Binding of Isaac: Rebirth Wiki
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(in Afterbirth †)

Afterbirth † is an expansion to The Binding of Isaac: Afterbirth that was released on January 3, 2017 and costs $9.99.

For a list of the pre-release blog posts, see The Binding of Isaac: Afterbirth † (Pre-Release).

Nicalis, the game's publisher, also created mod tools for easier creation of community mods with the release. They occasionally released updates to Afterbirth † that incorporated certain high-quality and popular mods. These updates are known as Booster Packs.

Features[ | ]

Additions[ | ]

Mechanics[ | ]

HUD[ | ]

Found HUD
  • Found HUD is a HUD addition that appears on the left side of the screen that gives numerical values to the player's current stats (e.g., damage, luck, speed, devil room chance). It can be enabled through the options menu.
  • It is based on the Missing HUD mod for Rebirth and Afterbirth.

Victory Lap[ | ]

  • A Victory Lap allows you to start a new run with almost all of your final items after completing the Dark Room. Multiple laps can be made as long as the Dark Room is cleared each time.
    • Completion Marks and most achievements cannot be earned.
    • Isaac will take a full heart of damage on all floors after beginning a victory lap (unless he has The Wafer).
    • Some items are lost upon starting a victory lap. Items lost this way are added back into their respective item pools and can be acquired again.
    • If the initial run was on normal difficulty, all victory laps will be on hard difficulty.
    • On the third and subsequent victory laps, the character will turn into The Lost. This version of The Lost does not get a Holy Mantle or D4. However, if the run was started as The Lost (or if the Holy Mantle was found) it is possible to keep the Holy Mantle from the previous run.
    • On the third and subsequent victory laps, Shops will no longer appear.
    • On the third and subsequent victory laps, Red Chests in the Dark Room will turn into Chests and Locked Chests.
    • Killing any final boss aside from The Lamb will end the game, and the run will not be continued further.

Menus[ | ]

Options[ | ]

Charge bars
RERUN
  • RERUN is unlocked after completing the RERUN achievement.
  • After winning a run the Continue option in the main menu will be replaced by Rerun. Selecting it starts a new run using most of the previous won run's items. Isaac will take full heart damage on all floors.

Player[ | ]

Characters[ | ]

Character Apollyon App
Character Apollyon iconApollyon
The Forgotten App
Character The Forgotten iconThe Forgotten
The Forgotten Character The Soul (Character) iconThe Soul
Health Stat Icon Health Full red heartFull red heart Full bone heartFull bone heart Full soul heart
Damage Stat Icon Damage 3.5 (*1.00) 3.50 (*1.50) 3.50 (*1.00)
Tears Stat Icon Tears +0 +0, x1/2 +0
Shot Speed Stat Icon Shot Speed 1 1 1
Range Stat Icon Range 23.75 23.75 23.75
Speed Stat Icon Speed 1.0 1.00 1.30
Luck Stat Icon Luck 0 0 0
Starting Item Icon Starting Pickups None None None
Starting Item Icon Starting Item(s) Collectible Void Afterbirth+ iconVoid Bone Club Flight

Spectral tears

Transformations[ | ]

ID Name Appearance Description
10 Bookworm Bookworm

Roughly 25% of the time, Isaac shoots an extra tear, like Collectible 20 20 icon20/20.

11 Adult Adult

+1 Red Heart container.

12 Spider Baby Spider Baby

Spawns a spider familiar that applies random status effects to enemies it comes in contact with.

13 Stompy Stompy

Taking damage has a chance to spawn rock waves. (in Repentance) Isaac can break obstacles by walking over them.

Co-op[ | ]

Special Babies

These Babies have special bonuses that will aid the player in some way.

ID Appearance Name Description
55 055 baby mort Mort Baby Spawns a blue fly, and spawns a new blue fly whenever its blue fly is destroyed.
Mort Baby Defeat Mega Satan as Character Apollyon iconApollyon to unlock it. The sprite greatly resembles Collectible Rotten Baby iconRotten Baby.
56 056 baby apollyon Apollyon Baby Spawns with two Pretty Flies.
Apollyon Baby Earn all Hard mode Completion Marks as Character Apollyon iconApollyon to unlock it.
57 057 baby boner Bone Baby Wields a melee bone club instead of shooting tears, similarly to The Forgotten.
Bone Baby Earn all Hard mode Completion Marks as Character The Forgotten iconThe Forgotten to unlock it.
58 058 baby bound Bound Baby Is bound to Isaac, similarly to The Forgotten's soul. Shoots spectral tears.
Bound Baby Defeat Mega Satan as Character The Forgotten iconThe Forgotten to unlock it.

Normal Babies

These Babies are purely cosmetic and do not have any special behaviors.

ID Appearance Name Description
428 428 baby magiccat Magiccat Baby A baby that resembles the avatar of Tikara, the artist of the Isaac Tarot deck.
429 429 baby littlehorn Little Horn Baby A baby that resembles Little Horn.
430 430 baby folder Folder Baby A baby with a folder for a head.
431 431 baby driver Driver Baby A baby that is driving a car.
432 432 baby dragon Dragon Baby A baby that resembles a dragon.
433 433 baby downwell Downwell Baby A baby that resembles the player character from Downwell.
434 434 baby cylinder Cylinder Baby A baby that is shaped like a cylinder.
435 435 baby cup Cup Baby A baby with a teacup for a head.
436 436 baby cave robot Cave Robot Baby A baby that resembles Quote from Cave Story.
437 437 baby breadmeat hoodiebread Breadmeat Hoodiebread Baby A toothy baby with a slice of toast for a head that resembles Breadmeat, a member of the Isaac community.
438 438 baby bigmouth Bigmouth Baby A baby with a large, wide-open mouth.
439 439 baby afro rainbow Afro Rainbow Baby A baby with a rainbow colored afro.
440 440 baby afro Afro Baby A baby with an afro.
441 441 baby tv TV Baby A baby with a television for a head.
442 442 baby tooth Tooth Baby A baby with a tooth for a head.
443 443 baby tired Tired Baby A tired-looking baby.
444 444 baby steroids Steroids Baby A muscular baby.
445 445 baby soap monster Soap Monster Baby A baby that resembles Balrog from Cave Story.
446 446 baby rojen whitefox Rojen Whitefox Baby A baby that resembles a white fox. (might be a reference?)
447 447 baby rocket Rocket Baby A baby that looks like a firework.
448 448 baby nurf Nurf Baby A baby that resembles D.Va from Overwatch.
449 449 baby mutated fish Mutated Fish Baby A baby that resembles Fish from Nuclear Throne.
450 450 baby moth Moth Baby A baby that resembles Moth from Creepy Castle.
451 451 baby buttface Buttface Baby A baby with a butt for a face.
452 452 baby flying candle Flying Candle Baby A baby that looks like a candle.
453 453 baby graven Graven Baby A baby with long hair. (might be a reference?)
454 454 baby gizzy chargeshot Gizzy Chargeshot Baby A baby that resembles Gizzy from ChargeShot.
455 455 baby green koopa Green Koopa Baby A baby that resembles a green koopa from Mario.
456 456 baby handsome mrfrog Handsome MrFrog Baby A baby that resembles Handsome Mr. Frog from the game of the same name.
457 457 baby pumpkin guy Pumpkin Guy Baby A baby with a pumpkin for a head wearing a purple rag. Possible reference to Terraria's Pumpking.
458 458 baby red koopa Red Koopa Baby A baby that resembles a red koopa from Mario.
459 459 baby sad bunny Sad Bunny Baby A baby that looks like a crying rabbit. This is a reference to the sprites creator, Mort Mort (MnrArt) and their character Sad Bunny Face.
460 460 baby saturn Saturn Baby A baby that resembles the main character from Sgt. Saturn.
461 461 baby toast boy Toast Boy Baby A baby with a slice of bread for a head. This is a reference to the sprite's creator, Mort Mort (MnrArt) and their character Toast Boy.
462 462 baby voxdog Voxdog Baby A baby that resembles Vox the Dog.
463 463 baby 404 404 Baby A baby that has the Error trinket for a head.
464 464 baby arrowhead Arrowhead Baby A baby with an arrow through its head.
465 465 baby beanie Beanie Baby A baby wearing a green beanie.
466 466 baby blindcursed Blindcursed Baby A baby with the Curse of the Blind's question mark for a head.
467 467 baby burning Burning Baby A baby that's been burnt to a crisp.
468 468 baby cursor Cursor Baby A baby that looks like a mouse cursor.
469 469 baby flybaby Flybaby A baby that looks like a fly.
470 470 baby headphone Headphone Baby A baby wearing headphones.
471 471 baby knife Knife Baby A baby with a knife for a head.
472 472 baby mufflerscarf Mufflerscarf Baby A baby wearing a scarf.
473 473 baby robbermask Robbermask Baby A baby wearing a stereotypical robber's ski mask.
474 474 baby scoreboard Scoreboard Baby A baby with a digital number display, like those at a sporting event or on an alarm clock, for a face.
475 475 baby somanyeyes So Many Eyes Baby A baby with eyes all over its body.
476 476 baby text Text Baby A baby made out of text characters. (ASCII art)
477 477 baby wing Wing Baby A baby with wings.
480 480 baby imp Imp Baby A baby that resembles the modded character Fiend from Devil's Harvest MOD.
481 481 baby 32bit 32bit Baby A baby that resembles Isaac in a 32 bit style.
482 482 baby adventure Adventure Baby A baby that resembles Finn the Human from Adventure Time.
483 483 baby bubbles Bubbles Baby A baby made entirely of tar.
484 484 baby bulb Bulb Baby A baby that's very bright for his age.
485 485 baby coolorange Cool Orange Baby A baby that resembles a very cool orange with sunglasses.
486 486 baby crazyghost Crazy Ghost Baby A baby that resembles Crazy Diamond from JoJo's Bizarre Adventure. (Also possibly a reference to the modded character.)
487 487 baby cursedpillow Cursed Pillow Baby A baby that's unfortunately pillow shaded.
488 488 baby egg Egg Baby A baby that resembles the modded item Greg the Egg.
489 489 baby factory Factory Baby A baby that resembles a strange cyborg.
490 490 baby falling Falling Baby A baby that resembles William Foster from Falling Down.
491 491 baby funny Funny Baby A baby that resembles Sans from Undertale.
492 492 baby gamer Gamer Baby A baby that resembles an epic gamer. Inspired by a prominent member of the Binding of Isaac community.
493 493 baby glitterypeach Glittery Peach Baby A baby resembling an oddly British Baby Plum.
494 494 baby pompadour Pompadour Baby A baby that resembles Josuke from JoJo's Bizarre Adventure. (Also possibly a reference to the modded character.)
495 495 baby headkick Head Kick Baby A baby that resembles the Facepunch Logo.
496 496 baby horn Horn Baby A baby that resembles the modded character Chronos.
497 497 baby ichor Ichor Baby A baby that resembles Ichor beasts from the game Heckland.
498 498 baby ill Ill Baby A baby that resembles the modded boss Mahalath.
499 499 baby lazy Lazy Baby A baby that resembles Garfield.
500 500 baby mern Mern Baby Mern.
501 501 baby necro Necro Baby A baby that resembles the Xenomorph from the Alien franchise.
502 502 baby peeping Peeping Baby A baby that resembles the modded boss The Peeping.
503 503 baby penance Penance Baby A baby that resembles the modded character Sarah from Revelations.
504 504 baby psychic Psychic Baby A baby that resembles the modded character Mei.
505 505 baby puppet Puppet Baby A baby that resembles the costume for the modded item Pinhead from Happy Items Pack.
506 506 baby reaper Reaper Baby A baby that resembles the modded character Samael.
507 507 baby roadkill Road Kill Baby A baby that got ran over.
508 508 baby sausagelover Sausage Lover Baby A baby that resembles _Kilburn, the lead developer for Antibirth.
509 509 baby scribble Scribble Baby A baby that resembles the modded character The Drawn.
510 510 baby starplant Star Plant Baby A baby that resembles the main character from Germination.
511 511 baby twitchy Twitchy Baby A baby that resembles Twitch from Heckland.
512 512 baby witch Witch Baby A baby that resembles the modded character Endor from Alphabirth.
513 513 baby workshop Workshop Baby A baby that references a common trope of workshop thumbnails when firing tears.
514 514 baby hooligan Hooligan Baby A baby that resembles Čeda from LeatherIceCream's "Poor 4" animations.
515 515 baby halfspider Half Spider Baby A baby that resembles Miroslav from LeatherIceCream's "Poor 4" animations.
516 516 baby silly Silly Baby A baby that resembles Djole from LeatherIceCream's "Poor 4" animations.
517 517 baby mastercook Master Cook Baby A baby that resembles Andre from LeatherIceCream's "Poor 4" animations.
518 518 baby greenpepper Green Pepper Baby A baby that resembles one of _Kilburn's characters.
519 519 baby baggycap Baggy Cap Baby A baby that resembles one of _Kilburn's characters.
520 520 baby stylish Stylish Baby A baby resembling the character Ren from the currently unreleased game Shenanigans: World of Illusions.



