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Issues: As this is information relating to newly released content, there may be more information planned to be released by the developers in the following months.

Repentance is a DLC expansion to The Binding of Isaac: Afterbirth † that was released on March 31st, 2021. It costs $15.00 (USD).

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

Features[]

General features revealed include:

The fan mod The Binding of Isaac: Antibirth integrated into the game as official content!
A new reworked co-op mode, allowing up to four players to play as actual characters instead of babies.
130+ new items (more than 700 items in total and some are from Antibirth)

A full alternate path with brand new chapters and two new final bosses and endings (one from Antibirth)
100+ new enemies
25 new bosses
19 new playable characters
10 new challenges
234 new achievements, for a grand total of 637.
5,000+ new room designs

Additions[]

Playable Characters[]

Character	Bethany	Jacob and Esau
Character	Bethany	Jacob	Esau
Health
Damage	3.50 (*1.00)	2.75 (*1.00)	3.75 (*1.00)
Tears	+0	3.00	2.50
Shot Speed	1	1.15	0.85
Range	6.5	5.00	8.00
Speed	1.0	1.00	1.00
Luck	0	1.00	-1.00
Starting Pickups	4 Soul Charges	None	None
Starting Item(s)	Book of Virtues	None	None

There is also a "tainted character" for each existing playable character (including Bethany and Jacob and Esau) which can be unlocked by finding a hidden room on the new stage " Home". Because of that, the total number of playable characters in the game is 34.

Items and Trinkets[]

Activated Collectibles[]

