Binding of Isaac: Rebirth Wiki
Binding of Isaac: Rebirth Wiki
Pica   Run
Character Isaac appearance.png
Full red heartFull red heartFull red heart
Table dividing line 1.png
Challenge Number
Available Rooms
Item Pool Treasure Room.png: yes          Item Pool Shop.png: yes
Boss Isaac portrait.png
Ice Cube Ice Cube
Unlock Method

Pica Run Defeat Mom's Heart 11 times and Unlock Marbles

Added in Repentance

Pica Run is challenge #41. The goal is to defeat Isaac. This challenge is unlocked by defeating Mom's Heart 11 times and unlocking 15►Marbles Marbles.


The challenge is played as Isaac, who starts with 15►Mom's Box Mom's Box, 15►Marbles Marbles, and 15►Mom's Purse Mom's Purse, resulting in 4 random trinkets spawned on the floor in the starting room. All item pedestals, including those ones from Devil Rooms, Shops, Libraries, etc., are replaced with trinket drops. It is, however, still possible to see a few item pedestals in this challenge.

Unlike its usual function, Marbles now causes Isaac to swallow his held trinkets every time he takes damage, rather than having a low chance of occurring. This allows building up a large collection of trinkets, quite easily making up for the lack of regular items. However, this has its downsides - some trinkets on their own or in combination with others can have undesirable or even disastrous results, such as wild teleportation or spontaneous explosions. If there is any uncertainty, looking up the trinket before committing to it by having it swallowed is recommended.

If you have a way to heal your red hearts, Devil Beggars and Blood Donation Machines can be extremely useful to swallow more trinkets while keeping your soul hearts and Devil room chance.

Certain Trinkets are much more valuable than others at the beginning of a run, especially since 15►Mom's Box Mom's Box, Isaac's starting active item in this run, doubles the effects of most Trinkets. Since four Trinkets are given to you to start with, it may be useful to restart until you find one (or more) of the following:

Items can still be obtained through rerolling key pieces.


  • In this challenge, every trinket is unlocked. This allows the player to see new trinkets they still have to unlock.
  • Picking up trinkets spawned in the Boss Rush room will not start the Boss Rush.
  • Items created by Wish Bone Wish Bone and Bag Lunch Bag Lunch are not replaced with trinkets.
  • Modeling Clay Modeling Clay does not display the item it is in the item section. Keep this in mind if you chose to keep it.

Unlockable achievements[]


  • Pica is a psychological disorder where a person experiences a compulsion to eat inedible objects and substances.