• 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.
  • 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.
  • 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.


  • Its costume has color alts.
  • Its costume has color alts.
  • Its costume has color alts.
Yes Mother?
  • Its costume has color alts.


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


  • Mushroom items play their unique pickup sound.

Activated Collectibles

  • Some sprites changed:
Item Old sprite New sprite
The Boomerang Collectible The Boomerang Rebirth icon.png Collectible The Boomerang icon.png
Box of Spiders Collectible Box of Spiders Rebirth icon.png Collectible Box of Spiders icon.png
D20 Collectible D20 Rebirth icon.png Collectible D20 icon.png
D7 Collectible D7 Afterbirth icon.png Collectible D7 icon.png
Glass Cannon Collectible Glass Cannon Afterbirth icon.png Collectible Glass Cannon icon.png
Isaac's Tears Collectible Isaac's Tears Rebirth icon.png Collectible Isaac's Tears icon.png
The Jar Collectible The Jar Afterbirth icon.png Collectible The Jar icon.png
Jar of Flies Collectible Jar of Flies Afterbirth icon.png Collectible Jar of Flies icon.png
Mega Blast Collectible Mega Blast Afterbirth icon.png Collectible Mega Blast icon.png
Ventricle Razor Collectible Ventricle Razor Afterbirth icon.png Collectible Ventricle Razor icon.png
We Need to Go Deeper! Collectible We Need to Go Deeper! Rebirth icon.png Collectible We Need to Go Deeper! icon.png
Collectible Breath of Life icon.png Breath of Life
  • Can be held down between rooms.
  • Added some visual feedback when it provides its invincibility.
Collectible Butter Bean icon.png Butter 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 icon.png D4
  • Re-rolls each of Isaac's passive items into a random item from the specific item pool where it was acquired.
Collectible Diplopia icon.png Diplopia
  • No longer spawns extra items for empty item pedestals.
Collectible Flush! icon.png Flush!
  • Poops spawned react to damage similarly to regular poops.
Collectible Friendly Ball icon.png Friendly Ball
Collectible Glowing Hour Glass icon.png Glowing Hour Glass
Collectible Guppy's Head icon.png Guppy's Head
  • The number of flies is seeded.
Collectible Head of Krampus icon.png Head of Krampus
  • Lasers no longer have a chance to rotate.
Collectible The Jar icon.png The Jar
  • Its sprite changes based on how many hearts it contains.
Collectible Jar of Flies icon.png Jar of Flies
  • Its sprite changes based on how many flies it contains.
Collectible Mine Crafter Afterbirth icon.png Mine Crafter
  • Spawns a TNT barrel directly at the player's position rather than on a nearby free tile.
Collectible My Little Unicorn icon.png My Little Unicorn
  • Its costume has color alts.
Collectible Pandora's Box icon.png Pandora's Box
Collectible Satanic Bible icon.png Satanic Bible
  • Plays its use animation.
Collectible Shoop Da Whoop! icon.png Shoop Da Whoop!
  • Damage halved to compensate.
Collectible Undefined icon.png Undefined
  • 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+ icon.png Ventricle Razor
  • Portals will now appear closed if they have no connected portal.
  • Portals got a few minor visual tweaks.