Items[ | ]

109 new items were added in the expansion: 29 activated items and 80 passive items.

Activated Collectibles[ | ]

Name ID Icon Quote Description Quality
Black Hole 5.100.512
Black Hole
4 rooms
Nothing can escape Throws a black hole on the ground which sucks in and damages enemies and destroys nearby obstacles. 1
Book of the Dead 5.100.545
Book of the Dead
6 rooms
Rise from the grave (except in Repentance) Creates a friendly BonyBony, Black BonyBlack Bony, or an orbital bone for each enemy killed in the current room.
(in Repentance)Creates a friendly BonyBony, Black BonyBlack Bony, Bone FlyBone Fly, RevenantRevenant, or an orbital bone for each enemy killed in the current room.
3
Broken Shovel 5.100.550
Broken Shovel
4 rooms
It feels cursed While held, causes Mom to continuously attempt to stomp on Isaac. Activating makes her stop for the current room or wave. One of two parts necessary to create Collectible Mom's Shovel iconMom's Shovel. 4
Brown Nugget 5.100.504
Brown Nugget
8 seconds
Friendly fly Spawns a stationary fly turret that lasts for the current room and fires tears at nearby enemies. 0
Clicker 5.100.482
Clicker
6 rooms
Change Transforms Isaac into a random character and removes the last item collected. 0
Compost 5.100.480
Compost
2 rooms
Gain more friends! Doubles Isaac's Blue Flies and Blue Spiders, or spawns one if Isaac has none. Converts pickups in the current room into Blue Flies or Blue Spiders. 1
Coupon 5.100.521
Coupon
6 rooms
Allow 6 weeks for delivery While held, guarantees one item in every ShopShop will be on sale. On use, makes a random item in the current room free. 2
Crooked Penny 5.100.485
Crooked Penny
4 rooms
50/50 Spawns a penny and has a 50% chance to double all items and pickups in the room. If the effect fails, the items and pickups disappear. 2
D infinity 5.100.489
D infinity
Variable
Reroll forever (except in Repentance) Grants a random die item that changes each use.
(in Repentance) Acts as any die item, and can by cycled by pressing the drop key.
4
D1 5.100.476
D1
4 rooms
What will it be? Duplicates a random pickup in the room. (in Repentance) The new pickup may be different than the original (i.e. a different card, etc). 2
Dataminer 5.100.481
Dataminer
4 rooms
109 Displaces enemy sprites for the current room, randomly increases one stat and decreases another. 0
Delirious 5.100.510
Delirious
12 rooms
Unleash the power! Spawns Boss Delirium ingameDelirium as a random friendly boss that fights for Isaac. 1
Dull Razor 5.100.486
Dull Razor
2 rooms
I feel numb... Hurts Isaac without depleting health, activating any items that trigger upon taking damage. 1
Eden's Soul 5.100.490
Eden's Soul
12 rooms
... Spawns two item pedestals then is consumed. Begins with no charges. 3
Mama Mega! 5.100.483
Mama Mega!
One time use
BOOOOOOOOOM! Damages all enemies and destroys all obstacles. The effect occurs every time a new room is entered for the rest of the floor. Opens the doors to the floor's Secret RoomSecret Rooms and Super Secret RoomSuper Secret Rooms. 3
Metronome 5.100.488
Metronome
2 rooms
Waggles a finger Grants a random item effect for the current room. 1
Mom's Shovel 5.100.552
Mom's Shovel
4 rooms
Lost but not forgotten Creates a trapdoor that leads to the next floor upon activation. Unlocks Character The Forgotten iconThe Forgotten when used on a mound of dirt that appears in Dark RoomDark Room. 4
Moving Box 5.100.523
Moving Box
4 rooms
Pack and unpack If the box is empty, picks up items and pickups in a room and stores them. If the box is not empty, places all stored items and pickups in the current room. (in Repentance) Can carry up to 10 items or pickups at once. 1
Mr. ME! 5.100.527
Mr
4 rooms
Caaan do! Summons a controllable ghost that can perform various tasks depending on what it targets. 3
Mystery Gift 5.100.515
Mystery Gift
One time use
Wrapped up nice for you! Upon use, spawns a random item from the current room's item pool, with a chance to spawn Collectible A Lump of Coal iconA Lump of Coal or Collectible The Poop iconThe Poop instead. 3
Pause 5.100.478
Pause
2 rooms
Stop! Freezes all enemies until a fire button is pressed. 1
Plan C 5.100.475
Plan C
One time use
My last resort Kills all enemies in the room, then kills Isaac three seconds later. 0
Potato Peeler 5.100.487
Potato Peeler
Unlimited
A pound of flesh Removes a Heart Container, increases damage and range, and grants a Collectible Cube of Meat iconCube of Meat. 2
Sacrificial Altar 5.100.536
Sacrificial Altar
One time use
He demands a sacrifice Sacrifices up to 2 familiars and spawns an item for each familiar sacrificed. Converts all friendly spiders and flies into coins. 2
Sharp Straw 5.100.507
Sharp Straw
10 seconds
More blood! (except in Repentance) Damages all enemies in the room. Has a chance to drop a Half Red HeartHalf Red Heart or Half Soul HeartHalf Soul Heart if an enemy is hit.
(in Repentance) Damages all enemies in the room. Has a chance to drop a Half Red HeartHalf Red Heart if an enemy is hit.
2
Smelter 5.100.479
Smelter
6 rooms
Trinket melter! Consumes Isaac's currently held trinket and applies its effect permanently. 2
Sprinkler 5.100.516
Sprinkler
4 rooms
Sprinkles. Upon use, creates a stationary sprinkler that rotates and fires tears in 8 directions. The tears copy Isaac's stats and most tear effects. 2
Telekinesis 5.100.522
Telekinesis
7 seconds
Power of the mind Upon use, for the next three seconds, any enemy shots that come near Isaac are held in place and then later reflected. 1
Void 5.100.477
Void
6 rooms
Consume Consumes all pedestal items in the room. Active items will have their effects added to Void, and passive items will grant random stat upgrades. 4
Wait What? 5.100.484
Wait What?
10 seconds
I can't believe it's not butter bean! Isaac farts, sending out rock waves. 1

Passive Collectibles[ | ]