Name	ID	Quote	Description	Quality
Abyss	5.100.706	Come forth from the depths	Destroys all items in the room and gives Isaac a unique locust familiar for each item destroyed.	4
Alabaster Box	5.100.585	A sacred offering	Spawns three Soul Hearts and two Angel Room items and is consumed. Starts with no charges, and can only be charged by picking up 6 Soul Hearts.	2
Anima Sola	5.100.722	Repent	Chains down the nearest enemy for 5 seconds, preventing them from acting.	2
Bag of Crafting	5.100.710	Make your destiny	Collects and holds up to 8 pickups. Holding the activate button crafts them into a passive item, with the power level based on the quality of pickups used.	3
Berserk!	5.100.704	Rip and tear	Causes Isaac to go berserk for 5 seconds, greatly increasing his speed, tears, and damage, but restricting him to using a melee weapon instead of his tears. This item charges by dealing damage to enemies instead of clearing rooms.	3
Book of Virtues	5.100.584	Spiritual companionship	On use, spawns an orbital Wisp familiar that fires spectral tears but can be destroyed. Also becomes a passive item that causes other active items to spawn themed Wisps.	3
Broken Glass Cannon	5.100.474	You broke it!	Begins with no charges and turns into Glass Cannon when used. Only acquired by taking damage while holding Glass Cannon.	0
Clear Rune	5.100.263	Rune mimic	Has the same effect as the rune or soul stone currently held by Isaac.	2
Damocles	5.100.577	A king's fortune... but at what cost?	Spawns a sword above Isaac's head, which doubles all item pedestals. After Isaac takes damage, the sword can randomly fall at any point, instantly killing him.	2
Dark Arts	5.100.705	One with the shadows	Makes Isaac invulnerable and intangible for one second. When the effect ends, all enemies Isaac ran through take damage and Isaac temporarily gains +1 damage for each one.	2
Death Certificate	5.100.628	Where am I?	Takes Isaac to an abandoned and expanded version of Home, which has one copy of every item in the game. After taking an item, Isaac returns to the room he used Death Certificate in.	4
Decap Attack	5.100.729	Chuck away!	Throws Isaac's head, which is still able to fire tears at the spot it lands. Reactivating the item or stepping on the head reattaches it.	2
Eraser	5.100.638	Erase thy enemy	Throws an eraser that instantly kills the first monster it hits, and prevents that monster from spawning for the rest of the run. Can only be used once per floor.	2
Esau Jr.	5.100.703	Lost brother	Swaps between the current character and Esau Jr., who has +2 flat damage and flight. Characters have independent items and health. Dying as either character ends the run.	2
Eternal D6	5.100.609	???	Rerolls all items in the room. Each item has a chance to disappear instead.	2
Everything Jar	5.100.720	Anything is possible	Spawns certain pickups based on how many charges it has. If fully charged, instead has one of many unique effects.	2
Flip	5.100.711	Life and death	Switch characters between Tainted Lazarus and Dead Tainted Lazarus.	3
Fortune Cookie	5.100.557	Reusable fortunes	Gives Isaac a fortune, soul heart, tarot card, or trinket.	2
Free Lemonade	5.100.578	Party time!	Creates a large pool of yellow creep beneath Isaac.	2
Friend Finder	5.100.687	Best friends forever!	Spawns a random friendly monster that mimics Isaac's movements and attacks.	3
Gello	5.100.728	Demonic gestation	Spawns a demon familiar that's attached to Isaac and moves and fires in the direction Isaac shoots, using Isaac's damage, tears, range, shot speed, and special tear effects.	2
Genesis	5.100.622	In the beginning	Removes all of Isaac's items and pickups and takes him to a unique Bedroom with some pickups and Chests and a trapdoor to the next floor. For every item Isaac lost, he gets to take an item from a set of three.	2
Golden Razor	5.100.555	Pain from gain	Spends five coins to increase Isaac's damage by 1.2 for the current room.	2
Hold	5.100.715	Saved for later	Exclusive to Tainted ???. Allows him to save one poop bomb for later, allowing him to gather more over time.	0
Jar of Wisps	5.100.685	Your faith grows	Spawns random wisps that shoot various tears, block shots, and deal contact damage. The number of wisps spawned increases every time the jar is used.	2
Keeper's Box	5.100.719	Portable shop	Spawns a random shop item or pickup which can be bought for its normal price.	3
Larynx	5.100.611	Hear my pain	Isaac shouts, damaging and pushing away nearby enemies. The shout gets stronger the more charges the item has. Can also be charged by taking damage.	2
Lemegeton	5.100.712	Item summoner	Spawns the ghost of a random passive item, which orbits Isaac but can be destroyed. While the ghost is alive, Isaac gains that item's effects.	3
Magic Skin	5.100.642	All your desires fulfilled	Consumes one heart container or two soul hearts to spawn an item and give Isaac a broken heart container that can never be filled. If Magic Skin isn't being held after being used, it is very likely to replace any future items.	2
Meat Cleaver	5.100.631	Slice but no dice	Splits all enemies in the room into two smaller versions of themselves with much less health.	1
Mega Mush	5.100.625	I'm a big boy now!	Gigantifies Isaac for 30 seconds, increasing damage and range while lowering tears, granting invulnerability, and allowing Isaac to crush enemies and obstacles he walks on. The effect persists between rooms.	4
Mom's Bracelet	5.100.604	Mother's strength	Lets Isaac pick up and throw rocks, TNT, poops, and other obstacles.	2
Plum Flute	5.100.650	Play time!	Summons the boss Baby Plum to fight for Isaac in the current room.	2
R Key	5.100.636	Time to start over	Brings Isaac back to the first floor of a new run, retaining all of his items.	4
Recall	5.100.714	Come back	Retrieves the Forgotten's body from any distance. Only available as the Birthright effect for Tainted Forgotten.	0
Red Key	5.100.580	Explore the other side	Creates a new room adjacent to a viable wall, indicated by the outline of a door. These rooms have a chance to be various special rooms.	3
Sharp Key	5.100.623	Open your enemies	Adds 5 keys on pickup. Allows Isaac to throw his keys to deal damage to enemies, destroy obstacles, and open doors.	1
Spin to Win	5.100.655	Let it rip!	When used, gives Isaac +0.5 speed and greatly increases the rotation speed of Isaac's orbitals for 3 seconds. Gives Isaac a spinning top orbital that blocks enemy shots and deals contact damage to enemies while held.	1
Spindown Dice	5.100.723	-1	Transforms all items in the room by decreasing their internal ID number.	4
Stitches	5.100.635	Bait and switch	Passively spawns a familiar that moves in the direction Isaac shoots. On use, Isaac swaps places with the familiar.	1
Sulfur	5.100.556	Temporary demon form	Grants Brimstone for the current room.	2
Sumptorium	5.100.713	Return	Holding down the fire button converts hearts into familiars that fire tears but can be destroyed. Activating converts the familiars back into hearts.	3
Suplex!	5.100.709	Angel breaker	Isaac dashes forward and picks up the first enemy hit. After a moment, he slams them into the ground to deal damage and create a circular rock wave.	3
The Scooper	5.100.605	Plop!	Summons a Peeper familiar for the current room, which leaves a trail of red creep.	0
Urn of Souls	5.100.640	Unleash their sorrow	Spews a stream of damaging flame. Gains Soul Charges each time an enemy dies, which are used to fuel the urn.	3
Vade Retro	5.100.653	Begone!	While held, enemies leave behind ghosts on death. Using the item causes the ghosts to explode, dealing damage to nearby enemies. Stronger enemies leave bigger ghosts.	3
Wavy Cap	5.100.582	Tears up. A mind changing experience!	Increases tears, decreases speed, and distorts the screen. All effects become more pronounced with repeated use, and wear off by clearing rooms.	1
Yuck Heart	5.100.639	Gross!	Gives Isaac a Rotten Heart.	3

Passive Collectibles[]