Passive Collectibles

  • Some sprites changed:
Item Old sprite New sprite
<3 Collectible Less Than Three Rebirth icon.png Collectible Less Than Three icon.png
8 Inch Nails Collectible 8 Inch Nails Afterbirth icon.png Collectible 8 Inch Nails icon.png
Abaddon Collectible Abaddon Rebirth icon.png Collectible Abaddon icon.png
Anemic Collectible Anemic Rebirth icon.png Collectible Anemic icon.png
Aquarius Collectible Aquarius Rebirth icon.png Collectible Aquarius icon.png
The Belt Collectible The Belt Rebirth icon.png Collectible The Belt icon.png
Best Bud Collectible Best Bud Rebirth icon.png Collectible Best Bud icon.png
Black Lotus Collectible Black Lotus Rebirth icon.png Collectible Black Lotus icon.png
Bob's Curse Collectible Bob's Curse Rebirth icon.png Collectible Bob's Curse icon.png
Box Collectible Box Rebirth icon.png Collectible Box icon.png
Brimstone Collectible Brimstone Rebirth icon.png Collectible Brimstone icon.png
Brother Bobby Collectible Brother Bobby Rebirth icon.png Collectible Brother Bobby icon.png
Bum Friend Collectible Bum Friend Rebirth icon.png Collectible Bum Friend icon.png
Caffeine Pill Collectible Caffeine Pill Rebirth icon.png Collectible Caffeine Pill icon.png
Cambion Conception Collectible Cambion Conception Afterbirth icon.png Collectible Cambion Conception icon.png
Cancer Collectible Cancer Rebirth icon.png Collectible Cancer icon.png
Celtic Cross Collectible Celtic Cross Rebirth icon.png Collectible Celtic Cross icon.png
The Compass Collectible The Compass Rebirth icon.png Collectible The Compass icon.png
Continuum Collectible Continuum Afterbirth icon.png Collectible Continuum icon.png
Cricket's Head Collectible Cricket's Head Rebirth icon.png Collectible Cricket's Head icon.png
Crown of Light Collectible Crown of Light Afterbirth icon.png Collectible Crown of Light icon.png
Cupid's Arrow Collectible Cupid's Arrow Rebirth icon.png Collectible Cupid's Arrow icon.png
Daddy Longlegs Collectible Daddy Longlegs Rebirth icon.png Collectible Daddy Longlegs icon.png
Dark Bum Collectible Dark Bum Rebirth icon.png Collectible Dark Bum icon.png
Demon Baby Collectible Demon Baby Rebirth icon.png Collectible Demon Baby icon.png
Distant Admiration Collectible Distant Admiration Rebirth icon.png Collectible Distant Admiration icon.png
Evil Eye Collectible Evil Eye Afterbirth icon.png Collectible Evil Eye icon.png
Farting Baby Collectible Farting Baby Afterbirth icon.png Collectible Farting Baby icon.png
Forever Alone Collectible Forever Alone Rebirth icon.png Collectible Forever Alone icon.png
Friend Zone Collectible Friend Zone Afterbirth icon.png Collectible Friend Zone icon.png
Gemini Collectible Gemini Rebirth icon.png Collectible Gemini icon.png
Ghost Baby Collectible Ghost Baby Rebirth icon.png Collectible Ghost Baby icon.png
Goat Head Collectible Goat Head Rebirth icon.png Collectible Goat Head icon.png
Guppy's Hair Ball Collectible Guppy's Hair Ball Rebirth icon.png Collectible Guppy's Hair Ball icon.png
Habit Collectible Habit Rebirth icon.png Collectible Habit icon.png
Harlequin Baby Collectible Harlequin Baby Rebirth icon.png Collectible Harlequin Baby icon.png
Holy Water Collectible Holy Water Rebirth icon.png Collectible Holy Water icon.png
Infestation Collectible Infestation Rebirth icon.png Collectible Infestation icon.png
Key Bum Collectible Key Bum Afterbirth icon.png Collectible Key Bum icon.png
Key Piece 2 Collectible Key Piece 2 Rebirth icon.png Collectible Key Piece 2 icon.png
Lil Brimstone Collectible Lil Brimstone Rebirth icon.png Collectible Lil Brimstone icon.png
Lil' Loki Collectible Lil' Loki Afterbirth icon.png Collectible Lil' Loki icon.png
Lord of the Pit Collectible Lord of the Pit Rebirth icon.png Collectible Lord of the Pit icon.png
Lost Fly Collectible Lost Fly Afterbirth icon.png Collectible Lost Fly icon.png
Lucky Foot Collectible Lucky Foot Rebirth icon.png Collectible Lucky Foot icon.png
Magic 8 Ball Collectible Magic 8 Ball Rebirth icon.png Collectible Magic 8 Ball icon.png
Magneto Collectible Magneto Rebirth icon.png Collectible Magneto icon.png
Mitre Collectible Mitre Rebirth icon.png Collectible Mitre icon.png
Mom's Contacts Collectible Mom's Contacts Rebirth icon.png Collectible Mom's Contacts icon.png
Mom's Eye Collectible Mom's Eye Rebirth icon.png Collectible Mom's Eye icon.png
Mom's Knife Collectible Mom's Knife Rebirth icon.png Collectible Mom's Knife icon.png
Money = Power Collectible Money = Power Rebirth icon.png Collectible Money = Power icon.png
The Mulligan Collectible The Mulligan Rebirth icon.png Collectible The Mulligan icon.png
Multidimensional Baby Collectible Multidimensional Baby Afterbirth icon.png Collectible Multidimensional Baby icon.png
The Peeper Collectible The Peeper Rebirth icon.png Collectible The Peeper icon.png
Pentagram Collectible Pentagram Rebirth icon.png Collectible Pentagram icon.png
Piggy Bank Collectible Piggy Bank Rebirth icon.png Collectible Piggy Bank icon.png
Polyphemus Collectible Polyphemus Rebirth icon.png Collectible Polyphemus icon.png
Proptosis Collectible Proptosis Rebirth icon.png Collectible Proptosis icon.png
Pyro Collectible Pyro Rebirth icon.png Collectible Pyro icon.png
Rainbow Baby Collectible Rainbow Baby Rebirth icon.png Collectible Rainbow Baby icon.png
Robo-Baby Collectible Robo-Baby Rebirth icon.png Collectible Robo-Baby icon.png
