Binding of Isaac: Rebirth Wiki

Added in Repentance

Tainted Azazel is a character added in The Binding of Isaac: Repentance. He is the alternate version of Azazel Azazel. His horns are broken with blood leaking from the left stump, and his wings were cut or ripped off. Tainted Azazel is unlocked by reaching Home Home and using the Red Key Red Key, Cracked Key Cracked Key, or Soul of Cain Soul of Cain to access a special room in one of the walls while playing as Azazel.

Tainted Azazel starts with 3 Black Heart Black Hearts and has his short Brimstone Brimstone replaced with a room-long version that is very thin, high-pitched in sound, deals only x0.5 damage per tick and has a shorter duration.

At the start of charging the Brimstone Brimstone attack Azazel will fire Hemoptysis Hemoptysis, causing a short-range, high-knockback "sneeze" attack that will curse enemies hit with small Brimstone icon that hovers above its head and deal x1.5 damage. Hitting enemies with the Hemoptysis sneeze halves Brimstone's remaining charge time. Enemies will also take damage when knocked into walls or obstacles, and deal damage when colliding with other enemies. Furthermore, enemies cursed by Hemoptysis will take full damage from his Brimstone beam for approximately 5 seconds; if killed during this time with Brimstone, they will explode, dealing damage to nearby enemies and spreading the curse to them. The Brimstone curse also applies to any enemies spawned by an enemy already affected by the curse. For example, the enemies and bosses spawned by Mom's Heart Mom's Heart will also have the curse if Mom's Heart had the curse at the time.

Unlike Azazel, Tainted Azazel doesn't start with Flight. (Because of the clipped wings)


Using the sneeze in tandem with brimstone is vital to use Tainted Azazel properly. Doing so will at least make him attack twice as fast and at best cause massive damage to enemies, making the run's speed highly variable on how well the player administrate the attack.

The sneeze can be used both defensively to push enemies away and shred them with the curse from affar and rejecting projectiles, but also pushing enemies to a wall or spikes will make them suffer high damage; the player should consider if it's better for the enemy to die right away or be pushed into enemies to pass the curse on.

This translates into a highly offensive play style, chaining attacks started upclose to enemies to charge the laser to soften enemies far away while walking closer to sneeze on them and repeat. This cycle is more evident with bosses, specially stationary ones like Gurdy and Hush.

Failing to connect the sneeze often means having to either charge a significantly slower and weaker brimstone shot or be unable to start the charge waiting for the sneeze to cooldown, although a short time, can leave Tainted Azazel without self defense options without aid from bombs or familiars and missing attacking opportunities, specially with highly mobile enemies like The Pile and Delirium.

Unlockable Items[]


  • Brimstone Brimstone will give Tainted Azazel a regular beam.
    • It is also worth mentioning that, due to Tainted Azazel's smaller-width Brimstone being functionally identical to 'standard' Brimstone, other synergies such as The Ludovico Technique The Ludovico Technique and A Lump of Coal A Lump of Coal work the same as they do on Brimstone.
  • Picking up items like Haemolacria Haemolacria or Mom's Knife Mom's Knife will change Brimstone to normal tears.
  • Tech X Tech X overrides Hemoptysis, and will fire thin Brimstone rings without the 0.5x damage multiplier.
  • Spirit Sword Spirit Sword overrides Hemoptysis and Brimstone but sword swings will deal increased damage.
  • The laser ring created by The Ludovico Technique The Ludovico Technique deals full damage without needing to first use Hemoptysis.
  • In Co-Op, when Tainted Azazel dies, his ghost will maintain his Brimstone and Hemoptysis abilities. The first is weakened by the damage debuff applied to ghostly players, and the second is weakened as it has a very small size when dead.
  • Ipecac Ipecac sneezes are harmless to Tainted Azazel, but sneezes from Incubus Incubus or Twisted Pair Twisted Pair with Ipecac are capable of damaging Tainted Azazel.
  • Picking up Lachryphagy Lachryphagy as Tainted Azazel turns his brimstone into a short range attack that leaves Lachryphagy tears.
  • Dr. Fetus Dr. Fetus is not recommended, as it overrides Hemoptysis and Brimstone, but uses the range value from Hemoptysis. This results in the bombs travelling a very short distance, often less than one tile and exploding on top of Tainted Azazel.
  • Eye of the Occult Eye of the Occult will act just like Brimstone, but Hemoptysis will be triggered automatically, needing it to deactivate the crosshair with ctrl in order to time it properly.
  • Picking up Pop! Pop! as Tainted Azazel turns his brimstone into a short range attack that leaves Pop! tears. (Not recommended, you will deal too small damage)

Birthright Birthright effect[]

Doubles the size of Tainted Azazel's Hemoptysis Hemoptysis attack, but doesn't increase damage.

Good items[]

  • Tears up are always welcomed to reduce the punishment for missing Hemoptysis shots.
  • Notched Axe Notched Axe: Can be used to delete projectiles and emergency knockback if Hemoptysis fails to connect. Also will make destroying poops faster without a high tears stat.
  • Brimstone Brimstone and related items like Athame Athame, Lil Brimstone Lil Brimstone, Lil Abaddon Lil Abaddon, Maw of the Void Maw of the Void, (more listed in the Hemoptysis page) benefit from the sneeze's curse

Situational Items[]

  • close range damaging items like Dead Tooth Dead Tooth, Jupiter Jupiter and Spear of Destiny Spear of Destiny damage close enemies further in Hemoptysis range and be a good option during cooldown, but can weaken them too much or kill them if the plan is to spread Hemoptysis curse further, needing more planning ahead for medium health enemies. Still strong option against bosses.

Bad items[]

  • 2Spooky 2Spooky: the fear effect can drive enemies away, making them stay less in sneeze range


  • The achievement for unlocking Tainted Azazel is "The Benighted", a possible title for the character.
    • "Benighted" means "overtaken by darkness" or "in a state of ignorance", which may be linked to how Azazel is Isaac's inner demon.
      • This is further referenced through his card, XV - The Devil? XV - The Devil?, meaning weakness and blindness; Azazel is Isaac overtaken by his inner evil, having lost his "righteous path", shown as Azazel being beaten up like Tainted Isaac Tainted Isaac.
      • This weakness is also manifested in his core mechanics and way of play, needing to rely on the curse of his sneeze and projectile reflection to weaken enemies to compensate for his own lack of firepower.



Bug Bug! When champion bosses are affected by the Hemoptysis effect, they just turn into their normal variation color.