Name	ID	Quote	Description	Quality
120 Volt	5.100.559	Zap!	Repeatedly zaps enemies that are close to Isaac.	3
2Spooky	5.100.554	4me	Enemies near Isaac are afflicted with fear.	2
4.5 Volt	5.100.647	Beat the juice out of them!	Active items don't charge when clearing rooms. Instead, they're charged by dealing damage to enemies.	2
A Bar of Soap	5.100.564	Tears + shot speed up	Gives Isaac +0.5 Tears and +0.2 Shot Speed.	3
A Pound of Flesh	5.100.672	Blood money	Devil deals now cost coins, shop items now cost health, and consumables in shops are free but surrounded by spikes.	1
Act of Contrition	5.100.601	Tears up, you feel forgiven	Increases tears and grants an Eternal Heart. Allows Angel Rooms to appear even if a Devil deal has been taken before. Greatly boosts Devil/Angel Deal chance if Isaac has taken Red Heart damage.	3
Akeldama	5.100.641	Spill your guts	While in an uncleared room, Isaac forms a trail of bloody tears that drags behind him, bursting and dealing damage upon contact with enemies.	2
Almond Milk	5.100.561	DMG down + tears up + you feel nutty	Quadruples fire rate, with x0.3 damage multiplier. Tears are given random worm trinket effects.	1
Astral Projection	5.100.677	The true out-of-body experience!	Causes Isaac to turn into a ghost if he gets hit while in an uncleared room, giving him flight and spectral tears and blocking the next hit he takes.	2
Azazel's Rage	5.100.699	Ancient power	Isaac builds rage every time a room is cleared. After four rooms, fires a large Brimstone laser when entering the next room.	3
Battery Pack	5.100.603	Instant energy!	Recharges Isaac's currently held active item and drops 2-4 batteries.	1
Belly Jelly	5.100.690	Bounce away!	Causes enemies to bounce off of Isaac, dealing damage to them if they hit an enemy or obstacle. Also gives Isaac the chance to deflect enemy shots.	2
Binge Eater	5.100.664	All you can eat	+1 red heart container and fully heals Isaac. Item pedestals cycle between their normal items and food, and collecting food grants a temporary damage boost and permanent bonuses to 2 stats.	3
Bird Cage	5.100.610	Fat buddy	The first time Isaac takes damage in a room, a familiar leaps on an enemy, dealing damage and releasing a rock wave. For the rest of the room, it chases enemies similar to Dead Bird.	1
Bird's Eye	5.100.616	It burns	Gives a chance to shoot fires alongside tears that block enemy shots and deal damage to enemies that touch them.	2
Birthright	5.100.619	???	Has a different effect for each character.	2
Blood Bombs	5.100.614	Bloody blast + HP up	Grants a Red Heart container and restores 5 hearts. Bombs leave behind damaging red creep. Isaac can place bombs at the cost of half a heart if he doesn't have any.	1
Blood Oath	5.100.569	Bleed me dry	Stabs Isaac at the beginning of each floor, draining his red hearts. Increases damage and speed for the floor based on the amount drained.	2
Blood Puppy	5.100.565	What a cute little thing!	Spawns a familiar that chases enemies. After killing enough enemies, it becomes more powerful but will also try to hurt Isaac. Attacking it returns it to normal.	2
Bloody Gust	5.100.695	May your rage bring haste	When Isaac takes damage, he gains speed and tears for the rest of the floor.	3
Boiled Baby	5.100.607	Messy friend	Gives Isaac a familiar that fires chaotic bursts of tears in all directions.	1
Bone Spurs	5.100.683	Break your enemies	Enemies spawn floating bones on death, which block shots and damage/repel enemies that touch them.	2
Booster Pack	5.100.624	Collect them all!	Spawns 5 random cards.	1
Bot Fly	5.100.629	Defense drone	Spawns an orbiting fly familiar that fires shielded tears at incoming enemy projectiles.	3
Brimstone Bombs	5.100.646	Demon blast +5 bombs	Gives Isaac +5 bombs and causes his bombs to fire Brimstone lasers in the cardinal directions upon exploding.	3
C Section	5.100.678	Fetus shots	Not fully implemented.	4
Candy Heart	5.100.671	Power of love	Gives Isaac a permanent stat boost whenever he heals with red heart pickups.	2
Card Reading	5.100.660	A link to your future	Spawns two portals at the beginning of each floor that each lead to either the Boss Room, Secret Room, or Treasure Room.	3
Consolation Prize	5.100.644	+1 to lowest stat	Increases Isaac's lowest stat and drops either 3 coins, 1 bomb, or 1 key depending on what Isaac has the least of.	1
Cracked Orb	5.100.675	Shards of knowledge	Unlocks doors and reveals a random room on the map when Isaac takes damage.	1
Cube Baby	5.100.652	Kick it!	Spawns an ice cube familiar that slides around when walked into. It slows and deals contact damage, freezing monsters it kills.	1
Dad's Note	5.100.668	...	Begins the sequence to access Home.	0