Robo-Baby 2.0 Collectible Robo-Baby 2.0 Rebirth icon.png Collectible Robo-Baby 2.0 icon.png
Rotten Baby Collectible Rotten Baby Rebirth icon.png Collectible Rotten Baby icon.png
Sacrificial Dagger Collectible Sacrificial Dagger Rebirth icon.png Collectible Sacrificial Dagger icon.png
Sad Bombs Collectible Sad Bombs Rebirth icon.png Collectible Sad Bombs icon.png
Sagittarius Collectible Sagittarius Rebirth icon.png Collectible Sagittarius icon.png
Sister Maggy Collectible Sister Maggy Rebirth icon.png Collectible Sister Maggy icon.png
Skeleton Key Collectible Skeleton Key Rebirth icon.png Collectible Skeleton Key icon.png
SMB Super Fan Collectible SMB Super Fan Rebirth icon.png Collectible SMB Super Fan icon.png
Spear of Destiny Collectible Spear of Destiny Afterbirth icon.png Collectible Spear of Destiny icon.png
Speed Ball Collectible Speed Ball Rebirth icon.png Collectible Speed Ball icon.png
Spirit of the Night Collectible Spirit of the Night Rebirth icon.png Collectible Spirit of the Night icon.png
Strange Attractor Collectible Strange Attractor Rebirth icon.png Collectible Strange Attractor icon.png
Taurus Collectible Taurus Rebirth icon.png Collectible Taurus icon.png
Tech.5 Collectible Tech.5 Rebirth icon.png Collectible Tech.5 icon.png
Tough Love Collectible Tough Love Rebirth icon.png Collectible Tough Love icon.png
Whore of Babylon Collectible Whore of Babylon Rebirth icon.png Collectible Whore of Babylon icon.png
Collectible Ball of Bandages icon.png Ball of Bandages
  • Decreased the damage rate of level 3 and 4 to match Cube of Meat.
Collectible The Battery icon.png The Battery
  • Self-recharging active items can charge the yellow meter, allowing Isaac to use them twice immediately.
Collectible Betrayal icon.png Betrayal
  • No longer triggers if there are fewer than 2 enemies in the room.
  • Its costume has color alts.
Collectible BFFS! icon.png BFFS!
  • Increases spawner familiar spawn rates.
Collectible Black Candle icon.png Black Candle
  • Makes the darkness from Curse of Darkness fade away instead of immediately lighting the room up.
Collectible The Body icon.png The Body
  • Its costume has color alts.
Collectible Bogo Bombs icon.png Bogo Bombs
  • Its costume has color alts.
Collectible Bursting Sack icon.png Bursting Sack
  • Its costume has color alts.
Collectible Cancer icon.png Cancer
  • Its costume has color alts.
Collectible Dead Eye icon.png Dead Eye
  • The multiplier will no longer be lost when hitting poops or TNT barrels.
Collectible E Coli icon.png E Coli
  • Poops spawned react to damage similarly to regular poops.
Collectible Eden's Blessing icon.png Eden's Blessing
  • Is now limited to a maximum of 10 to prevent potential crashes.
Collectible Epiphora icon.png Epiphora
  • 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 icon.png Fate
  • Its costume has color alts.
Collectible Fruit Cake icon.png Fruit Cake
Collectible Gemini icon.png Gemini
  • Added extra familiar animations.
Collectible Hive Mind icon.png Hive Mind
  • The effect also applies to locusts.
Collectible Holy Grail icon.png Holy Grail
  • Its costume has color alts.
Collectible Holy Mantle icon.png Holy Mantle
  • The shield is no longer restored if the player saves and continues after losing it.
Collectible Immaculate Conception icon.png Immaculate Conception
  • Its costume has color alts.
Collectible Key Piece 1 icon.png Key Piece 1 / Collectible Key Piece 2 icon.png Key Piece 2
Collectible Kidney Stone icon.png Kidney Stone
  • Causes Isaac to fire "tears" from the middle instead of from his eyes, and at a slightly lower height.
Collectible Lil Brimstone icon.png Lil Brimstone
  • Got renamed from "Lil' Brimstone" to "Lil Brimstone".
  • Can damage Fire Places and poops.
Collectible Lil Haunt icon.png Lil Haunt
  • Got renamed from "Lil' Haunt" to "Lil Haunt".
Collectible Lord of the Pit Afterbirth+ icon.png Lord of the Pit
  • Its costume has color alts.
Collectible Lost Contact icon.png Lost Contact
  • Only affects the player and Incubus's tears.
Collectible Lusty Blood icon.png Lusty Blood
  • Its costume has color alts.
Collectible Number One icon.png Number One
  • Causes Isaac to fire "tears" from the middle instead of from his eyes, and at a slightly lower height.
Collectible Ouija Board icon.png Ouija Board
  • Its costume no longer overwrites the player's skin color to pink instead of white.
Collectible PHD icon.png PHD
  • 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 icon.png Piggy Bank
  • Its costume has color alts.
Collectible Purity icon.png Purity
  • Better visualization of Purity's glow.
Collectible Restock icon.png Restock
  • Purchasing an item that is on sale will replace it with another that is on sale.
Collectible Robo-Baby Afterbirth+ icon.png Robo-Baby
Collectible Rubber Cement icon.png Rubber Cement
  • Tears bounce off bombs.
  • Spectral tears no longer bounce off rocks.
Collectible Sagittarius icon.png Sagittarius
  • Its costume has color alts.
Collectible Scatter Bombs icon.png Scatter Bombs
  • Bombs actually scatter around.
  • Small bombs leave smaller craters.
Collectible The Small Rock icon.png The 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 icon.png Steam 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 icon.png Sticky Bombs
  • Its costume has color alts.
Collectible Succubus icon.png Succubus
Collectible Synthoil icon.png Synthoil
  • Its costume has color alts.


