- 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 / Dogma / Holy Card / Holy Mantle / The Lost / Soul of the Lost / White Fire Places / Wooden Cross: Losing the shield does not destroy Perfection.
- Dull Razor: Does not destroy Perfection.
- Glowing Hour Glass: Makes it much easier to hold on to Perfection since, as long as it can be used in the room where you take damage before you leave, Isaac can reset to the previous room with the trinket intact.
- 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.
- 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).
- Sharp Plug: Does not destroy Perfection.
- Blood Oath: The forced damage will not destroy the trinket, or prevent its acquisition.