Name ID Icon Quote Description Quality
7 Seals 5.100.526 7 Seals Lil harbingers! Spawns a random Harbinger familiar that changes every 10 seconds. Harbingers have different behaviors and spawn themed Locusts. 2
Acid Baby 5.100.491 Acid Baby Pills pills pills! Spawns a familiar that drops a random pill every 3 rooms. Upon using a pill, all enemies in the room are poisoned. 2
Adrenaline 5.100.493 Adrenaline Panic = power Increases damage based on how many empty Red Heart containers Isaac has. 2
Analog Stick 5.100.465 Analog Stick 360 tears! +0.35 tears up. Allows Isaac to fire tears diagonally. 2
Angelic Prism 5.100.528 Angelic Prism Eclipsed by the moon Spawns an orbital familiar with a large orbital radius. Tears that pass through the prism split into four multi-colored tears. 3
Angry Fly 5.100.511 Angry Fly He's violent Spawns a fly familiar that orbits around a random enemy and deals 30 damage per second to enemies it comes in contact with. 1
Apple! 5.100.443 Apple! Trick or treat? +0.3 tears. Adds a chance to fire a razor blade that deals 4x Isaac's damage. 3
Backstabber 5.100.506 Backstabber Watch your back! Isaac's tears deal double damage and inflict bleeding on enemies if they're facing away from Isaac. 3
Belly Button 5.100.458 Belly Button What's in there? Drops a random trinket. Grants a second trinket slot. 2
Big Chubby 5.100.473 Big Chubby Chub chub Spawns a familiar that follows Isaac and charges across the room when Isaac fires, blocking shots and dealing 40.5 damage per second on contact. 1
Blanket 5.100.535 Blanket You feel Safe Grants one Soul HeartSoul Heart. Upon entering a boss room, grants a shield that blocks one hit, then disappears. 2
Bloodshot Eye 5.100.509 Bloodshot Eye Bloody friend Spawns an orbital familiar that deals 30 damage per second and fires a randomly angled tear every 2 seconds. 1
Bozo 5.100.513 Bozo Party time! +0.1 flat damage, grants a Soul HeartSoul Heart. Enemies can randomly become briefly charmed or feared. Taking damage has a chance to spawn a Rainbow PoopRainbow Poop. 2
Brittle Bones 5.100.549 Brittle Bones Everything hurts Replaces all Red HeartRed Heart Containers with 6 empty Bone HeartBone Hearts. (except in Repentance) Upon losing a Bone Heart, Isaac fires bones in 8 directions and permanently gains a tears up. (in Repentance) Upon losing a Bone Heart, Isaac fires bones in 8 directions and permanently gains a fire rate up. 3
Broken Modem 5.100.514 Broken Modem Lag! Enemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals. 3
Broken Shovel 5.100.551 Broken Shovel It feels cursed One of two parts necessary to create Collectible Mom's Shovel iconMom's Shovel. No effect if somehow obtained on its own. 4
Buddy in a Box 5.100.518 Buddy in a Box What could it be?! Spawns a familiar with a random tear effect. The familiar is randomized at the start of each floor. 2
Camo Undies 5.100.497 Camo Undies Camo kid Isaac becomes camouflaged at the beginning of each room. Until he shoots, all non-boss enemies will be confused. (in Repentance) Isaac gains +0.5 Speed while camouflaged, and gains Tears and Damage upon breaking it. 3
Compound Fracture 5.100.453 Compound Fracture Bone tears! Increases Range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle. 3
Cone Head 5.100.457 Cone Head Hard headed! Grants a Soul HeartSoul Heart. Gives Isaac a chance to ignore any damage taken. 2
Contagion 5.100.466 Contagion Outbreak! The first enemy killed in a room releases a gas cloud that poisons nearby enemies. Affected enemies will also release gas upon death, spreading the effect. 2
Dad's Lost Coin 5.100.455 Dad's Lost Coin I remember this... (except in Repentance)+1.5 range, +1 tear falling speed. Drops a Lucky Penny.
(in Repentance)+2.5 range. Drops a Lucky Penny.
1
Dad's Ring 5.100.546 Dad's Ring Father's blessing Creates a ring of light around Isaac that petrifies enemies in contact. 3
Dark Prince's Crown 5.100.442 Dark Prince's Crown Loss is power (except in Repentance) When at exactly one Red HeartRed Heart, +0.75 tears, +1.5 range, and +0.2 shot speed.
(in Repentance) When at exactly one Red HeartRed Heart, +2 fire rate, +1.5 range, and +0.2 shot speed.
1
Dead Tooth 5.100.446 Dead Tooth Toxic breath While firing, Isaac gains a green aura that poisons nearby enemies. 1
Death's List 5.100.530 Death's List Just hope you're not next... Grants a pickup or stat upgrade if all enemies in a room are killed in the order they are marked. 2
Depression 5.100.469 Depression :( Spawns a familiar that leaves a trail of creep that damages enemies at 6 damage per second. Has a chance to spawn damaging beams of light onto enemies that touch the cloud. 1
Divorce Papers 5.100.547 Divorce Papers Tears up + you feel empty Grants one Bone HeartBone Heart, +0.7 tears, spawns a Mysterious PaperMysterious Paper. 3
Dog Tooth 5.100.445 Dog Tooth Bark at the moon! +0.3 damage, +0.1 speed. Plays a howl or bark sound when entering a room with undiscovered Secret RoomSecret Rooms or Crawl SpaceCrawl Spaces. 2
Duality 5.100.498 Duality You feel very balanced Whenever a Devil RoomDevil Room or Angel RoomAngel Room would spawn after defeating a boss, both rooms spawn. Only one can be entered. 1
Eucharist 5.100.499 Eucharist Peace be with you An Angel RoomAngel Room door will always spawn after every boss fight, excluding the first floor and floors after WombWomb II/UteroUtero II/Scarred WombScarred Womb II. 3
Euthanasia 5.100.496 Euthanasia Needle shot Adds a chance to fire needles that instantly kill basic enemies and deal triple damage to bosses. If a needle kills an enemy, it bursts into more tears/needles. 3
Eye of Belial 5.100.462 Eye of Belial Possessed tears! Grants piercing tears. After piercing one enemy, tears start homing and deal double damage. 3
Eye of Greed 5.100.450 Eye of Greed Gold tears! Every 20 tears, Isaac loses 1 PennyPenny and shoots an additional gold tear that petrifies enemies and turns them into gold. Any enemy killed while in this state will drop coins. 2
Fast Bombs 5.100.517 Fast Bombs Rapid bomb drops +7 BombBombs. Removes the delay between bomb placements, allowing them to be placed rapidly. (in Repentance) Bombs will no longer knock each other away. 1
Finger! 5.100.467 Finger! Watch where you point that! Spawns a finger familiar that faces in the same direction as Isaac, rapidly damaging enemies it points at for 10% of Isaac's damage. 1
Flat Stone 5.100.540 Flat Stone Skipping tears Tears bounce off the floor, creating splashes. Splashes deal 25% of Isaac's tear damage to all enemies in a small area. 2
Ghost Pepper 5.100.495 Ghost Pepper Flame tears (except in Repentance)Gives a chance to shoot fires alongside tears that block enemy shots and deal damage to enemies that touch them.
(in Repentance)Gives a chance to shoot blue fires alongside tears that become smaller as they travel.
3
Glaucoma 5.100.460 Glaucoma Blind tears! Adds a chance to shoot tears that confuse enemies for an extremely long time. 1
Glyph of Balance 5.100.464 Glyph of Balance A gift from above Grants 2 Soul HeartSoul Hearts and modifies drops from Champion monsters based on certain conditions. (in Repentance) Also modifies room clear drops. 2
Greed's Gullet 5.100.501 Greed's Gullet Money = health! Grants a Red Heart container for every 25 PennyCoins Isaac has. 1
Haemolacria 5.100.531 Haemolacria I'm seeing red... Tears are now fired in an arc. Upon hitting the floor, an obstacle, or an enemy, they burst into many smaller tears in all directions. Increases tear delay. 4
Hallowed Ground 5.100.543 Hallowed Ground Portable sanctuary Spawns a white poop familiar, which turns into a White PoopWhite Poop when Isaac is hurt. White poop has an aura that increases tear fire rate and can block enemy shots. (in Repentance) The aura also increases damage by 20% and gives homing. 1
Hushy 5.100.470 Hushy Lil hush! Spawns a Boss Hush ingameHush familiar that bounces diagonally around the room and deals contact damage. While firing tears, it stops moving. 0
Jacob's Ladder 5.100.494 Jacob's Ladder Electric tears Tears fire sparks of electricity in random directions upon hitting an obstacle or enemy. 3
Jaw Bone 5.100.548 Jaw Bone Fetch! Spawns a familiar that flies through the room while firing, dealing a flat 7 contact damage to enemies and retrieving pickups. 1
Jumper Cables 5.100.520 Jumper Cables Bloody recharge Grants an active item charge every 15 enemies killed. 3
King Baby 5.100.472 King Baby Hail to the king baby Spawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, other familiars stop moving. 1
Lachryphagy 5.100.532 Lachryphagy Feed them! Isaac's tears decelerate as they travel. Upon stopping or hitting an obstacle, they burst into 8 tears in all directions. Tears can be fired into other tears to feed them, increasing their damage. 2
Large Zit 5.100.502 Large Zit Creep shots Adds a chance to fire a creep shot that deals double damage and leaves a trail of slowing white creep. 1
Lead Pencil 5.100.444 Lead Pencil He's a bleeder! After every 15 tears fired, Isaac will fire a high-damage cluster of tears. 3
Leprosy 5.100.525 Leprosy You're tearing me apart! Upon taking damage, grants a body part as an orbital, which blocks enemy shots and deals 7 damage per tick to enemies it comes in contact with. The orbitals will be destroyed if they take enough damage from enemies or enemy shots. 1
Lil Delirium 5.100.519 Lil Delirium Delirious friend Grants a familiar that transforms into another random familiar every 10 seconds. 2
Lil Monstro 5.100.471 Lil Monstro Ain't he cute? Spawns a familiar that fires clusters of tears. Must be charged before shooting. 2
Lil Spewer 5.100.537 Lil Spewer Puking buddy Drops a random pill, and spawns a familiar that charges up and fires creep. Using pills changes the creep type. 1
Linger Bean 5.100.447 Linger Bean Crying makes me toot Constantly shooting causes Isaac to release gas clouds that can be pushed by his tears and damage nearby enemies. 0
Little Horn 5.100.503 Little Horn Big brother is watching (except in Repentance) Adds a chance to fire a piercing tear that instantly kills any enemy that it touches.
(in Repentance) Adds a chance to fire a tear that summons Big Horn's hand to crush the first enemy it hits, instantly killing monsters or greatly damaging bosses.
3
Marbles 5.100.538 Marbles Choking hazard Spawns 3 random trinkets. Taking damage has a 5% chance to swallow Isaac's currently held trinket, gaining its effect permanently. 2
Marrow 5.100.541 Marrow HP up? Grants one Bone HeartBone Heart and spawns three Red HeartRed Hearts. 1
Metal Plate 5.100.449 Metal Plate It itches... Grants one Soul HeartSoul Heart. Enemy shots have a chance to be reflected at the shooter as confusing tears. 1
Midnight Snack 5.100.456 Midnight Snack HP up Grants one full Red Heart container. (in Repentance) Heals 1 additional Red HeartRed Heart. 1
Mom's Razor 5.100.508 Mom's Razor It's sharp! Spawns an orbiting razor that deals contact damage and inflicts bleeding on enemies, causing them to slowly take damage over time. 2
Mystery Egg 5.100.539 Mystery Egg Sacrificial insemination Spawns an egg familiar, which hatches a random friendly monster when Isaac is hurt once per room. The power of the monster improves for each consecutive room cleared without taking damage. 1
Parasitoid 5.100.461 Parasitoid Egg tears! Adds a chance to fire an egg sack which creates slowing creep and spawns a Blue Fly or Blue Spider upon hitting an enemy. 3
Pointy Rib 5.100.544 Pointy Rib Stabbing time Spawns a bone familiar that hovers back and forth in front of Isaac, dealing damage equal to Isaac's damage. 2
Poke Go 5.100.505 Poke Go Gotta catch em... Upon entering a room with enemies in it, has a chance to spawn a random friendly enemy that persists across rooms. 2
Polydactyly 5.100.454 Polydactyly Hold me! Allows Isaac to carry two cards, pills, or any combination of both. Spawns one random card, rune, or pill. 2
Pop! 5.100.529 Pop! Eyeball tears! Replaces Isaac's tears with eyeballs that can bounce off of each other. The eyeballs are not limited by range, and will instead dissipate when they stop moving or when hitting an enemy or obstacle. 1
Sack of Sacks 5.100.500 Sack of Sacks Gives sacks Spawns a familiar that drops a Grab BagGrab Bag every 5-6 rooms cleared. 3
Schoolbag 5.100.534 Schoolbag Extra active item room Allows Isaac to hold two active items. 3
Shade 5.100.468 Shade It follows Spawns a shadow familiar that follows Isaac's movements on a 1 second delay and deals contact damage to enemies. After dealing enough damage, it is absorbed by Isaac and spawns friendly My ShadowChargers. 0
Shard of Glass 5.100.448 Shard of Glass Blood and guts! (except in Repentance) Upon taking damage, Isaac has a chance to drop a full red heart, gain 5 range, and leave a trail of damaging red creep for the current room.
(in Repentance) Taking damage causes Isaac to bleed, spraying a volley of blood in the direction he fires. Bleeding will eventually damage him, but it can be stopped by picking up a Red HeartRed Heart.
1
Sinus Infection 5.100.459 Sinus Infection Booger tears! Adds a chance to fire a booger that sticks to enemies and deals damage over time. 3
Slipped Rib 5.100.542 Slipped Rib Projectile shield Spawns a bone familiar that circles around Isaac and reflects enemy shots. 2
Sulfuric Acid 5.100.463 Sulfuric Acid Acid tears! +0.3 damage. Adds a chance to fire acidic tears which can destroy obstacles and open doors. 2
Tarot Cloth 5.100.451 Tarot Cloth I see the future Drops a random card or rune. (except in Repentance) Doubles the effects of most cards and runes. (in Repentance) Doubles the effects of tarot cards. 2
Technology Zero 5.100.524 Technology Zero Static tears! Connects Isaac's tears with electricity that can damage enemies. 3
Trisagion 5.100.533 Trisagion Smite thy enemy Tears are replaced with piercing white blasts of light that deal less damage but can damage the same enemy multiple times. 3
Varicose Veins 5.100.452 Varicose Veins I'm leaking... Taking damage releases a ring of 10 high damage tears. 1
YO LISTEN! 5.100.492 YO LISTEN! Yo listen! +1 luck. Spawns a fairy familiar that points out Secret RoomSecret Rooms, Crawl SpaceCrawl Space entrances, and tinted rocks. 2
Tonsil 5.100.474 Tonsil Gross... Grants a familiar that follows Isaac and blocks enemy shots.

Trinkets[ | ]

38 new trinkets were added in the expansion.