Dirty Mind	5.100.576	Filthy friends	Destroying poop spawns Dip Familiars that follow Isaac and damage enemies. Destroying different types of poop spawns different Dips with special effects.	2
Divine Intervention	5.100.568	Double tap shield	Double tapping a fire key creates a shield that pushes away enemies and reflects enemy projectiles and lasers.	2
Dogma	5.100.633	Ascended	Grants flight, +0.1 speed, +2 damage, and the Holy Mantle effect. Grants enough health to have 6 full hearts, if possible. Automatically given to Isaac after defeating Dogma.	0
Dream Catcher	5.100.566	Sweet dreams	During the transition between floors, Isaac's nightmare shows the floor's Treasure Room item and boss. Grants half a soul heart when entering a new floor.	2
Echo Chamber	5.100.700	I can see see the future future future	When Isaac uses a card, pill, or rune, he also uses a copy of every card/pill/rune he used after picking up Echo Chamber.	2
Empty Heart	5.100.676	It multiplies	If Isaac has one red heart or less at the beginning of a floor, he gains an empty red heart container.	2
Evil Charm	5.100.632	Luck up + you feel protected	Increases luck by 2.0. Provides immunity to burn, confusion, fear, and poison.	1
Eye Drops	5.100.600	Tears up	Lowers the tear delay in Isaac's left eye, causing his eyes to fire at different rates.	3
Eye of the Occult	5.100.572	DMG up + range up + controlled tears	Isaac's tears are now controlled mid-flight with tear controls. Also increases damage and range, but decreases shot speed.	3
Eye Sore	5.100.558	More eyes	Causes Isaac to occasionally fire extra tears in random directions while shooting.	2
False PHD	5.100.654	Worse pills + evil up	Converts good pills into bad pills and identifies all pills. Bad pills now have secondary positive effects. Grants one Black Heart.	2
Freezer Baby	5.100.608	Iced iced baby	Spawns a shooting familiar that has a chance to petrify enemies, and Freezes monsters upon killing them.	2
Fruity Plum	5.100.649	Bouncy friend	Gives Isaac a miniature Baby Plum familiar that propels itself diagonally around the room, firing tears behind itself as it travels.	1
Ghost Bombs	5.100.727	Spooky blast +5 bombs	+5 bombs. Bombs become spectral and spawn ghosts that deal contact damage to enemies and explode after 10 seconds.	2
Giant Cell	5.100.658	Micro friends	Causes Isaac to spawn micro-Isaacs when he takes damage, which chase and shoot at nearby enemies.	1
Glitched Crown	5.100.689	?????	Before being picked up, item pedestals cycle between 5 random items.	4
Guppy's Eye	5.100.665	An eye for secrets	Shows the contents of Chests, Sacks, and Fire Places before they're opened.	2
Heartbreak	5.100.694	Eternal sorrow	Grants 3 broken hearts and +0.25 damage for every broken heart Isaac has. Every otherwise fatal hit will add 2 more until Isaac has nothing but broken hearts.	3
Hemoptysis	5.100.726	Double tap sneeze	Double-tapping a fire button causes Isaac to sneeze blood, dealing damage to enemies in front of him.	3
Hungry Soul	5.100.684	Out for blood	Enemies have a chance to spawn ghosts on death, which chase and deal contact damage to enemies and explode after a short time.	3
Hypercoagulation	5.100.724	Thick blooded	After Isaac takes damage from an enemy or donates health, launches red hearts from Isaac that despawn after 1.5 seconds.	3
IBS	5.100.725	Your stomach rumbles	Causes Isaac to throw poop, create buffing creep, or drop bombs while fighting enemies.	2
Immaculate Heart	5.100.573	Halo of tears	Adds one red heart container and fully restores health. x1.2 damage multiplier. Isaac will occasionally fire extra tears that orbit around him.	3
Inner Child	5.100.688	Let him free	Upon death, Isaac respawns in the current room with half a heart left, a massive size down, and +0.2 speed.	3
Isaac's Tomb	5.100.701	Buried memories	Spawns an Old Chest at the start of each floor.	3
It Hurts	5.100.560	No it doesn't...	Releases a ring of tears and increases tears for the current room when Isaac takes damage.	1
Jupiter	5.100.594	You're a gas giant!	+2 red Heart containers, -0.3 speed. Isaac builds speed while standing still, and releases poison gas clouds when he moves afterwards.	3
Keeper's Kin	5.100.717	Under a rock	Rocks and props spawn blue spiders over time while in a room with enemies, and spawn two blue spiders when destroyed.	2
Keeper's Sack	5.100.716	Spending power	Gives range, speed, or damage when buying things from a shop. Also spawns three coins and a key on pickup.	3
Knife Piece 1	5.100.626	???	Combined with Knife Piece 2, creates a knife familiar that damages enemies and can open the door to the Corpse.	0
Knife Piece 2	5.100.627	???	Combined with Knife Piece 1, creates a knife familiar that damages enemies and can open the door to the Corpse.	0