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





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.


Lucky Penny
  • Has a green shine.


Golden Bomb
  • Has unique sounds.


Friends Till The End!
  • Has narration.

Cards and Runes

Pickup Q Card icon.png ? Card
  • Its card ID is 48 instead of 43.
Pickup A Card Against Humanity icon.png A Card Against Humanity
  • Has a unique card back.
Pickup Chaos Card icon.png Chaos Card
  • Has a unique card back.
Pickup Credit Card icon.png Credit Card
  • Has a unique card back.
Pickup Get out of Jail Free Card icon.png Get out of Jail Free Card
  • Has a unique card back.


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



  • 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.
  • 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.
  • 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.
  • 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.
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".


  • 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
  • Spawns with its head retracted and extends over 2 seconds.


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.
  • 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.
  • 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.
  • 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.
  • Has a death animation.


Red creep


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


  • 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.
  • Has a new floor transition animation.
  • Some rooms contain Angel Statues that can be bombed to summon the Angels and acquire key pieces.


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 31.png
Treasure Room 32.png
Treasure Room 33.png
Treasure Room 34.png
Treasure Room 35.png
Treasure Room 36.png
Treasure Room 37.png
Treasure Room 38.png
Treasure Room 39.png
  • 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 7.png
Shop 6.png
(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.png
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.
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.png
Crawl Space
  • New layouts (rares):
ItemDungeon 10.png
ItemDungeon 11.png
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.


Reward plate
  • Locks the room when spawning enemies.
Silver button
  • No longer grants a charge when bombing out of its room.
Pushable TNT
  • Takes damage exactly like their regular counterparts.
  • 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.


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.


  • Killing Delirium will count as completing challenges.


  • Popups can be fast-forwarded by tapping Start.
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