Name ID Icon Quote Description
Baby-Bender 5.350.127 Baby-Bender Feed them magic! Grants Isaac's familiars homing shots.
Bag Lunch 5.350.105 Bag Lunch I wonder what it is Taking damage has a small chance to destroy the trinket and spawn Collectible Lunch iconLunch.
Bat Wing 5.350.118 Bat Wing They are growing... Upon killing an enemy, has a chance to grant flight for the rest of the room.
Black Tooth 5.350.95 Black Tooth It looks dead Adds a chance to fire a black tooth that deals double damage and poisons enemies.
Bloody Crown 5.350.111 Bloody Crown Drips with blood... Treasure RoomTreasure Rooms appear in Chapter 4.
Butter! 5.350.122 Butter! Can't hold it! Using an active item will drop it onto a pedestal on the ground. Taking damage may result in dropping an owned passive item.
Cracked Crown 5.350.92 Cracked Crown Stat booster (except in Repentance) Decreases Isaac's tear delay by 20%, and improves the effectiveness of his other stat upgrades by 33%.
(in Repentance) Improves the effectiveness of stat upgrades by 20%.
Crow Heart 5.350.107 Crow Heart Drain me Red HeartRed Heart damage will be taken before Soul HeartSoul Heart, Black HeartBlack Heart, and (in Repentance) Rotten HeartRotten Heart damage.
Dim Bulb 5.350.101 Dim Bulb I think it's broken Provides a boost to all stats when Isaac's active item is completely uncharged.
Door Stop 5.350.124 Door Stop Hold the door! The last door Isaac went through stays open, allowing him to leave the room even if enemies are in it.
Duct Tape 5.350.109 Duct Tape Stuck! Holds Isaac's familiars in place relative to his position.
Equality! 5.350.103 Equality! = Turns pickups into their doubled versions while Isaac's numbers of coins, bombs, and keys are equal.
Extension Cord 5.350.125 Extension Cord Charged friends Bolts of electricity arc between Isaac and his familiars, damaging any enemies between them.
Filigree Feather 5.350.123 Filigree Feather Angelic spoils Angels drop Angel Room items instead of key pieces when defeated.
Finger Bone 5.350.128 Finger Bone It looks brittle Grants a chance to gain a Bone HeartBone Heart upon taking damage.
Fish Tail 5.350.94 Fish Tail It also stinks! Items and trinkets that generate Blue Flies or Locusts will generate twice as many.
Fragmented Card 5.350.102 Fragmented Card Double moon Makes two Secret RoomSecret Rooms spawn on each floor.
Hairpin 5.350.120 Hairpin Danger charge Fully recharges Isaac's active item upon entering a boss fight.
Locust of Conquest 5.350.117 Locust of Conquest I bring Conquest Upon entering a room with enemies, spawns 1-4 White Locusts which damage enemies.
Locust of Death 5.350.116 Locust of Death I bring Death Upon entering a room with enemies, spawns a Black Locust that does a very high amount of damage.
Locust of Famine 5.350.115 Locust of Famine I bring Famine Upon entering a room with enemies, spawns a Yellow Locust that damages and slows enemies.
Locust of Pestilence 5.350.114 Locust of Pestilence I bring Pestilence Upon entering a room with enemies, spawns a Green Locust which damages and poisons enemies.
Locust of War 5.350.113 Locust of War I bring War Upon entering a room with enemies for the first time, spawns a Red Locust which detonates upon impact with enemies.
Lost Cork 5.350.106 Lost Cork Uncorked Increases the radius of any creep produced by Isaac.
Meconium 5.350.91 Meconium Eww Black PoopBlack Poops can drop Black HeartBlack Hearts when destroyed. PoopPoop has a chance to turn into Black PoopBlack Poop.
Nose Goblin 5.350.98 Nose Goblin Seems magic... Chance to fire a homing booger that sticks to enemies and deals damage over time.
Ouroboros Worm 5.350.96 Ouroboros Worm Foop foop! Tears travel in a large spiral pattern and gain spectral, with a small chance to gain homing. (in Repentance) Also adds +0.4 Tears.
Pay to Win 5.350.112 Pay to Win ... Shop Restock MachineShop Restock Machines always spawn in Treasure RoomTreasure Rooms.
Rotten Penny 5.350.126 Rotten Penny Wealth of flies Spawns a Blue Fly every time a coin is picked up.
Silver Dollar 5.350.110 Silver Dollar Feels lucky... ShopShops appear in Chapter 4.
Stem Cell 5.350.119 Stem Cell Regen! (except in Repentance) Heals Isaac for a Half Red HeartHalf Red Heart upon traveling to the next floor.
(in Repentance) Heals 50% of Isaac's empty Red HeartRed Heart containers upon traveling to the next floor.
Super Ball 5.350.99 Super Ball Boing! Makes tears have a chance to bounce off enemies and obstacles.
Tonsil 5.350.97 Tonsil Sick... When hit, there is a small chance to spawn a permanent tonsil familiar that blocks enemy shots. This can happen twice, after which the trinket is destroyed.
Used Diaper 5.350.93 Used Diaper You stink Grants the Collectible Skatole iconSkatole effect in some rooms.
Vibrant Bulb 5.350.100 Vibrant Bulb It needs power Provides a boost to all stats when Isaac's active item is fully charged.
Walnut 5.350.108 Walnut That's a hard nut to crack! Being hit by explosions will eventually destroy the trinket and spawn various pickups.
Wish Bone 5.350.104 Wish Bone Make a wish Taking damage has a small chance to destroy the trinket and spawn a random item.
Wooden Cross 5.350.121 Wooden Cross My faith protects me Grants a shield that negates the first damage taken once per floor.

Pickups[ | ]

Hearts[ | ]

Heart ID Image Worth Additional Info Unlocked By
Scared Heart 9 Red Heart Full red heart Identical to the standard Red Heart, but will run away as the player moves towards it.
Heals Full red heartFull red heart with Collectible Maggy's Bow iconMaggy's Bow.
Collectible Humbleing Bundle iconHumbleing Bundle and Equality!Equality! will not double this.
Half Soul Heart 8 Half Soul Heart Half soul heart Mr Reset 7 times in a row

Switch PS4 Get a minus 10-win streak

Blended Heart 10 Blended Heart Full red heart/Full soul heart/Half red heartHalf soul heart Fills up a full red Heart Container, but will act as a Soul Heart when no Containers are free. If Isaac is only missing half a Red Heart, it will fill that half, and give him half a soul heart as well.
Collectible Dark Bum iconDark Bum and Collectible The Jar iconThe Jar will not collect this.
Bone Heart 11 Bone heart Empty bone heart Takes three hits to deplete and can be refilled with red hearts, but disappears permanently upon depleting. Bone Heart It's complicated

Keys[ | ]

Key ID Image Worth Additional Info Unlocked By
Charged Key 4 Charged Key 1 Fully charges your currently held active item upon pickup.
Key Bum will pick this up, but will not give Isaac any active charge.
Charged Key Complete Pokey Mans (challenge #33)

Pills[ | ]

ID Pill Effect
39 X-Lax

Creates a pool of slippery brown creep underneath Isaac.

40 Something's wrong...

Creates a pool of black creep beneath Isaac.

41 I'm Drowsy...

Upon use, slows all enemies for the duration of the room.

42 I'm Excited!!!

Upon use, increases the speed of all enemies for the duration of the room. The effect triggers again 30 seconds after use and 60 seconds after use.

43 Needs to be unlocked Gulp!

Upon use, any trinkets that the player is holding are destroyed, and their effects are permanently applied to the player.
Unlocked by acquiring the Once More With Feeling! achievement.

44 Needs to be unlocked Horf!

Upon use, Isaac shoots an explosive tear with the Collectible Ipecac iconIpecac effect that always deals 200 damage.
Unlocked by acquiring the Dedication achievement.

45 Needs to be unlocked Feels like I'm walking on sunshine!

Temporarily makes Isaac invincible, similar to Collectible Unicorn Stump iconUnicorn Stump.
Unlocked by acquiring the Sin Collector achievement.

46 Needs to be unlocked Vurp!

Throws up the last pill you used. Will spawn itself if no other pills were taken beforehand.
Unlocked by acquiring the U Broke It! achievement.

Cards[ | ]

Name ID Icon Message Description
Ace of Clubs 5.300.27 Ace of Clubs Convert all Turns all Pickups, Chests, and (in Repentance) non-boss enemies in the room into random Bomb pickups, including Troll BombTroll Bombs.
Ace of Diamonds 5.300.28 Ace of Diamonds Convert all Turns all Pickups, Chests, and (in Repentance) non-boss enemies in the room into random Coin pickups.
Ace of Spades 5.300.29 Ace of Spades Convert all Turns all Pickups, Chests, and (in Repentance) non-boss enemies in the room into random Key pickups.
Ace of Hearts 5.300.30 Ace of Hearts Convert all Turns all Pickups, Chests, and (in Repentance) non-boss enemies in the room into random Hearts.
Holy Card 5.300.51 Holy Card You feel protected Grants a one-time Collectible Holy Mantle iconHoly Mantle effect. (except in Repentance) It lasts for the current room.
Huge Growth 5.300.52 Huge Growth Become immense! (except in Repentance) For the current room, makes Isaac larger, allows him to crush obstacles he walks on, and grants +7 flat Damage and +30 Range.
(in Repentance) For the current room, makes Isaac larger, allows him to crush obstacles he walks on, and grants +7 flat Damage and +3 Range.
Ancient Recall 5.300.53 Ancient Recall Draw 3 cards Spawns 3 random cards.
Era Walk 5.300.54 Era Walk Savor the moment For the current room, enemies are slowed, Isaac's speed is increased by 0.50, and his shot speed is decreased by 1.00.

Runes[ | ]

Name ID Icon Message Description
Black Rune 5.300.41 Black Rune Void Deals 40 damage to all enemies in the room. Consumes all pickups in the room and turns them into Blue Flies and Spiders. Consumes all pedestal items in the room and turns them into random stat upgrades.

Chests[ | ]

Mimic Chest Mimic Chests
  • Mimic Chests appear similar to Brown Chests until Isaac moves near, at which point they sprout spikes that damage the player as a Spike Chest would. They can be distinguished from Brown Chests by their darker, purplish-brown coloring, the grayish spot on each side of the latch where the spikes will sprout from and the bloodstain.

Entities[ | ]

Monsters[ | ]

Entity ID Description
Blended Heart
Blended Heart
5.10.10 {{{behavior}}}
Bone Heart
Bone Heart
5.10.11 {{{behavior}}}
Half Soul Heart
Half Soul Heart
5.10.8 {{{behavior}}}
Scared Heart
Scared Heart
5.10.9 {{{behavior}}}
Charged Key
Charged Key
5.30.4 {{{behavior}}}
Mimic Chest
Mimic Chest
5.54 {{{behavior}}}
Dank Charger
Dank Charger
23.2 Slowly moves around the room, launching itself at Isaac if he gets in its line of sight. Bounces off of walls and leaves a trail of slowing Black Creep while charging.
Mr. Red Maw
Mr
35.2 Walks towards Isaac and attacks by launching its head towards him. Turns into a Red MawRed Maw or Gusher upon death depending on the killed body segment. Occasionally separates at will.
Soul Sucker
Soul Sucker
61.2 Flies slowly towards Isaac. Spawns a vortex that fires four Collectible Brimstone iconBrimstone beams in the cardinal directions upon death.
Cross Stone Shooter
Cross Stone Shooter
202.10 Stationary and invulnerable monster that continuously fires shots in four directions, alternating between cardinal and ordinal.
Crispy
Crispy
226.2 Slowly walks towards Isaac, but increases in speed as they take damage. Constantly passively takes damage.
Nerve Ending 2
Nerve Ending 2
231.1 Static enemy which whips at Isaac if he gets too close.
Tube Worm
Tube Worm
244.1 Pops out of the ground in random locations and fires a long-range spray of arcing shots where Isaac will be.
White Poop
White Poop
245.4 {{{behavior}}}
Mushroom
Mushroom
300.0 Stationary enemy that occasionally pops up and fires four shots in the cardinal or diagonal directions. Takes less damage while its head is down.
Poison Mind
Poison Mind
301.0 Slowly (except in Repentance)crawls/(in Repentance)floats around the room diagonally, leaving a trail of damaging green creep. (in Repentance) Explodes upon death.
Stoney
Stoney
302.0 Chases Isaac and blocks tears, but does not deal contact damage. Temporarily pauses in exhaustion after a certain amount of time. Invulnerable; dies when the room is cleared.
Cross Stoney
Cross Stoney
302.10 Chases Isaac and shoots 4 tears vertically and diagonally like a Cross Stone ShooterCross Stone Shooter. Dies when the room is cleared.
Only appears in Aprils Fool (challenge #32) as replacements to regular Stoneys.
Blister
Blister
303.0 Slowly hops towards Isaac, occasionally spawning a Dark Ball. Spawns a SackSack upon death.
The Thing
The Thing
304.0 Crawls along a wall and attempts to line up with Isaac, then spits a line of damaging Red Creep.
Ministro
Ministro
305.0 Hops around randomly and hop towards Isaac when he gets close, occasionally spitting out a cluster of disorganized shots.
Portal
Portal
306.0 Spawns various enemies from the current floor until it either vanishes or is killed.
Tar Boy
Tar Boy
307.0 Fires a short-ranged spray of shots that leave behind slowing Black Creep. Occasionally burrows underground and reappears under any pools of black creep in the room. If Isaac stands on the Creep, the Tar Boy can (except in Repentance) fire shots straight upwards out of the Creep underneath Isaac/(in Repentance) send out a tentacle underneath Isaac.
Fistuloid
Fistuloid
308.0 Flies towards Isaac in an erratic waving motion, periodically firing a blood shot towards Isaac that also knocks itself back. Upon death, fires a worm that flies off screen.
Gush
Gush
309.0 Stationary, harmless enemy that continually creates slowing black creep.
Leper
Leper
310.0 Alternating between walking towards and running away from Isaac. Releases a Leper Flesh each time it takes enough damage. At low health, constantly chases Isaac and leaves behind damaging red creep. Spawns a Leper Flesh and GusherGusher upon death.
Leper Flesh
Leper Flesh
310.1 Floats slowly toward Isaac and fires a predictive projectile at him upon death.
Mr. Mine
Mr
311.0 Can only appear in pits. Attempts to launch itself at Isaac if he comes near. Occasionally burrows and pops up in another pit, and fires six shots in all directions upon death.
Purple Ball
Purple Ball
409.1 Floats towards Isaac, doing contact damage.

