Binding of Isaac: Rebirth Wiki

Added in Afterbirth

Sack Head is a passive item added in The Binding of Isaac: Afterbirth.


  • Coins have a 10% chance to be replaced with Grab Bags. Bombs, Keys, Cards, Runes, and Lil' Batteries have a 20% chance.
    • This includes pickups spawned by most sources: room rewards, chests, slot machines, special shopkeepers, etc.
    • Golden Coins can reappear as a sack when collected.
    • Added in Repentance Coins bombed out of a Donation Machine can become sacks.
    • The exception to this are pickups spawned by Isaac himself directly, e.g. with the likes of IV Bag IV Bag or Fanny Pack Fanny Pack, and contents of other sacks.
  • Spawns a sack upon pickup.


  • The item does not replace hearts, pills and chests.
  • The item can also replace Troll Bombs and Megatroll Bombs that are not used as attacks, i.e. generated as room rewards, chest contents and such.
  • The pickup replacement is applied retroactively when the item is collected: any appropriate pickup already existing on the current level may be replaced by a sack.
  • Removed in Afterbirth † Sacks on each floor tend to have the same contents, which can be taken advantage of if cards are involved.
  • Added in Repentance Picking up a Golden Penny may spawn a sack instead of another Golden Penny.
  • Added in RepentanceCracked Key Cracked Key in the Ascent can be replaced by a sack, thus it is not recommended to take the item if you're going to unlock a tainted character.


  • Added in Afterbirth †Equality! Equality!: Sacks may drop new sacks while Equality! is active, potentially resulting in massive amounts of resources from a single sack.
  • Head of the Keeper Head of the Keeper: Coins spawned from hitting enemies have a chance to become sacks.
  • Added in Repentance Tainted Keeper Tainted Keeper: The coins dropped from killing enemies have a chance to be sacks instead. The sacks do not flash and disappear.

In-game Footage[]


  • The appearance given by the item is most likely based on one of the trailers for Rebirth [1], where several naked people are wearing sacks with crying eyes, strikingly similar to Sack Head.