Knockout Drops	5.100.637	They pack a punch!	Adds a chance to shoot a fist tear that has extremely high knockback and confuses enemies.	3
Lil Abaddon	5.100.679	Abyssal friend	Spawns a familiar that charges a miniature Maw of the Void attack while Isaac shoots.	3
Lil Dumpy	5.100.615	Puffy buddy	Gives Isaac a Dumpy familiar that pushes, confuses, or poisons nearby enemies and flies in a random direction after taking damage.	0
Lil Portal	5.100.681	It hungers	A familiar that flies forward, consuming pickups in its path. Each one will increase its size and damage and spawn a Blue Fly. Every four pickups, it opens a portal that leads to an unexplored room.	1
Lodestone	5.100.617	Magnetizing tears	Gives Isaac the chance to fire tears that magnetize enemies they hit, causing them to attract nearby pickups and enemies, as well as tears/shots from all sources.	3
Lost Soul	5.100.612	Protect him	Gives Isaac a soul familiar that dies in one hit, respawning at the start of the next floor. If it survives an entire floor, it rewards Isaac with hearts or items.	2
Luna	5.100.589	The moon's blessing shines upon you	Adds an extra Secret Room and Super Secret Room to each floor. Secret Rooms contain a beam of light that increases tears for the current floor and gives half a soul heart.	2
Mars	5.100.593	Double tap dash	Dash by double-tapping the movement key, becoming invulnerable and damaging enemies. There's a short cooldown before Isaac can dash again.	2
Member Card	5.100.602	Exclusive access!	Adds a trapdoor to every shop that leads to a second shop with a unique stock and marked-up prices.	1
Mercurius	5.100.590	Speed up + you feel elusive	+0.4 speed. Doors stay open after entering a room, even in rooms with enemies.	3
Monstrance	5.100.574	Purifying light	Isaac gains an aura that deals damage to enemies inside it.	2
Montezuma's Revenge	5.100.680	Oh no...	While firing, Isaac charges up a short-ranged Brimstone-like diarrhea beam that shoots behind him.	3
Mucormycosis	5.100.553	Spore shot	Gives Isaac the chance to fire spore tears that stick to enemies and blow up after a few seconds, dealing damage and poisoning nearby enemies and releasing more spores.	3
Nancy Bombs	5.100.563	Random blast +5 bombs	Gives Isaac +5 bombs and gives his bombs random bomb synergies.	1
Neptunus	5.100.597	Open the floodgates	Isaac's mouth fills with tears over time while not firing, up to a cap. Holding the fire button will release all stored tears in rapid succession.	3
Ocular Rift	5.100.606	Stare into the abyss	Gives Isaac the chance to fire tears that create rifts where they land, which damage nearby enemies and pull in enemies, pickups, and tears/shots from all sources.	3
Options?	5.100.670	There might be options	If a room gives a reward when cleared, there will be two different rewards to chose from. Taking one causes the other to disappear.	2
Orphan Socks	5.100.571	Speed up + your feet feel stronger	Prevents creep and floor spikes from damaging Isaac. Also gives Isaac +0.3 speed and 2 soul hearts.	1
Paschal Candle	5.100.567	Keep the flame burning	Gives Isaac a tears bonus based on how many consecutive rooms he's cleared without taking damage.	3
Playdough Cookie	5.100.570	Tasty rainbow	Grants multicolored tears. Each color comes with a different status or tear effect.	3
Pluto	5.100.598	Size down	Significantly shrinks Isaac, allowing him to squeeze between objects and makes some enemy shots pass over him. Also gives +0.7 tears.	3
Psy Fly	5.100.581	Flamboyant protector	Spawns a fly orbital familiar that chases and deflects enemy shots and converts them into homing tears.	3
Purgatory	5.100.634	Help from beyond	While in a room with enemies, spawns cracks on the ground. Walking over these cracks summons ghosts that launch themselves at enemies and explode.	2
Quints	5.100.661	They lurk inside	The first five enemies killed in a room will spawn stationary shooting familiars where they died.	1
Red Stew	5.100.621	Full HP + temporary DMG up	Refills all heart containers. Grants an enormous damage boost that wears off over time.	0
Redemption	5.100.673	Deliver me from evil	Gives Isaac a soul heart and +1 damage if he goes into a Devil Room but doesn't take anything from it.	2
Revelation	5.100.643	Awaken your faith	Grants flight and two soul hearts. In addition to tears, Isaac can charge up and fire a powerful holy laser.	4
Rock Bottom	5.100.562	It's only up from there	Locks Isaac's attributes to their highest values reached.	2
Rocket in a Jar	5.100.583	Rocket propulsion +5 bombs	+5 bombs. If Isaac is currently moving, placing a bomb will instead shoot a fast-moving, explosive rocket in the direction he's facing.	2