Bosses[ | ]

5 bosses were added in Afterbirth †. Additionally, Ultra Greed received a second form in Greed Mode's hard mode.

Boss Rag Mega
Boss Big Horn
Boss Sisters Vis
Boss The Matriarch
Rag Mega Big Horn Sisters Vis The Matriarch
Boss Delirium
Boss Ultra Greedier
Delirium Ultra Greedier

Environment[ | ]

Chapters[ | ]

The Void
The VoidThe Void

Obstacles[ | ]

Super Special Rocks Super special rock
  • Super special rocks are tinted rock variants which are much harder to spot, as they have a smaller mark and are not discolored. Super special rocks takes two bombs to blow up, and drop the contents of two tinted rocks.
White Poop White poop
  • White poop is surrounded by an aura that halves tear delay and has a high chance to block damage like the Collectible Cone Head Afterbirth+ iconCone Head item while Isaac stands within it. The aura disappears if the poop is destroyed.
DirtPatchDirtPatchForgotten Dirt Patch

Machines[ | ]

Mom's Dressing Table Mom's Dressing Table

Challenges[ | ]

Name Conditions Goal Unlocked by Unlocks
31. Backasswards
Character Isaac appearance
Full red heartFull red heartFull red heart
Starts with:
8-10 random items
Item Pool Treasure Room: no
Item Pool Shop: yes
All chapters progress in reverse order, losing 1 item and 1 Red Heart container each floor ascended.
BasementBasement/CellarCellar/Burning BasementBurning Basement I Backasswards (except in Repentance) Defeat ??? or The Lamb
(in Repentance) Defeat Mega Satan and unlock Collectible The Negative iconThe Negative
Laz Bleeds More! Laz Bleeds More!
32. Aprils Fool
Character Isaac appearance
Full red heartFull red heartFull red heart
Item Pool Treasure Room: yes
Item Pool Shop: yes
The minimap displays the floor's layout accurately but displays Isaac's position inaccurately. Pedestal items and pickups are not what they appear to be. Active items, pills, cards, and rune effects are randomized upon each use, making them very unreliable or deadly (for example Suicide KingSuicide King). Items with no charge time (i.e. Collectible How to Jump iconHow to Jump, Collectible IV Bag iconIV Bag, etc) can be used repeatedly for random effects. StoneyStonies have a chance of being replaced by a Cross StoneyCross Stoney. Every boss is Boss The Bloat ingameThe Bloat. Isaac's health is not what it appears to be. Inventory pickups numbers are accurate.
Boss Mom's Heart portrait Aprils fool Defeat Mom Maggy Now Holds a Pill! Maggy Now Holds a Pill!
33. Pokey Mans
Character Isaac appearance
Full red heartFull red heartFull red heart
Starts with:
Collectible Friendly Ball iconFriendly Ball
Collectible Mom's Eyeshadow iconMom's Eyeshadow
Item Pool Treasure Room: no
Item Pool Shop: yes
Each use of Friendly Ball causes a random monster to be spawned. Friendly Ball instantly charges once the spawned monster is killed.
Boss Isaac portrait Pokey Mans Defeat Mom's Heart 11 times Charged Key Charged Key
34. Ultra Hard
Character Isaac appearance
Full red heartFull red heartFull red heart
Starts with:
Collectible Key Piece 1 iconKey Piece 1
Collectible Key Piece 2 iconKey Piece 2
Curse of the LabyrinthCurse of the Labyrinth
Curse of the BlindCurse of the Blind
Curse of the LostCurse of the Lost
Curse of the MazeCurse of the Maze
Item Pool Treasure Room: yes
Item Pool Shop: yes
All enemies spawn as champions if possible. Boss fights will be double trouble if possible. No heart pickups drop.
Boss Mega Satan portrait Ultra Hard (except in Repentance) Defeat ??? or The Lamb. Possession of Collectible The Polaroid iconThe Polaroid / Collectible The Negative iconThe Negative is required, barring getting to Dark RoomDark Room through a Sacrifice RoomSacrifice Room.
(in Repentance) Defeat Mega Satan and unlock Collectible The Negative iconThe Negative
Samson Feels Healthy! Samson Feels Healthy!
35. Pong
Character Isaac appearance
Full red heartFull red heartFull red heart
Starts with:
Collectible Cupid's Arrow iconCupid's Arrow
Collectible Rubber Cement iconRubber Cement
Item Pool Treasure Room: no
Item Pool Shop: yes
Damage fixed at 100, tear delay fixed at 150.
Boss ??? portrait PONG Defeat Isaac 5 times Greed's Gullet Greed's Gullet

Achievements[ | ]

Name Image Description Unlock In Game Secret Number


1000000% 1000000% Just Stop! Collect every item in the game, unlock all secrets and endings, and complete the Bestiary 339
5 Nights at Mom's 5 Nights at Mom's Unlocked super special rocks. Get a 5-win streak, using a different character each time ((in Repentance) this number can be reduced to 3, see the notes section) 323
7 Seals 7 Seals Unlocked a new item. Defeat all 5 Harbingers 372
Ancient Recall Ancient Recall Unlocked a new item. Use Cards and Runes 20 times 362
Angelic Prism Angelic Prism Unlocked a new item. Defeat an Angel 10 times 373
Angry Fly Angry Fly Unlocked a new item. Become Beelzebub 352
Apollyon Apollyon Unlocked a new character. Defeat Mega Satan 340
Apollyon Baby Apollyon Baby Unlocked a new co-player baby. Earn all Hard mode Completion Marks as Character Apollyon iconApollyon 319
Aprils fool Aprils fool Unlocked a new challenge. Defeat Mom 278
Baby-Bender Baby-Bender Unlocked a new item. Use I - The MagicianI - The Magician or Collectible Telepathy For Dummies iconTelepathy For Dummies while already having homing tears 389
Backasswards Backasswards Unlocked a new challenge. (except in Repentance) Defeat ??? or The Lamb
(in Repentance) Defeat Mega Satan and unlock Collectible The Negative iconThe Negative
277
Bat Wing Bat Wing Unlocked a new item. Defeat Ultra Greedier as Character Azazel iconAzazel 304
Black Hole Black Hole Unlocked a new item. Defeat 20 Portals 349
Black Rune Black Rune Unlocked a new item. Defeat Ultra Greedier as Character Apollyon iconApollyon 309
Blanket Blanket Unlocked a new item. Sleep in 10 beds 385
Bloody Crown Bloody Crown Unlocked a new item. Defeat Delirium as Character Samson iconSamson 287
Bone Baby Bone Baby Unlocked a new co-player baby. Earn all Hard mode Completion Marks as Character The Forgotten iconThe Forgotten 402
Bone Heart Bone Heart Unlocked a new item. It's complicated 391
Book of the Dead Book of the Dead Unlocked a new item. Defeat Delirium as Character The Forgotten iconThe Forgotten 401
Bound Baby Bound Baby Unlocked a new co-player baby. Defeat Mega Satan as Character The Forgotten iconThe Forgotten 403
Bozo Bozo Unlocked a new item. Destroy 5 rainbow poops 353
Brittle Bones Brittle Bones Unlocked a new item. Defeat The Lamb as Character The Forgotten iconThe Forgotten 396
Broken Modem Broken Modem Unlocked a new item. Complete 7 Daily Challenges (by touching the trophy at the end) 354
Brown Nugget Brown Nugget Unlocked a new item. Defeat Ultra Greed as Character Apollyon iconApollyon 316
Buddy in a Box Buddy in a Box Unlocked a new item. Pick up 5 familiars in a single run 355
Burning Basement Burning Basement Alt stage to the basement. Defeat Mom's Heart 11 times 342
Butter! Butter! Unlocked a new item. Complete 2 Victory Laps by defeating The Lamb 360
Charged Key Charged Key Unlocked a new item. Complete Pokey Mans (challenge #33) 333
Compound Fracture Compound Fracture Unlocked a new item. Defeat Delirium as Character Lazarus iconLazarus 291
Coupon Coupon Unlocked a new item. Purchase anything from ShopShops, Devil RoomDevil Rooms, and/or Black MarketBlack Markets 50 times 364
Crooked Penny Crooked Penny Unlocked a new item. Defeat Delirium as Character Keeper iconKeeper 294
Crow Heart Crow Heart Unlocked a new item. Defeat Ultra Greedier as Character Eve iconEve 302
D infinity D infinity Unlocked a new item. Defeat Delirium as Character Isaac iconIsaac 282
D1 D1 Unlocked a new item. Defeat Ultra Greedier as Character Isaac iconIsaac 296
Dad's Lost Coin Dad's Lost Coin Unlocked a new item. Defeat Ultra Greedier as Character The Lost iconThe Lost 307
Dad's Ring Dad's Ring Unlocked a new item. Defeat Ultra Greedier as Character The Forgotten iconThe Forgotten 400
Dank Depths Dank Depths Alt stage to the depths. Defeat It Lives! 21 times 344
Dark Prince's Crown Dark Prince's Crown Unlocked a new item. Defeat Delirium as Character Azazel iconAzazel 290
Death's List Death's List Unlocked a new item. Take 25 Deals with the Devil 376
Dedication Dedication Unlocked a new item. Participate in 31 Daily Challenges (they don't have to be consecutive; it will still count if Isaac dies in the first room) 325
Delirious Delirious Unlocked a new item. Defeat Delirium 338
Divorce Papers Divorce Papers Unlocked a new item. Complete the Boss RushBoss Rush as Character The Forgotten iconThe Forgotten 397
Door Stop Door Stop Unlocked a new item. Blow up doors and Secret RoomSecret Room walls 50 times 375
Duality Duality Unlocked a new item. Defeat Ultra Greedier as Character Lilith iconLilith 306
Dull Razor Dull Razor Unlocked a new item. Defeat Delirium as Character Eve iconEve 288
Eden's Soul Eden's Soul Unlocked a new item. Defeat Delirium as Character Eden iconEden 289
Era Walk Era Walk Unlocked a new item. Add both the Collectible Broken Watch iconBroken Watch and the Collectible Stop Watch iconStop Watch to your collection 363
Eucharist Eucharist Unlocked a new item. Defeat Delirium as Character Magdalene iconMagdalene 283
Euthanasia Euthanasia Unlocked a new item. Defeat Delirium as Character Lilith iconLilith 292
Extension Cord Extension Cord Unlocked a new item. Have Collectible The Battery iconThe Battery, Collectible 9 Volt icon9 Volt, and Collectible Car Battery iconCar Battery in Isaac's collection 381
Eye of Belial Eye of Belial Unlocked a new item. Defeat Ultra Greedier as Character Judas iconJudas 299
Eye of Greed Eye of Greed Unlocked a new item. Defeat Ultra Greedier as Character Keeper iconKeeper 308
Fast Bombs Fast Bombs Unlocked a new item. Defeat Little Horn 20 times 356
Filigree Feather Filigree Feather Unlocked a new item. Acquire both Collectible Key Piece 1 iconKey Piece 1 and Collectible Key Piece 2 iconKey Piece 2 370
Finger Bone Finger Bone Unlocked a new item. Defeat Ultra Greed as Character The Forgotten iconThe Forgotten 399
Flat Stone Flat Stone Unlocked a new item. Acquire Collectible Rubber Cement iconRubber Cement 5 times 382
Flooded Caves Flooded Caves Alt stage to the caves. Defeat It Lives! 16 times 343
Glyph of Balance Glyph of Balance Unlocked a new item. Defeat Ultra Greedier as Character Magdalene iconMagdalene 297
Greed's Gullet Greed's Gullet Unlocked a new item. Complete Pong (challenge #35) 335
Greedier! Greedier! New mode unlocked! Donate 500 Coins to the Greed Donation MachineGreed Donation Machine 341
Haemolacria Haemolacria Unlocked a new item. Acquire Collectible Blood Clot iconBlood Clot 10 times 377
Hairpin Hairpin Unlocked a new item. Recharge using Lil' Batteries 20 times 358
Hallowed Ground Hallowed Ground Unlocked a new item. Defeat Hush as Character The Forgotten iconThe Forgotten 398
Hat trick! Hat trick! Unlocked a new item. Get a 3-win streak 322
Holy Card Holy Card Unlocked a new item. Defeat Delirium as Character The Lost iconThe Lost 293
Huge Growth Huge Growth Unlocked a new item. Increase in size 5 times in a single run via Collectible Magic Mushroom iconMagic Mushroom, "One makes you larger" pills, XI - StrengthXI - Strength, etc. 361
Hushy Hushy Unlocked a new item. Defeat Hush as Character Apollyon iconApollyon 315
It's the Key It's the Key Unlocked a new item. Defeat Boss The Lamb ingameThe Lamb without taking Hearts, Coins, or Bombs through the entire run. Letting certain familiars (e.g. Collectible Bum Friend iconBum Friend, Collectible Dark Bum iconDark Bum, (except in Rebirth)Collectible Bumbo iconBumbo or (in Repentance)Collectible Lil Portal iconLil Portal) or bosses (e.g. (in Repentance) Boss Bumbino ingameBumbino) pick up the consumables fails this condition as well. 327
Jaw Bone Jaw Bone Unlocked a new item. Defeat ??? as Character The Forgotten iconThe Forgotten 395
Jumper Cables Jumper Cables Unlocked a new item. Pick up any 2 of the following items/trinkets in a single run: Collectible 9 Volt icon9 Volt, Collectible The Battery iconThe Battery, Collectible Car Battery iconCar Battery, AAA BatteryAAA Battery, and Watch BatteryWatch Battery ((in Repentance) Any 2 items that have the 'battery' item tag) 367
King Baby King Baby Unlocked a new co-player baby. Defeat Delirium as Character ??? (Character) icon??? 286
Lachryphagy Lachryphagy Unlocked a new item. Collect 10 "Tears Up" items or pills in one run 378
Laz Bleeds More! Laz Bleeds More! Unlocked a new starting item. Complete Backasswards (challenge #31) 331
Leprosy Leprosy Unlocked a new item. Beat Chapter 3 without taking damage 368
Lil Delirium Lil Delirium Unlocked a new item. Defeat Delirium for the 1st time 357
Lil Spewer Lil Spewer Unlocked a new item. Have Isaac die to his own explosion from Collectible Ipecac iconIpecac, Collectible Bob's Rotten Head iconBob's Rotten Head, or a Horf! pill 384
Living on the edge Living on the edge Unlocked a new item. Complete a Chapter (floors I and II) after BasementBasement, start-to-finish, with only half a Heart total (can use Character The Lost iconThe Lost) 329
Locust of Conquest Locust of Conquest Unlocked a new item. Complete the Boss RushBoss Rush as Character Apollyon iconApollyon 314
Locust of Death Locust of Death Unlocked a new item. Defeat The Lamb as Character Apollyon iconApollyon 313
Locust of Famine Locust of Famine Unlocked a new item. Defeat ??? as Character Apollyon iconApollyon 312
Locust of Pestilence Locust of Pestilence Unlocked a new item. Defeat Satan as Character Apollyon iconApollyon 311
Locust of Wrath Locust of Wrath Unlocked a new item. Defeat Isaac as Character Apollyon iconApollyon 310
Maggy Now Holds a Pill! Maggy Now Holds a Pill! Unlocked a new starting item. Complete Aprils Fool (challenge #32) 332
Marbles Marbles Unlocked a new item. Use 5 Gulp! pills in one run (Collectible Placebo iconPlacebo uses count) 386
Marrow Marrow Unlocked a new item. Defeat Mom's Heart or It Lives! on Hard mode as Character The Forgotten iconThe Forgotten 392
Meconium Meconium Unlocked a new item. Defeat Ultra Greedier as Character ??? (Character) icon??? 300
Metronome Metronome Unlocked a new item. Defeat Ultra Greedier as Character Eden iconEden 303
Mort Baby Mort Baby Unlocked a new co-player baby. Defeat Mega Satan as Character Apollyon iconApollyon 317
Moving Box Moving Box Unlocked a new item. Use Collectible Pandora's Box iconPandora's Box in Dark RoomDark Room 366
Mr. ME! Mr Unlocked a new item. Open 20 Locked Chests 371
Mr. Resetter! Mr Unlocked a new item. Reset 7 times in a row

