Binding of Isaac: Rebirth Wiki

Pestilence is a Harbinger that can appear in all environments of Chapter 2 (CavesCaves, CatacombsCatacombs, (except in Rebirth)Flooded CavesFlooded Caves).

Behavior[ | ]

Phase 1[ | ]

  • Floats around the room, leaving a large trail of damaging Green Creep.
  • Fires an Collectible Ipecac iconIpecac projectile at Isaac, which leaves Green Creep on impact.
  • Summons two ChargerChargers or SpittySpitties and can have a maximum of four summons.
    • Any Chargers or Spitties caught in Pestilence's Ipecac explosion will be killed.

Phase 2[ | ]

After taking enough damage, Pestilence's head will explode, beginning the second phase.

  • No longer moves around the room but slowly drifts around, leaving Green Creep.
  • Continues to fire Ipecac projectiles at Isaac, but at a faster rate.
  • Summons two Attack FlyAttack Flies.

Pestilence deals a whole heart of contact damage in both phases, though without flight Isaac is more likely to be damaged by the Green Creep instead.

Champion Versions Needs to be unlocked[ | ]

Grey: Leaves a trail of slowing White Creep instead of Green Creep, shoots 6 projectiles in all directions instead of an Ipecac shot and spawns TriteTrites instead of Chargers or Spitties. He cannot spawn more than 3 Trites at once. It spawns SpiderSpiders instead of Attack Flies in Phase 2.

Gallery[ | ]

Unlockable achievements[ | ]

Trivia[ | ]

  • Pestilence appeared in the original The Binding of Isaac.
  • Pestilence is not directly one of the Four Horsemen of the Apocalypse and is not present with the other Horsemen in Revelations (Revelation 6:2). The canonical Four Horsemen are Conquest (white), War (red), Famine (black), and Death (pale).
    • However, pestilence is featured as one of God's "four disastrous acts of judgment" alongside sword, famine, and wild beasts (Ezekiel 14:21), which, in some cases, can be interpreted as symbolic of the Horsemen- as the acts of judgement are often used by God for destructive purposes throughout the Bible.
      • These four acts are given to the Horseman of Death to perform (Revelation 6:8) despite the contradictory fact that famine, the attribute of a completely separate Horsemen is among the acts.
    • Despite not being a true Horseman, (in Repentance) Boss Ultra Pestilence ingameUltra Pestilence still appears instead of an ultra version of Boss Conquest ingameConquest during (in Repentance) Boss The Beast ingameThe Beast fight.
  • Pestilence means a fatal disease epidemic.
  • Pestilence is the only Harbinger that is unable to charge out of the room.
  • (except in Repentance) Pestilence’s head resembles Boss The Husk ingameThe Husk.
  • Pestilence makes a "Hey!" sound when launching explosive projectiles at Isaac. Boss Famine ingameFamine makes the same noises when spitting shots at Isaac at its second phase.