Sacrificial Altar

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Sacrificial   Altar
Item icon
Item altar
"He demands a sacrifice"
Table dividing line 1.png
Item ID
5.100.536
Character Appearance
Character appearance
Table dividing line 2.png
Recharge Time
One time use One time use
Table dividing line 3.png
Collection Grid
Removed in Repentance(page 5, column 11, row 3)
Added in Repentance(page 5, column 12, row 3)
Unlock Method
Sacrificial Altar Take 50 Devil deals
Added in Afterbirth †


Sacrificial Altar is an unlockable activated item added in The Binding of Isaac: Afterbirth †.

Effects[edit | edit source]

  • Upon use, sacrifices up to 2 familiars and spawns an item from the Devil Room pool for each familiar sacrificed.
    • The order in which the familiars were obtained does not matter; it picks 2 at random to sacrifice.
    • If Isaac has no familiars, no Blue Flies and no Blue Spiders, the item will do nothing and will not be consumed.
    • If the Devil Room pool has no items left, one or two copies of 15►Pentagram Pentagram are spawned.
    • When playing Greed mode the normal Devil Room pool is still used, instead of the Greed mode pool.
  • In addition to the familiars, any Blue Flies or Blue Spiders will be converted to 1 Penny each.

Notes[edit | edit source]

  • If playing as Lilith, the 15►Incubus Incubus familiar cannot be sacrificed.
  • Charmed enemies cannot be sacrificed, even if permanently charmed.
  • Any Pretty Flies are counted as a single sacrifice.

Interactions[edit | edit source]

  • 15►7 Seals 7 Seals: cannot be sacrificed in itself, but Locusts can be sacrificed for one coin each, much like Blue Flies.
  • 15►Best Bud Best Bud / 15►Dead Bird Dead Bird / Eve's Bird Foot Eve's Bird Foot: These familiars can be sacrificed only when they're active.
  • 15►Cube of Meat Cube of Meat / 15►Ball of Bandages Ball of Bandages: The altar consumes the whole familiar, up to 4 cubes or balls at a time. If more than 4 are available, they count as other familiar(s) that may be separately chosen for sacrifice.
  • 15►Box of Friends Box of Friends / 15►Monster Manual Monster Manual / Umbilical Cord Umbilical Cord: The familiars generated by these items can be sacrificed and turned into items.
  • 15►Brown Nugget Brown Nugget: Spawned fly turrets count as familiars for sacrificing, although dropping the Brown Nugget will despawn the last fly turret, older ones will remain and can be sacrificed.
  • 15►Car Battery Car Battery: No effect; only spawns one item per familiar sacrificed, and can only sacrifice up to 2 familiars.
  • 15►Chaos Chaos: The Altar ignores the effects of Chaos, always spawning items from the Devil Room pool instead of a random pool.
  • 15►Guardian Angel Guardian Angel / 15►Seraphim Seraphim / 15►Sworn Protector Sworn Protector: 2 Black Hearts will also drop.
  • Removed in Repentance15►Isaac's Heart Isaac's Heart: Can remove the Isaac's Heart familiar while the item remains, making Isaac invulnerable.
  • 15►Lil Delirium Lil Delirium: Lil Delirium may be sacrificed, but the item is not removed. The familiar will return once another familiar is gained or lost, or the run is quit and resumed.
  • 15►More Options More Options / 15►There's Options There's Options: Sacrificial Altar ignores the effect of these items.
  • 15►The Pinking Shears The Pinking Shears: Body familiars that are spawned by this item can be sacrificed by switching between the Pinking Shears and Sacrificial Altar. However, the body familiars reappear when picking one of the spawned items up.
  • 15►Void Void: When absorbed by Void, the one time use no longer applies unlike other one time use active items. Familiars can be sacrificed with every activation of Void.
    • Added in RepentanceHas only one use, and then is removed from Void's effects
  • 15►Zodiac Zodiac: A Gemini familiar granted by Zodiac can be sacrificed without losing the item.
  • Added in RepentanceConjoined: If after sacrificing you don't have enough familiars for the Conjoined transformation, the transformation will be lost.
  • Added in Repentance15►The Intruder The Intruder: This item will be sacrificed, even though it doesn't act like a traditional familiar.
  • Added in Repentance15►Quints Quints: The item will be lost, and each spawned familiar counts as one sacrifice.
  • Added in Repentance15►Giant Cell Giant Cell: Converts all micro-Isaacs into 1 Penny each upon use.
  • Plum Flute: using Plum Flute then using Sacrificial Altar will remove the Baby plum spawned and give you an item for it. The Plum Flute is not removed upon doing this.

The following familiars, followers, and orbitals cannot be sacrificed:

In-game Footage[edit | edit source]

Trivia[edit | edit source]

  • Sacrificial Altar was added in Booster Pack #5, after the initial release of the DLC.
  • Sacrificial Altar is based on this Steam Workshop item by Niro and PJJLegend, originally known as Satanic Ritual.

Gallery[edit | edit source]

Bugs[edit | edit source]

Bug Bug! If used to sacrifice 15►Succubus Succubus while Isaac is in its dark aura, the damage multiplier will remain active until the remainder of the floor.


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