Switch PS4 Get a minus 10-win streak

328
Mystery Egg Mystery Egg Unlocked a new item. Spawn three charmed enemies in the same room 387
Mystery Gift Mystery Gift Unlocked a new item. Destroy 500 rocks 350
New Area New Area Unlocked a new area. Defeat Hush 320
Once More with Feeling! Once More with Feeling! Unlocked a new item. Complete a Victory Lap by defeating The Lamb 321
Plan C Plan C Unlocked a new item. Defeat Ultra Greedier as Character Lazarus iconLazarus 305
Pointy Rib Pointy Rib Unlocked a new item. Defeat Satan as Character The Forgotten iconThe Forgotten 394
Pokey Mans Pokey Mans Unlocked a new challenge. Defeat Mom's Heart 11 times 279
PONG PONG Unlocked a new challenge. Defeat Isaac 5 times 281
Pop! Pop! Unlocked a new item. Beat Chapter 4 without taking damage 374
RERUN RERUN Unlocked the power of RERUN. Complete 3 Victory Laps by defeating The Lamb 337
Rotten Penny Rotten Penny Unlocked a new item. Have 20 Blue Flies at the same time 388
Sack of Sacks Sack of Sacks Unlocked a new item. Defeat Ultra Greedier as Character Cain iconCain 298
Sacrificial Altar Sacrificial Altar Unlocked a new item. Take 50 Deals with the Devil 383
Samson Feels Healthy! Samson Feels Healthy! Unlocked a new starting item. Complete Ultra Hard (challenge #34) 334
Scarred Womb Scarred Womb Alt stage to the womb. Defeat It Lives! 30 times 345
Schoolbag Schoolbag Unlocked a new item. Enter 6 ShopShops in one run 379
Shade Shade Unlocked a new item. Defeat Delirium as Character Judas iconJudas 285
Silver Dollar Silver Dollar Unlocked a new item. Defeat Delirium as Character Cain iconCain 284
Sin collector Sin collector Unlocked a new item. Collect every entry in the Bestiary (bugged v190 - Mobs that don't exist in the bestiary are being counted. This allows Sin Collector to be unlocked without a complete bestiary) 324
Slipped Rib Slipped Rib Unlocked a new item. Defeat Isaac as Character The Forgotten iconThe Forgotten 393
Smelter Smelter Unlocked a new item. Defeat Mom's Heart or It Lives! on Hard mode as Character Apollyon iconApollyon 318
Something wicked this way comes! Something wicked this way comes! Unlocked new bosses! Defeat ??? as 3 different Characters 346
Something wicked this way comes+! Something wicked this way comes+! Unlocked even more bosses! Defeat ??? as 6 different Characters 347
Sprinkler Sprinkler Unlocked a new item. Beat Chapter 1 without taking damage 351
Stem Cell Stem Cell Unlocked a new item. Defeat Ultra Greedier as Character Samson iconSamson 301
Technology Zero Technology Zero Unlocked a new item. Pick up any 2 technology items in a single run ((in Repentance) Any 2 items that have the 'tech' item tag) 369
Telekinesis Telekinesis Unlocked a new item. Beat Chapter 2 without taking damage 365
The Forgotten The Forgotten Unlocked a new character. It's complicated 390
The gate is open! The gate is open! Unlocked new enemies! Defeat The Lamb 348
The Marathon The Marathon Unlocked a new item. Get a 5-win streak in the Daily Challenges (they don't have to be consecutive days, only the runs you play are counted) 336
Trisagion Trisagion Unlocked a new item. Take 25 Angel Rooms items 380
U Broke It! U Broke It! Unlocked a new item. Obtain 50 items in a run (duplicate passive items/familiars count towards the total, e.g., multiple Collectible Breakfast iconBreakfast) 330
Ultra Hard Ultra Hard Unlocked a new challenge. (except in Repentance) Defeat ??? or The Lamb. Possession of Collectible The Polaroid iconThe Polaroid / Collectible The Negative iconThe Negative is required, barring getting to Dark RoomDark Room through a Sacrifice RoomSacrifice Room.
(in Repentance) Defeat Mega Satan and unlock Collectible The Negative iconThe Negative
280
Void Void Unlocked a new item. Defeat Delirium as Character Apollyon iconApollyon 295
Wooden Cross Wooden Cross Unlocked a new item. Sleep in a bed 359
ZIP! ZIP! Unlocked a new item. Defeat The Lamb in under 20 minutes 326

Changes[ | ]

Menus[ | ]

Collection page
  • The navigation is faster and loops back on itself when scrolling vertically.
Loading screen
  • Loading images are smoother.

Player[ | ]

Characters[ | ]

General
  • Adjusted the stats of each character in the character selection menu to better reflect their actual in-game stats.
  • Adjusted pickup animation so items no longer obstruct Isaac's face.
  • Bloodstains on costumes are now consistently the same color.
Eden
  • Holding R to reset will consume an Eden Token and start a new run.
  • Added 30 hairstyles.
  • Can be randomized if the player has Eden tokens.
Eve
  • Starts with Razor Blade only if it has been unlocked.
  • Leaves a pool of blood behind instead of pee when walking between rooms at low HP.
Lilith

Transformations[ | ]

Conjoined
  • Its costume has color alts.
Seraphim
  • Its costume has color alts.
Spun
  • Its costume has color alts.
Yes Mother?
  • Its costume has color alts.

Familiars[ | ]

  • Teleport to the player's new position if it was changed by a boss such as Gurdy or Mom's Heart.
  • Most sources of Blue Spiders throw those spiders out instead of spawning them on the ground.
  • Following familiars are no longer pushed back when very close to the player.

Co-op[ | ]

  • Co-op babies can no longer drop out while the player is playing a pickup animation.

Items[ | ]

General
  • Mushroom items play their unique pickup sound.

Activated Collectibles[ | ]

General
  • Some sprites changed:
Item Old sprite New sprite
The Boomerang Collectible The Boomerang Rebirth icon Collectible The Boomerang icon
Box of Spiders Collectible Box of Spiders Rebirth icon Collectible Box of Spiders icon
D20 Collectible D20 Rebirth icon Collectible D20 icon
D7 Collectible D7 Afterbirth icon Collectible D7 icon
Glass Cannon Collectible Glass Cannon Afterbirth icon Collectible Glass Cannon icon
Isaac's Tears Collectible Isaac's Tears Rebirth icon Collectible Isaac's Tears icon
The Jar Collectible The Jar Afterbirth icon Collectible The Jar icon
Jar of Flies Collectible Jar of Flies Afterbirth icon Collectible Jar of Flies icon
Mega Blast Collectible Mega Blast Afterbirth icon Collectible Mega Blast icon
Ventricle Razor Collectible Ventricle Razor Afterbirth icon Collectible Ventricle Razor icon
We Need To Go Deeper! Collectible We Need To Go Deeper! Rebirth icon Collectible We Need To Go Deeper! icon
Collectible Breath of Life Rebirth iconBreath of Life
  • Can be held down between rooms.
  • Added some visual feedback when it provides its invincibility.
Collectible Butter Bean iconButter Bean
  • If Isaac swaps Butter Bean for a different active item, then picks up Butter Bean again, it has a small chance to transform into Wait What?.
Collectible D4 iconD4
  • Re-rolls each of Isaac's passive items into a random item from the specific item pool where it was acquired.
Collectible Diplopia iconDiplopia
  • No longer spawns extra items for empty item pedestals.
Collectible Flush! iconFlush!
  • Poops spawned react to damage similarly to regular poops.
Collectible Friendly Ball iconFriendly Ball
Collectible Glowing Hourglass iconGlowing Hourglass
Collectible Guppy's Head iconGuppy's Head
  • The number of flies is seeded.
Collectible Head of Krampus iconHead of Krampus
  • Lasers no longer have a chance to rotate.
Collectible The Jar iconThe Jar
  • Its sprite changes based on how many hearts it contains.
Collectible Jar of Flies iconJar of Flies
  • Its sprite changes based on how many flies it contains.
Collectible Mine Crafter Afterbirth iconMine Crafter
  • Spawns a TNT barrel directly at the player's position rather than on a nearby free tile.
Collectible My Little Unicorn iconMy Little Unicorn
  • Its costume has color alts.
Collectible Pandora's Box iconPandora's Box
Collectible Satanic Bible iconSatanic Bible
  • Plays its use animation.
Collectible Shoop da Whoop! iconShoop da Whoop!
  • Damage halved to compensate.
Collectible Undefined iconUndefined
  • The Void is reset on exiting the I AM ERROR room and can be cleared repeatedly as long as the player is able to gather enough charges to successfully warp to it.
Collectible Ventricle Razor Afterbirth+ iconVentricle Razor
  • Portals will now appear closed if they have no connected portal.
  • Portals got a few minor visual tweaks.