Rotten Tomato	5.100.618	Delicious!	Adds a chance to fire tears that Mark enemies. Marked enemies are attacked by other enemies.	1
Sacred Orb	5.100.691	Destined for greatness	Prevents low-quality items from spawning, greatly increasing the quality of items received from all item pools.	4
Salvation	5.100.696	Divine protection	Gives Isaac a halo that summons beams of light on enemies inside it. The halo grows larger the more times Isaac has taken damage this floor.	2
Sanguine Bond	5.100.692	He awaits your offering	Spawns a special set of spikes in the Devil Room. Taking damage from the spikes has a chance to grant a reward.	1
Saturnus	5.100.595	Ring of tears	Upon entering a room, a circle of tears orbits Isaac. Enemy tears have a chance to be caught in orbit, turning them friendly.	1
Sausage	5.100.669	All stats up	Adds a Red Heart container, and increases speed, damage, tears, range, shot speed, and luck.	3
Sol	5.100.588	Radiant victory	Reveals the location of the Boss room. Upon defeating a boss, activates XIX - The Sun, fully recharges Isaac's active item, grants bonus damage and luck for the rest of the floor, and removes curses.	2
Soul Locket	5.100.686	Power of faith	Gives Isaac a permanent stat boost whenever he picks up a soul heart.	2
Spirit Shackles	5.100.674	Unfinished business	On death, Isaac's ghost is chained to his dead body and he can continue to fight with 1/2 of a heart, returning to life after 10 seconds. After it activates, it must be recharged by picking up a soul heart.	3
Spirit Sword	5.100.579	Divine blade	Instead of tears, Isaac swings a sword. Charging does a spin attack and fires a projectile, and a projectile is sometimes fired with normal swings if Isaac has no empty red hearts.	3
Stapler	5.100.708	DMG up	+1 damage. Prevents Isaac from firing tears from one eye, like Cain.	3
Star of Bethlehem	5.100.651	Follow the light	Spawns a star familiar that slowly travels towards the Boss Room, giving an aura that increases damage and tears and grants homing tears.	2
Strawman	5.100.667	A helping hand	Spawns Keeper to fight enemies alongside Isaac. If Keeper dies, he spawns blue spiders and Strawman is removed from Isaac's inventory.	2
Supper	5.100.707	HP up	Grants one full Red Heart container. Heals 1 additional heart of health.	1
Terra	5.100.592	Born to rock	Replaces tears with rocks that deal variable damage, have increased knockback, and can destroy obstacles.	3
The Intruder	5.100.575	Invasive friend	A familiar burrows in Isaac's head, firing 4 slowing tears. Upon taking damage, there's a chance it will burst out of Isaac's head, spawning blue spiders and chasing enemies for the current room.	3
The Stairway	5.100.586	May you get what you came for	Generates a ladder at the start of every floor that leads to a unique Angel Room shop.	3
The Swarm	5.100.693	Infest	Spawns eight orbital flies, which turn into Blue Flies after they block a shot. Each time a room is cleared, spawns another orbital fly.	2
Tinytoma	5.100.645	Itching for revenge	Gives Isaac a Teratoma orbital that blocks shots, deals contact damage, and splits into smaller versions of itself upon taking damage. The smaller versions break into blue spiders.	1
TMTRAINER	5.100.721	ZZaZZ ZZdZZiZZmZZhZZ ZZvZZ ZZoZZ ZZ ZZsZZlZZhZZsZZoZZaZZiZZ	Causes all future items to be "glitched", granting them completely random effects.	2
Tooth and Nail	5.100.663	You feel prickly	Isaac periodically turns into a spiked statue, briefly becoming invulnerable and dealing contact damage.	2
Tropicamide	5.100.659	Tear size + range up	+1.5 range, Increases tear size.	1
Twisted Pair	5.100.698	Double trouble!	Spawns two familiars that float on either side of Isaac and fire tears that use his tears, range, shot speed, and tear effects, and scale with damage.	4
Uranus	5.100.596	Ice tears	Isaac shoots ice tears, which slow enemies and freeze monsters they kill. Frozen enemies slide away and explode into ice shards when touched.	3
Vanishing Twin	5.100.697	He wants revenge	Spawns a familiar that becomes a clone of the floor's boss when entering the boss room. Defeating it drops an extra item.	3
Vasculitis	5.100.657	Clogged enemies	Enemies explode into tears upon death, which inherit the effects of Isaac's tears.	2
Vengeful Spirit	5.100.702	Hot blooded	After taking damage, spawns an orbital wisp that lasts for the entire floor, up to a maximum of six. They fire tears but do not block shots.	2
Venus	5.100.591	HP up + you feel pretty	Adds one red Heart container. Enemies near Isaac become charmed.	1
Voodoo Head	5.100.599	Extra curse rooms	Spawns an additional curse room on each floor.	1
Worm Friend	5.100.682	Clingy buddy	Gives Isaac a Nerve Ending familiar that burrows out of the ground to grab and deal damage to enemies over time.	2

