- Gives +10 luck.
- This trinket is destroyed if Isaac takes non-self damage while holding it (i.e getting hit by Monsters, walking on Spikes, getting hit by an explosion, etc.).
- This trinket can only be obtained by clearing 3 consecutive floors without taking damage. It will drop upon the final boss room of said consecutive floors being cleared.
- Blood Donation Machines, Devil Beggars, Hell Games, Confessionals, Curse Rooms, Spiked Chests, Bad Trip pills, White Fire Places and the Mausoleum doors count as self-damage and won't destroy Perfection.
- Every XL floor cleared counts as a single floor for the purposes of obtaining this trinket.
- Perfection can intentionally be dropped if Isaac must take damage for whatever reason, allowing him to keep it.
- Due to the unique method of obtaining it, Perfection can never naturally spawn as a Golden Trinket.
- 10 Luck is coincidentally the highest amount of luck Isaac can have that would help with room clear rewards paying out.
- If Isaac holds multiple copies of Perfection via Mom's Purse or Belly Button, upon taking a hit only one of them will get destroyed.
- If Isaac gulps Perfection as he's taking damage (e.g. because of Marbles), the trinket will stay in your inventory as a passive item until the next instance of taking damage.
- Blanket/ Holy Card/ Holy Mantle/ Wooden Cross/ Dogma/ The Lost/ Soul of the Lost/White Fire Places: Losing the shield does not destroy Perfection.
- Dull Razor: Does not destroy Perfection.
- Sharp Plug: Does not destroy Perfection.
- Rock Bottom: The +10 luck persists after switching trinkets as stats are locked to their highest values ever reached after picking Rock Bottom up. However, after losing Perfection, additional luck-ups will have no effect until the luck bonus lost is made up. (The stats are still being calculated behind-the-scenes, but until it surpasses the run's post-rock-bottom luck record, the record will be used instead).
- The Lost / Tainted Lost: Since these characters are likely to die instantly after taking a single hit, Perfection is almost guaranteed to drop after the third floor boss room is cleared, and is also almost guaranteed to stay with them until their deaths.
- Smelter/ Marbles/Gulp!: The effect is still lost after taking damage.
- Blood Oath: The forced damage will not destroy the trinket, or prevent its acquisition.