Passive Collectibles[ | ]

General
  • Some sprites changed:
Item Old sprite New sprite
<3 Collectible Less Than Three Rebirth icon Collectible Less Than Three icon
8 Inch Nails Collectible 8 Inch Nails Afterbirth icon Collectible 8 Inch Nails icon
Abaddon Collectible Abaddon Rebirth icon Collectible Abaddon icon
Anemic Collectible Anemic Rebirth icon Collectible Anemic icon
Aquarius Collectible Aquarius Rebirth icon Collectible Aquarius icon
The Belt Collectible The Belt Rebirth icon Collectible The Belt icon
Best Bud Collectible Best Bud Rebirth icon Collectible Best Bud icon
Black Lotus Collectible Black Lotus Rebirth icon Collectible Black Lotus icon
Bob's Curse Collectible Bob's Curse Rebirth icon Collectible Bob's Curse icon
Box Collectible Box Rebirth icon Collectible Box icon
Brimstone Collectible Brimstone Rebirth icon Collectible Brimstone icon
Brother Bobby Collectible Brother Bobby Rebirth icon Collectible Brother Bobby icon
Bum Friend Collectible Bum Friend Rebirth icon Collectible Bum Friend icon
Caffeine Pill Collectible Caffeine Pill Rebirth icon Collectible Caffeine Pill icon
Cambion Conception Collectible Cambion Conception Afterbirth icon Collectible Cambion Conception icon
Cancer Collectible Cancer Rebirth icon Collectible Cancer icon
Celtic Cross Collectible Celtic Cross Rebirth icon Collectible Celtic Cross icon
The Compass Collectible The Compass Rebirth icon Collectible The Compass icon
Continuum Collectible Continuum Afterbirth icon Collectible Continuum icon
Cricket's Head Collectible Cricket's Head Rebirth icon Collectible Cricket's Head icon
Crown Of Light Collectible Crown Of Light Afterbirth icon Collectible Crown Of Light icon
Cupid's Arrow Collectible Cupid's Arrow Rebirth icon Collectible Cupid's Arrow icon
Daddy Longlegs Collectible Daddy Longlegs Rebirth icon Collectible Daddy Longlegs icon
Dark Bum Collectible Dark Bum Rebirth icon Collectible Dark Bum icon
Demon Baby Collectible Demon Baby Rebirth icon Collectible Demon Baby icon
Distant Admiration Collectible Distant Admiration Rebirth icon Collectible Distant Admiration icon
Evil Eye Collectible Evil Eye Afterbirth icon Collectible Evil Eye icon
Farting Baby Collectible Farting Baby Afterbirth icon Collectible Farting Baby icon
Forever alone Collectible Forever alone Rebirth icon Collectible Forever alone icon
Friend Zone Collectible Friend Zone Afterbirth icon Collectible Friend Zone icon
Gemini Collectible Gemini Rebirth icon Collectible Gemini icon
Ghost Baby Collectible Ghost Baby Rebirth icon Collectible Ghost Baby icon
Goat Head Collectible Goat Head Rebirth icon Collectible Goat Head icon
Guppy's Hairball Collectible Guppy's Hairball Rebirth icon Collectible Guppy's Hairball icon
Habit Collectible Habit Rebirth icon Collectible Habit icon
Harlequin Baby Collectible Harlequin Baby Rebirth icon Collectible Harlequin Baby icon
Holy Water Collectible Holy Water Rebirth icon Collectible Holy Water icon
Infestation Collectible Infestation Rebirth icon Collectible Infestation icon
Key Bum Collectible Key Bum Afterbirth icon Collectible Key Bum icon
Key Piece 2 Collectible Key Piece 2 Rebirth icon Collectible Key Piece 2 icon
Lil Brimstone Collectible Lil Brimstone Rebirth icon Collectible Lil Brimstone icon
Lil' Loki Collectible Lil' Loki Afterbirth icon Collectible Lil' Loki icon
Lord of the Pit Collectible Lord of the Pit Rebirth icon Collectible Lord of the Pit icon
Lost Fly Collectible Lost Fly Afterbirth icon Collectible Lost Fly icon
Lucky Foot Collectible Lucky Foot Rebirth icon Collectible Lucky Foot icon
Magic 8 Ball Collectible Magic 8 Ball Rebirth icon Collectible Magic 8 Ball icon
Magneto Collectible Magneto Rebirth icon Collectible Magneto icon
Mitre Collectible Mitre Rebirth icon Collectible Mitre icon
Mom's Contacts Collectible Mom's Contacts Rebirth icon Collectible Mom's Contacts icon
Mom's Eye Collectible Mom's Eye Rebirth icon Collectible Mom's Eye icon
Mom's Knife Collectible Mom's Knife Rebirth icon Collectible Mom's Knife icon
Money = Power Collectible Money = Power Rebirth icon Collectible Money = Power icon
The Mulligan Collectible The Mulligan Rebirth icon Collectible The Mulligan icon
Multidimensional Baby Collectible Multidimensional Baby Afterbirth icon Collectible Multidimensional Baby icon
The Peeper Collectible The Peeper Rebirth icon Collectible The Peeper icon
Pentagram Collectible Pentagram Rebirth icon Collectible Pentagram icon
Piggy Bank Collectible Piggy Bank Rebirth icon Collectible Piggy Bank icon
Polyphemus Collectible Polyphemus Rebirth icon Collectible Polyphemus icon
Proptosis Collectible Proptosis Rebirth icon Collectible Proptosis icon
Pyro Collectible Pyro Rebirth icon Collectible Pyro icon
Rainbow Baby Collectible Rainbow Baby Rebirth icon Collectible Rainbow Baby icon
Robo-Baby Collectible Robo-Baby Rebirth icon Collectible Robo-Baby icon
Robo-Baby 2.0 Collectible Robo-Baby 2.0 Rebirth icon Collectible Robo-Baby 2.0 icon
Rotten Baby Collectible Rotten Baby Rebirth icon Collectible Rotten Baby icon
Sacrificial Dagger Collectible Sacrificial Dagger Rebirth icon Collectible Sacrificial Dagger icon
Sad Bombs Collectible Sad Bombs Rebirth icon Collectible Sad Bombs icon
Sagittarius Collectible Sagittarius Rebirth icon Collectible Sagittarius icon
Sister Maggy Collectible Sister Maggy Rebirth icon Collectible Sister Maggy icon
Skeleton Key Collectible Skeleton Key Rebirth icon Collectible Skeleton Key icon
SMB Super Fan Collectible SMB Super Fan Rebirth icon Collectible SMB Super Fan icon
Spear of Destiny File:Collectible Spear of Destiny Afterbirth icon.png File:Collectible Spear of Destiny icon.png
Speed Ball Collectible Speed Ball Rebirth icon Collectible Speed Ball icon
Spirit of the Night Collectible Spirit of the Night Rebirth icon Collectible Spirit of the Night icon
Strange Attractor Collectible Strange Attractor Rebirth icon Collectible Strange Attractor icon
Taurus Collectible Taurus Rebirth icon Collectible Taurus icon
Tech.5 Collectible Tech.5 Rebirth icon Collectible Tech.5 icon
Tough Love Collectible Tough Love Rebirth icon Collectible Tough Love icon
Whore of Babylon Collectible Whore of Babylon Rebirth icon Collectible Whore of Babylon icon
Collectible Ball of Bandages iconBall of Bandages
  • Decreased the damage rate of level 3 and 4 to match Cube of Meat.
Collectible The Battery iconThe Battery
  • Self-recharging active items can charge the yellow meter, allowing Isaac to use them twice immediately.
Collectible Betrayal iconBetrayal
  • No longer triggers if there are fewer than 2 enemies in the room.
  • Its costume has color alts.
Collectible BFFS! iconBFFS!
  • Increases spawner familiar spawn rates.
Collectible Black Candle iconBlack Candle
  • Makes the darkness from Curse of Darkness fade away instead of immediately lighting the room up.
Collectible The Body iconThe Body
  • Its costume has color alts.
Collectible BOGO Bombs iconBOGO Bombs
  • Its costume has color alts.
Collectible Bursting Sack iconBursting Sack
  • Its costume has color alts.
Collectible Cancer iconCancer
  • Its costume has color alts.
Collectible Dead Eye iconDead Eye
  • The multiplier will no longer be lost when hitting poops or TNT barrels.
Collectible E. Coli iconE. Coli
  • Poops spawned react to damage similarly to regular poops.
Collectible Eden's Blessing iconEden's Blessing
  • Is now limited to a maximum of 10 to prevent potential crashes.
Collectible Epiphora iconEpiphora
  • Being hit, changing rooms, and using items no longer reset the Epiphora bonus.
    • During the delay when transitioning between rooms, picking up an item, or using an active item, it's possible to change firing direction without resetting the bonus.
Collectible Fate iconFate
  • Its costume has color alts.
Collectible Fruit Cake iconFruit Cake
Collectible Gemini iconGemini
  • Added extra familiar animations.
Collectible Hive Mind iconHive Mind
  • The effect also applies to locusts.
Collectible Holy Grail iconHoly Grail
  • Its costume has color alts.
Collectible Holy Mantle iconHoly Mantle
  • The shield is no longer restored if the player saves and continues after losing it.
Collectible Immaculate Conception iconImmaculate Conception
  • Its costume has color alts.
Collectible Key Piece 1 iconKey Piece 1 / Collectible Key Piece 2 iconKey Piece 2
Collectible Kidney Stone iconKidney Stone
  • Causes Isaac to fire "tears" from the middle instead of from his eyes, and at a slightly lower height.
Collectible Lil Brimstone iconLil Brimstone
  • Got renamed from "Lil' Brimstone" to "Lil Brimstone".
  • Can damage Fire Places and poops.
Collectible Lil Haunt iconLil Haunt
  • Got renamed from "Lil' Haunt" to "Lil Haunt".
Collectible Lord of the Pit Afterbirth+ iconLord of the Pit
  • Its costume has color alts.
Collectible Lost Contact Rebirth iconLost Contact
  • Only affects the player and Incubus's tears.
Collectible Lusty Blood iconLusty Blood
  • Its costume has color alts.
Collectible Number One iconNumber One
  • Causes Isaac to fire "tears" from the middle instead of from his eyes, and at a slightly lower height.
Collectible Ouija Board iconOuija Board
  • Its costume no longer overwrites the player's skin color to pink instead of white.
Collectible PHD iconPHD
  • Converts:
    • ??? into Telepills
    • Addicted into Percs!
    • Paralysis into Pheromones
    • Retro Vision into I can see forever!
    • R U A Wizard? into Power Pill!
    • X-Lax into Something's wrong...
Collectible Piggy Bank iconPiggy Bank
  • Its costume has color alts.
Collectible Purity iconPurity
  • Better visualization of Purity's glow.
Collectible Restock iconRestock
  • Purchasing an item that is on sale will replace it with another that is on sale.
Collectible Robo-Baby Afterbirth+ iconRobo-Baby
Collectible Rubber Cement iconRubber Cement
  • Tears bounce off bombs.
  • Spectral tears no longer bounce off rocks.
Collectible Sagittarius iconSagittarius
  • Its costume has color alts.
Collectible Scatter Bombs iconScatter Bombs
  • Bombs actually scatter around.
  • Small bombs leave smaller craters.
Collectible The Small Rock iconThe Small Rock
  • The speed and tears changes will take effect immediately. Without Afterbirth+, they didn't immediately change until Isaac's speed or tears stats are updated the next time.
Collectible Steam Sale iconSteam Sale
  • Items have a chance to be discounted further by random sales; for example, a discounted item originally costing 5 coins will then cost 2 coins instead of 3.
Collectible Sticky Bombs iconSticky Bombs
  • Its costume has color alts.
Collectible Succubus iconSuccubus
Collectible Synthoil iconSynthoil
  • Its costume has color alts.