Trinkets[]

Name	ID	Quote	Description
'M	5.350.138	t's broken9Reroll your dest	Using an activated item rerolls it.
A Lighter	5.350.135	Watch the world burn	Adds a chance for enemies to burn upon entering a room.
Adoption Papers	5.350.184	Give them a home	Shops can sell familiars, which will always be at a discounted price.
Apollyon's Best Friend	5.350.186	Attack buddy	Spawns an attack locust familiar which will fly forward while Isaac shoots.
Apple of Sodom	5.350.140	It feels empty	Picking up red hearts, even while at full health, can convert them into blue spiders. The effect may consume hearts needed for healing.
Azazel's Stump	5.350.162	Unleash your inner demon	When clearing a room, adds a chance to turn into Azazel until clearing another.
Beth's Essence	5.350.182	Virtue's reward	Upon entering an Angel Room, spawns 5 wisp orbitals. Giving money to beggars can spawn wisps.
Beth's Faith	5.350.142	My faith protects me	At the beginning of each floor, spawn 4-8 wisps that orbit Isaac and fires tears alongside him.
Blessed Penny	5.350.131	Wealth of purity	Gives a chance to drop a Half Soul Heart when a coin is collected.
Blue Key	5.350.150	Look between the rooms	Doors can be unlocked without using keys. Opening a door this way brings Isaac to an in-between room that resembles ???, with a few monsters.
Brain Worm	5.350.144	Ding!	Tears snap 90 degrees to target enemies that they may have missed.
Broken Glasses	5.350.187	Double vision?	Gives a 33% chance to add a '?' item to Treasure Rooms. Only one item can be taken. The extra items on the alt path are revealed instead.
Broken Padlock	5.350.136	Bombs are key	Locks can be opened with explosions.
Broken Syringe	5.350.132	Mystery medicine	Grants a chance to gain a random syringe effect for the current room.
Charged Penny	5.350.147	Wealth of power	Picking up coins has a chance to give an Active Item charge.
Chewed Pen	5.350.130	It's leaking	Adds a chance to fire tears that slow enemies.
Cricket Leg	5.350.185	Infested	Adds a chance to spawn a random locust when killing an enemy.
Crystal Key	5.350.170	Call to the other side	Adds a chance to automatically create Red Key rooms after clearing a room.
Cursed Penny	5.350.172	Wealth of misery	Picking up coins teleports Isaac to a random room.
Devil's Crown	5.350.146	His special customer	Treasure Rooms are replaced with unique Red Treasure Rooms, offering a Deal with the Devil in place of an item.
Dice Bag	5.350.154	Bonus roll	When Isaac enters a new room, has a chance to give him a Dice item as a consumable for the current room.
Dingle Berry	5.350.163	Oops!	Spawns a Dip Familiar upon clearing a room.
Expansion Pack	5.350.181	Fun extras	Once per room, using an active item triggers another random active item effect.
Flat File	5.350.151	No more spikes	Causes all spikes to retract, making them harmless. Also affects the doors to Curse Rooms.
Forgotten Lullaby	5.350.141	Sing for your friends	Improves the fire rate of Isaac's familiars.
Found Soul	5.350.180	Finally!	Spawns a familiar that copies Isaac's movements and scales with damage and tears. If it takes damage, it will die and respawn on the next floor.
Friendship Necklace	5.350.148	Gather round	Causes familiars to orbit Isaac.
Gigante Bean	5.350.134	Mega farts	Increases the size of Isaac's farts.
Gilded Key	5.350.159	Less is more	Replaces all new chests, except Mega Chests, with Locked Chests.
Hollow Heart	5.350.168	A brittle blessing	Grants an empty bone heart upon entering a new floor.
Holy Crown	5.350.155	Walk the path of the saint	A Treasure Room and Shop appears in the Cathedral.
Ice Cube	5.350.188	Stay frosty	Adds a chance to petrify enemies when entering the room. Killing the petrified enemy freezes it.
Jawbreaker	5.350.129	Don't chew on it	Adds the chance to fire teeth that deal 3.2x damage, similar to Tough Love.
Keeper's Bargain	5.350.171	Money talks	Adds a chance for Devil Deals to cost money instead of health.
Kid's Drawing	5.350.169	Looks familiar...	While held, counts towards the Guppy transformation.
Lil Clot	5.350.176	Mini friend	Spawns a clot familiar that mimics Isaac's movements and tears. It dies for the current room after taking too much damage.
Lucky Sack	5.350.160	Free goodies!	Spawns a Grab Bag upon traveling to the next floor.
Modeling Clay	5.350.166	???	Grants the effect of a random passive Item each room.
Mom's Lock	5.350.153	A piece of her love	Grants the effects of a random Mom item each room.
Mother's Kiss	5.350.156	HP up	Grants one heart container.
Myosotis	5.350.137	Forget me not...	When entering a new floor, up to four uncollected pickups from the previous floor spawn in the starting room.
Nuh Uh!	5.350.165	Don't want!	Replaces keys and coins that spawn in Chapter 4 and beyond with more useful pickups.
Number Magnet	5.350.174	6	Increases the chance of earning a Devil Room by 10%, prevents Krampus from spawning, and generates special Devil Room layouts.
Old Capacitor	5.350.143	Voltage starving	Active items don't charge when clearing rooms. Adds a chance to spawn a Lil' Battery when clearing a room, independent of the room's original drop.
Panic Button	5.350.149	Push in case of emergency	Activates Isaac's active item just before he takes damage.
Perfection	5.350.145	Luck way up. Don't lose it!	+10 Luck. If Isaac takes damage, the trinket is destroyed and its effect is removed.
Polished Bone	5.350.167	Friends from beyond	After clearing a room, adds a chance to spawn a friendly Bony.
RC Remote	5.350.179	Controllable buddies!	Instead of trailing behind Isaac, familiars are directly controlled by the same inputs as Isaac's.
Ring Cap	5.350.164	Twice the bang!	Placing a bomb spawns an extra bomb for free.
Short Fuse	5.350.133	Faster explosions	Bombs placed by Isaac explode quicker.
Sigil of Baphomet	5.350.189	Revel in death	Grants an invulnerability shield for 1 second after killing an enemy.
Strange Key	5.350.175	What could it open?	Unlocks the passageway to ??? and the Hush fight, regardless of the run duration. Using Pandora's Box grants it a special effect, consuming the key.
Swallowed M80	5.350.178	Bang!	Isaac explodes upon taking damage.
Teardrop Charm	5.350.139	It feels lucky	Luck-based tear effects have a higher chance of occurring.
Telescope Lens	5.350.152	Seek the stars	Increases the chance for Planetariums to spawn even if one has been visited and allows Planetariums to spawn in Chapter 4.
Temporary Tattoo	5.350.177	You feel braver	Spawns a chest after clearing a mob Challenge Room, or an item after clearing a boss Challenge Room.
The Twins	5.350.183	I'm seeing double...	Adds a chance to duplicate one of Isaac's familiars when entering a new room.
Torn Card	5.350.157	Death awaits	Every 15 shots, Isaac shoots an Ipecac + My Reflection tear.
Torn Pocket	5.350.158	A hole in your pocket	Upon taking damage, Isaac drops 2 random Pickups from his inventory.
Wicked Crown	5.350.161	Walk the path of the wicked	A Treasure Room and Shop appears in Sheol.
Your Soul	5.350.173	Give it to me	Can be used to pay for a Devil deal without losing hearts, and is then consumed.

