- Rerolls all pedestal items in a room by subtracting their internal ID number by one until a valid item is rolled. This effect occurs per item and is independent of any other items in the room.
- Items created by using Spindown Dice are not considered "normally generated" and can be encountered again in their normal pools if they were not picked up.
- The following is a list of rerolls notable because the items rerolled into are considered to be very powerful:
- Abaddon: Rerolls into Monstro's Lung.
- Belly Jelly: Rerolls into Glitched Crown.
- Blood Bag: Rerolls into Brimstone.
- Bot Fly: Rerolls into Death Certificate.
- Cambion Conception: Rerolls into Lusty Blood.
- Chemical Peel: Rerolls into Mutant Spider.
- Consolation Prize: Rerolls into Revelation.
- Cricket's Body: Rerolls into Pyromaniac.
- Daddy Longlegs: Rerolls into Polyphemus, which can be rerolled into Epic Fetus.
- Dark Prince's Crown: Rerolls into Mega Blast.
- Deep Pockets: Rerolls into Crown of Light.
- E Coli: Rerolls into Infestation 2.
- Eden's Soul: Rerolls into D Infinity.
- Host Hat: Rerolls into Holy Light.
- Isaac's Tomb: Rerolls into Echo Chamber.
- Key Piece 1: Rerolls into Death's Touch.
- Knife Piece 1: Rerolls into Mega Mush.
- Knockout Drops: Rerolls into R Key.
- Lazarus' Rags: Rerolls into Godhead.
- Magneto: Rerolls into Dr. Fetus.
- Missing Page 2: Rerolls into Proptosis, which can be rerolled into Black Candle.
- My Reflection: Rerolls into Cricket's Head, which can be rerolled into Spoon Bender
- Nancy Bombs: Rerolls into Rock Bottom.
- Ouija Board: Rerolls into Mom's Knife.
- Sanguine Bond: Rerolls into Sacred Orb.
- Sol: Rerolls into The Stairway.
- Spear of Destiny: Rerolls into Maw of the Void.
- Spiderbaby: Rerolls into Gnawed Leaf.
- Thunder Thighs: Rerolls into Holy Mantle.
- Toothpicks: Rerolls into Sacred Heart.
- Tough Love: Rerolls into Ipecac.
- Ventricle Razor: Rerolls into Tech X.
- The Virus: Rerolls into Magic Mushroom.
- Wavy Cap: Rerolls into Psy Fly, which can be rerolled into Red Key.
- The following is a list of rerolls notable because the item rerolled into is difficult to obtain under normal circumstances:
- Bomb Bag: Rerolls into A Pony, which is only obtainable otherwise by defeating Headless Horseman.
- Boom!: Rerolls into A Dollar, which is only obtainable otherwise by playing Slot Machines.
- Butter Bean: Rerolls into Head of Krampus, which is only obtainable otherwise by defeating Krampus.
- Halo of Flies: Rerolls into Skatole, which is only obtainable by playing Shell Games.
- Guppy's Paw: Rerolls into A Lump of Coal, which is only obtainable otherwise by defeating Krampus.
- Lil Abaddon: Rerolls into C Section, which is only obtainable otherwise by starting with it as Eden or through Death Certificate.
- Mom's Bra: Rerolls into Tammy's Head, which is only obtainable otherwise through Crane Games.
- Mucormycosis: Rerolls into Mom's Shovel, which is only obtainable otherwise through Broken Shovel on the process to unlock The Forgotten.
- Papa Fly: Rerolls into Head of the Keeper, which is only obtainable otherwise by bombing Shopkeepers.
- Pentagram: Rerolls into Steven, which is only obtainable otherwise as a rare drop from killing Steven.
- Purgatory: Rerolls into Dogma, which is only obtainable otherwise by defeating Dogma or using Death Certificate.
- Sacred Heart: Rerolls into White Pony, which is only obtainable otherwise by defeating Conquest.
- Spelunker Hat: Rerolls into The Small Rock, which is only obtainable otherwise from destroying a Tinted Rock or from Crane Games.
- Spirit of the Night: Rerolls into Crystal Ball, which is only obtainable otherwise by playing a Fortune Teller machine.
- Spirit Shackles: Rerolls into Redemption, which is only obtainable otherwise by playing a Confessional or Sacrifice Room after taking a devil deal.
- Glitched Crown/ Tainted Isaac: Rerolling a cycling item will reduce the ID number of the displayed item by 1 and randomize all other options. This may allow Isaac to acquire items with large ID number by jumping to a higher ID, which is restricted by regular means of the dice.
- Tainted Isaac + Butter!: The pedestal that Spindown Dice spawns on is considered a new pedestal generation, which means said pedestal not only has an alternate option that isn't Spindown Dice, but Spindown Dice also fully recharges upon use. This means that you are capable of obtaining any item in the game with a lower item ID than the one you started with.
- Tainted Lost: Allows Tainted Lost to obtain items otherwise hardcoded to never naturally spawn for him.
- Car Battery: All future rerolls turn into the item that is 2 less than the previous ID. While this can work in your favor to get chains further down the ID list, it also makes it impossible to get even numbered IDs from odd numbered items and vice versa, and takes away a lot of potential items for you to reroll into.
- The Sad Onion: Disappears upon being rerolled, as its internal ID number is 1.
- TMTRAINER / Corrupted Data: Glitch items will disappear if rerolled.
- A spindown die is a type of die used as a life counter for Magic: The Gathering. It is a D20 with the numbers laid out in a sequential pattern, to allow for the face-up number to be changed easily when a player's life goes up or down.
- The item's color scheme matches the D8 dice included in The Binding of Isaac: Four Souls card game, which is used as a spindown dice to keep track of an enemy's health.
- Spindown Dice is the only die item that cannot be copied by the D Infinity.
- Hidden items are defined with the attribute
|Tainted Isaac Unlocks|
|The Binding of Isaac: Rebirth|
|Achievements||Attributes||Bosses||Cards and Runes||Challenges||Chapters|