Sacrifice Room

Sacrifice Rooms are special rooms that contain a set of spikes in their center. Isaac can damage himself on the spikes for a chance to spawn a brown chest or a golden chest. The chance is determined by the seed, meaning Isaac must damage himself on the spikes a set number of times for a chest.

Sacrifice Rooms can be replaced with a Dice Room if Isaac is carrying two keys or more.

Sacrifice Rooms were reworked, with a wide variety of possible rewards.

Rewards

The payouts only depend on the number of sacrifices made. The number of sacrifices is reset to 0 when the player goes to the next floor.

№ of sacrifices on Current Floor	Chance	Reward
1^st/2^nd	50%	Nothing
	50%	1 Penny
	100%	1 Bomb (Only if the first floor boss has been defeated in less than one minute and the player has no bombs, to help obtain Broken Shovel)
3^rd	33%	Nothing
3^rd	67%	"You feel blessed!" (increased chance to receive an Angel Room over a Devil Room for the current floor) Does not increase the chance of a Devil/Angel room after defeating a boss, only the chance of getting an Angel Room over a Devil Room. Can cause an Angel Room to spawn even if you already took a deal with the devil. Less of a modifier than the "You feel blessed!" effect below.
4^th	50%	Nothing
4^th	50%	1 random chest (The type of chest is governed by the same mechanic as room drops. Thus, brown chests are more likely to spawn than any other kind of chest.)
5^th	33%	3 Pennies (These coins do not have a chance to spawn as a nickel or a dime.)
5^th	67%	You feel blessed!" (Same conditions as 3^rd sacrifice but a stronger modifier.)
6^th	33%	Teleport to the Devil/Angel Room. (If the floor's Devil/Angel Room has not been entered yet, an Angel Room is guaranteed to spawn — even if you already took a Devil Deal.)
6^th	67%	1 random chest (The type of chest is governed by the same mechanic as room drops. Thus, brown chests are more likely to spawn than any other kind of chest.)
7^th	33%	1 random Angel Room pedestal item.
7^th	67%	1 Soul Heart
8^th	100%	6 Troll Bombs
9^th	100%	Uriel battle
10^th	50%	7 Soul Hearts
10^th	50%	30 Pennies
11^th	100%	Gabriel battle
12^th and onwards	50%	Nothing
12^th and onwards	50%	Teleport directly to the Dark Room

Layouts

(Rare)

Notes

The sacrifice rewards are determined ahead of time, not when the player steps on the spikes.
- Received items/trinkets can be changed, however. If the player checks the items and resets (such as with the Glowing Hour Glass), they can find that item on the same level, then redo the sacrifice to force an item reroll.
- Resetting will reset your number of sacrifices to what it was prior to your reset unless stated otherwise.
Spikes in a sacrifice room cannot be flown over, so Isaac can use them even with Flight.
Invincibility and shields will not trigger a sacrifice (including Holy Mantle).
The Callus prevents the sacrifice room from functioning.
Sacrifice Rooms do not appear in the The Chest or Dark Room.

Notes on Rebirth Sacrifice Rooms (non-revamped)

Only one chest can be received per Sacrifice Room.
Taking damage down to half a red heart will always drop a chest. (Because ??? has no red health, dropping down to half a heart does not guarantee a drop.)
Dying on the spikes guarantees a chest, which can be useful if Isaac is low on health and has more lives from something like the Dead Cat.
Dying in a sacrifice room with the Missing Poster will reveal puzzle pieces used to unlock the The Lost.

Notes on Afterbirth Sacrifice Rooms (revamped)

If a player receives both of the "You feel blessed!" effects, they will stack for a 65% Angel Room Generation Chance.
The amount of health the player has left after taking a sacrifice does not affect the payout probabilities.
Losing red hearts due to the spikes will reduce the chance for a Devil Room to appear.
The player's Luck stat does not affect the payout probabilities.
If Uriel or Gabriel spawn, they can be despawned by exiting and reentering the room. However, they will not drop the Key Pieces unless defeated.
- Angels drop nothing if you already have their corresponding key piece.
Angels can normally fly over spikes, but they take damage from sacrifice room spikes.
Dying in a sacrifice room while holding Missing Poster will unlock The Lost (except during a Challenge or Victory Lap).
The Wafer, Cancer, and Percs reduce the spikes' damage to half a heart, letting the player make more sacrifices.
If using the BASE MENT seed, the Dark Room teleport can escape the infinite Basement levels.
Even if The Negative isn't unlocked, the player can still teleport to the Dark Room.
Dying and respawning does not affect the number of sacrifices made, so Dead Cat can be used on low health in an attempt to acquire soul hearts.

Unlockable Achievements

The Lost - It's complicated
Die in a Sacrifice Room while holding Missing Poster.

Trivia

It is possible to use a Sacrifice Room to access the Dark Room while in Endless Mode. This can be used to start a Victory Lap while the BASE MENT seed is active.