leaf: The player can stand still and allow the Leech to clear a room, granting simple clears and easy health.
  • (in Repentance) Character Tainted Bethany iconTainted Bethany: The leech can grant blood charges by killing enemies.
  • (in Repentance) Character Tainted Magdalene iconTainted Magdalene: Leech restores a full Red HeartRed Heart.

Interactions[ | ]

  • (in Repentance)Collectible E. Coli iconE. Coli/Collectible Flush! iconFlush!: Enemies that are turned into poop are now treated as regular poop and can't be damaged by Leech.
  • Collectible Maggy's Bow iconMaggy's Bow: No effect on healing.

In-game Footage[ | ]

Trivia[ | ]

  • This familiar is notorious for having bad tracking AI.

Bugs[ | ]

Bug Bug! Tends to get confused when attacking Maggot like enemies and just moves around in the attacking animation without attacking anything until the Maggot is killed by The Player.
Bug Bug! The Leech will continuously heal the player while it's attacking Mama Gurdy.