Trinkets[ | ]

General
  • Some sprites changed:
Item Old sprite New sprite
???'s Soul Blue Baby's Soul Rebirth Icon Blue Baby's Soul Icon
Black Feather Black Feather Afterbirth Icon Black Feather Icon
Blasting Cap Blasting Cap Afterbirth Icon Blasting Cap Icon
Blister Blister Afterbirth Icon Blister Icon
Bob's Bladder Bob's Bladder Afterbirth Icon Bob's Bladder Icon
Broken Magnet Broken Magnet Rebirth Icon Broken Magnet Icon
Brown Cap Brown Cap Afterbirth Icon Brown Cap Icon
Cain's Eye Cain's Eye Rebirth Cain's Eye Icon
Cracked Dice Cracked Dice Afterbirth Icon Cracked Dice Icon
Daemon's Tail Daemon's Tail Rebirth Icon Daemon's Tail Icon
Endless Nameless Endless Nameless Afterbirth Icon Endless Nameless Icon
Error Error Afterbirth Icon Error Icon
Karma Karma Afterbirth Icon Karma Icon
Lazy Worm Lazy Worm Afterbirth Icon Lazy Worm Icon
Lil Larva Lil Larva Afterbirth Icon Lil Larva Icon
Louse Louse Afterbirth Icon Louse Icon
Lucky Rock Lucky Rock Rebirth Icon Lucky Rock Icon
Mom's Locket Mom's Locket Afterbirth Icon Mom's Locket Icon
Mom's Pearl Mom's Pearl Rebirth Icon Mom's Pearl Icon
Mysterious Paper Mysterious Paper Rebirth Icon Mysterious Paper Icon
NO! NO! Afterbirth Icon NO! Icon
Poker Chip Poker Chip Afterbirth Icon Poker Chip Icon
Purple Heart Purple Heart Rebirth Icon Purple Heart Icon
Push Pin Push Pin Rebirth Icon Push Pin Icon
Rainbow Worm Rainbow Worm Afterbirth Icon Rainbow Worm Icon
Rib of Greed Rib of Greed Afterbirth Icon Rib of Greed Icon
Second Hand Second Hand Afterbirth Icon Second Hand Icon
Shiny Rock Shiny Rock Afterbirth Icon Shiny Rock Icon
Stud Finder Stud Finder Afterbirth Icon Stud Finder Icon
Super Magnet Super Magnet Afterbirth Icon Super Magnet Icon
Tape Worm Tape Worm Afterbirth Icon Tape Worm Icon
Umbilical Cord Umbilical Cord Rebirth Icon Umbilical Cord Icon
Watch Battery Watch Battery Afterbirth Icon Watch Battery Icon
Whip Worm Whip Worm Rebirth Icon Whip Worm Icon
The Left HandThe Left Hand
Safety ScissorsSafety Scissors
TickTick

Interactions[ | ]

Pickups[ | ]

General

Hearts[ | ]

Black Heart
  • Has unique sounds.
Eternal Heart
  • Takes half a heart worth of damage from any lethal hit taken with only Soul Hearts.
Gold Heart
  • Turns nearby enemies to gold when breaking.
  • Added better visual feedback when breaking.
  • Minimap icon added.
  • Has unique sounds.
Half Red Heart
  • Minimap icon added.

Coins[ | ]

Lucky Penny
  • Has a green shine.

Bombs[ | ]

Golden Bomb
  • Has unique sounds.

Pills[ | ]

Friends Till The End!
  • Has narration.

Cards and Runes[ | ]

? Card? Card
  • Its card ID is 48 instead of 43.
A Card Against HumanityA Card Against Humanity
  • Has a unique card back.
Chaos CardChaos Card
  • Has a unique card back.
Credit CardCredit Card
  • Has a unique card back.
Get out of Jail Free CardGet out of Jail Free Card
  • Has a unique card back.

Chests[ | ]

General
  • Items dropped no longer revert to their generic stone pedestal look upon leaving and reentering the room.
Locked Chest
Spiked Chest

Entities[ | ]

Monsters[ | ]

General
  • Champion enemies no longer deal contact damage if the non-champion version doesn't.
  • Charmed enemies prioritize non-charmed enemies unless there aren't any.
  • Permanently charmed enemies no longer try to go after Punching Bag.
  • Permanently charmed enemies can shoot projectiles through each other and familiars.
  • Monster replacements will now only occur with enemies spawned as part of the room layout.
Begotten
  • Is chained to an adjacent rock if the nearest wall is more than 1 grid cell away.
Big Spider
Blue Gaper
  • Reduced Base HP and added stage HP.
  • Has a proper appearance animation if spawned by a room rather than by a boss.
Conjoined Fatty
  • Added extra sounds and effects to creep attacks.
Death's Head
  • No longer deals contact damage during its death animation.
Greed Gaper
  • Has a proper appearance animation if spawned by a room rather than by a boss.
Homunculus
  • Is chained to an adjacent rock if the nearest wall is more than 1 grid cell away.
Lil Haunt
  • Is no longer considered a boss.
  • Has a unique death portrait.
Lump
Meatball
  • Added extra sounds and effects to creep attacks.
Mega Clotty
  • Make a sound when stomping.
Rage Creep
  • Its brimstone is no longer moved upwards and no longer causes the player to take damage along the top wall in Womb/Utero room #202.
  • Its attack animation slightly longer.
Spider
Stone Grimace and all its variants
Stone Grimace
  • Closes its eyes when the room is cleared.
  • No longer respawn when reentering the room if killed.
Super Pooter
  • Renamed from "Fat Fly" to "Super Pooter".

Mini-Bosses[ | ]

Greed
  • The Greed fight before Ultra Greed triggers the victory jingle when cleared.
Stone Grimace
  • No longer plays its appear animation if encountered in an already cleared room.
Super Greed
Swinger
  • Spawns with its head retracted and extends over 2 seconds.

Bosses[ | ]

Brownie
The Cage
  • Its grey creep blinks.
The Forsaken
  • Moves to a more appropriate place to perform his Brimstone attack in L-shaped rooms.
  • Multiple Forsakens in the same room can spawn their own Bony each and always spin their Brimstone attack in the same direction at the same speed.
The Haunt
  • Champion variants are transparent during their first phase.
Hush
  • Due to the way entity stacking works ??? may rarely appear instead and once defeated will skip "phase 2" entirely and will give a completion mark as if Hush was defeated.
Krampus
  • Does a short dash towards the player before doing a spinning Brimstone attack.
  • Can shoot Brimstone lasers in all 4 diagonal directions.
The Lamb
  • No longer do its rotating Brimstone attack when close to a wall.
Little Horn
  • Has new champion versions:
    • Orange: Spits out an orange Troll Bomb instead of a black ball. The bomb deals contact damage and leave a patch of fire similar to Hot Bombs.
    • Black: Does not attack with Pits or troll bombs, but fires smoke balls more frequently.
Mega Satan
  • If The Void is unlocked, there is a 50% chance that the game will not immediately end, and Mega Satan will instead drop an ending chest along with a portal. Entering the chest ends the game and plays the cutscene while entering the portal will take Isaac to The Void.
Mom
  • Familiars are teleported to the player's position when entering the boss room.
Rag Man
  • Has new champion versions:
    • Black: Spawns 2 spiders instead of a Ragling. Uses his resurrect frequently. This won't resurrect anything since the spiders don't leave corpses but still heals him. Sprays tears during his resurrection, similar to Monstro's spit.
    • Red: No longer fires tears. Can have up to 4 Raglings at one time and can revive up to 2 Raglings at once.
Triachnid
  • Has a death animation.

Creeps[ | ]

Red creep

Environment[ | ]

General
  • Added some backdrop tiling fixes.
  • Pit seams are fixed.

Chapters[ | ]

Womb
  • Womb trapdoors have a new sprite for when they are closed.
???
  • Additionally, an exit will spawn in the corner of the room, containing a Portal leading to The Void.
Cathedral
  • Has a new floor transition animation.
  • Some rooms contain Angel Statues that can be bombed to summon the Angels and acquire key pieces.

Rooms[ | ]

Treasure Room
  • There is a chance that 2-3 Greed Gapers may appear in the room.
  • Treasure rooms can rarely contain two items that can both be taken or poop, trinket, and a couple of pickups instead of an item.
  • New layouts:

Treasure Room 31Treasure Room 32Treasure Room 33Treasure Room 34Treasure Room 35Treasure Room 36Treasure Room 37Treasure Room 38Treasure Room 39

Shop
  • There is a 20% chance for Donation Machine to be replaced by Restock Machine.
  • There is a small chance for the shop to be replaced by one of its two rare variants:

Shop 7Shop 6 (the two pennies are lucky pennies)

Curse Room
  • Can contain a Devil statue and a random item, surrounded by spikes.
  • Minimap icon changed.
Sacrifice Room
  • Minimap icon changed.
  • New layout:

Sacrifice Room 10

Secret Room
Devil Room
  • Can contain:
  • Urns may spawn in the Devil Room.
  • An angel statue can rarely substitute the Satan statue and can be awoken with an explosion.
    • Angels spawned in this way do not drop Key Pieces.
  • Red Chests inside a Devil Room no longer teleport the player to the Devil Room.
Angel Room
  • Can contain 5 Soul Hearts.
  • Two angel statues can appear in the same room, allowing Isaac to fight both Uriel and Gabriel. It is possible to get both Key Pieces if Isaac awakes and fights each of them one by one; however, fighting both at once will only spawn one Key Piece corresponding to the last defeated angel.
Dice Room
  • The 1 pip room re-rolls each of Isaac's passive items into a random item from the specific item pool where it was acquired.
  • The 4 pips room rerolls item pedestals located in the Shop and the Library.
  • Have a small icon in the corner of the room that denotes what the effect of the room is.
I AM ERROR
Boss Rush
  • There is a small chance that there will be 8 items to choose from.
  • Using the Black Rune will start the Boss Rush.
  • New layout:

Boss Rush 6

Crawl Space
  • New layouts (rares):

ItemDungeon 10ItemDungeon 11

Black Market
  • Players can no longer access the Black Market through the wall glitch. However, it is still possible to access the Black Market using the glitch via special circumstances including having Ipecac and The Inner Eye.

Obstacles[ | ]

Mushrooms
Reward Plate
  • Locks the room when spawning enemies.
Pressure Plate
  • No longer grants a charge when bombing out of its room.
Movable TNT
  • Takes damage exactly like their regular counterparts.
Spikes
  • No longer stay in their raised position when clearing Pressure Plate rooms.
  • Start (and remain) in their lowered position when entering a cleared Pressure Plate room.

Machines[ | ]

Donation Machine
  • Donation gradually accelerates if the player stays in contact with the donation machine.
Greed Donation Machine
  • No longer jams when the HUD displays a jamming rate of 0%.
  • Donation gradually accelerates if the player stays in contact with the greed machine.
Slot Machine
  • Items dropped no longer revert to their generic stone pedestal look upon leaving and reentering the room.

Challenges[ | ]

  • Killing Delirium will count as completing challenges.
I RULE!

Achievements[ | ]

General
  • Popups can be fast-forwarded by tapping Start.


New bugs/Fixed bugs[ | ]

Bug Bug! If an angel statue is broken inside the devil room the door will incorrectly be shown to be open, but can't be escaped from
Bug Bug! When Scolex is slowed, some of his body parts may detach or won't even show up - they will only be visible while entering the ground (especially the tail).


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