Scapular is a passive item.
- Once per room, when Isaac is reduced to his last half heart (either red, soul, or black), the aura around his head temporarily vanishes and he is granted one Soul Heart.
- After re-entering a room, the ability can be triggered again.
- With Bone Hearts, the effect triggers on both half-filled and empty ones.
- If the Scapular is active and Isaac is already at his last half heart, the effect won't trigger even on fatal damage.
- Scapular does not charge between waves in Greed mode, though it can still be recharged by moving between rooms.
- Does not work with The Lost or Keeper, as they cannot reach the required heart value.
- Reaching only half a heart remaining may be more difficult in Chapter 4 onwards, since all half-heart hits are upgraded to a full heart.
- Damage sources that count as "health donation" no longer activate Scapular. This includes Blood Donation Machines, Devil Beggars, Hell Games, Confessionals, IV Bag, Razor Blade, Blood Rights, Dull Razor, Sharp Plug, Shard of Glass, Blood Bombs, and Blood Oath. Sacrifice Rooms spikes still activate Scapular.
- Cursed Skull: Provided Scapular can always trigger, grants effective immortality, as the soul heart is always given before the teleport takes place.
- + The Wafer: Grants true immortality, plus one hit on the soul heart, allowing the player to get hit once before teleporting.
The Scapular allows practically free use of damage-triggered effects, as long as care is taken to keep track of the item's state and remaining health, and possibly being forced to proceed with minimal health after reaching the desired goal is acceptable. The room can be left to reactivate the item at latest when only half a red heart and half a soul heart remain; usually, this necessitates performing the actions in rooms without enemies. Examples include:
- Forcing a Sacrifice Room to pay out.
- Entering and leaving a Curse Room without net loss of health.
- Fully charging the held active item with Habit by purposefully running into a hazard.
- Continuously using Sharp Plug. As Isaac cannot take soul heart damage and red heart damage on the same hit, the single soul heart absorbs two hearts worth of damage by itself.
- Using damage-triggered items that pay out with resources or items such as Fanny Pack or Cambion Conception.
PC EASX 92JD (Treasure Room adjacent to spawn)
PC B7W3 3HQ9 (First floor Treasure Room)
PC 4G3S SVNB (Treasure Room adjacent to spawn (if The Halo has not been unlocked))
PC 4ENG XYYW (Treasure Room adjacent to spawn; includes Gimpy, Dead Cat, and The Wafer)
PC GSSV HL2M (First floor Treasure Room)
PC JW0T PBNC (First floor Treasure Room)
PS4 SCHS XTT4 (Second floor Treasure Room)
3DS S6EY 7YZT (First floor Treasure Room (west); Curse of the Labyrinth)
3DS QAEQ VRDP (Treasure Room adjacent to spawn)
Switch FPC7 G387 (First floor Treasure Room)
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