Pointy Rib is an unlockable passive item added in Booster Pack #5.
- Spawns a bone familiar that can be aimed with the fire buttons in all directions and does contact damage.
- The familiar will continuously hover back and forth in the direction that it is pointing in.
- The damage is equal to Isaac's tear damage and is dealt 6 times per second.
- Being hurt boosts the damage slightly for a short moment.
- The familiar will damage poop and fire.
- The item is possibly a reference to the Genesis story where God created Eve by removing a rib from Adam.
Concept art for Pointy Rib (labeled as "Sharp Rib") on the right side, along with other Booster Pack items and trinkets, by Edmund McMillen.