Pickups[]

Hearts[]

Heart	ID	Image	Worth	Additional Info	Unlocked By
Rotten Heart	5.10.12			Rotten Hearts fill up one whole heart container, or the rightmost Red Heart if all of Isaac's heart containers are full. (It isn't possible to have one-half a Rotten Heart; they are always depleted in one hit.) Each Rotten Heart in Isaac's life bar spawns two Blue Flies upon clearing a room.	Enter the Corpse for the first time

Coins[]

Coin	ID	Image	Worth	Additional Info	Unlocked By
Golden Penny	5.10.7		1	Spawns another golden penny in a random spot in the same room after being picked up, but has a 5% chance of disappearing instead.	Defeat Mega Satan as Tainted Keeper

Bombs[]

Bomb	ID	Worth	Additional Info
Golden Troll Bomb	4.18	0	Similar to troll bombs, spawns already ignited and cannot be picked up. However, it explodes endlessly, similar to unlimited bombs of the golden bomb pickup. Safety Scissors will turn this into a Golden Bomb before it explodes.
Giga Bombs	5.40.7	1	Thrown by Bombgaggers and are spawned naturally in some rooms in Ashpit. Explodes and destroys tiles in a diamond shape. Can be obtained by the player with Safety Scissors or Everything Jar.
Throwable Bomb	5.41	0	Can only be picked up and thrown, explodes in a few seconds after pickup. Spawned only by the Bomb Grimace enemy.

Batteries[]

Battery	ID	Worth	Additional Info	Unlocked By
Micro Battery	5.90.2	2 Charges.		Always Available
Mega Battery	5.90.3	Fully charges the player's Active Item twice.		Always available
Golden Battery	5.90.4	Fully charges the player's Active Item.	Damages the player for a full heart when picked up, and reappears somewhere else in the floor.	Defeat Mega Satan as Tainted Forgotten

Pills[]

Pill effects[]

Pill	ID	Effect	Unlocked By
Shot Speed Down	47	-0.15 shot speed.	Always available
Shot Speed Up	48	+0.15 shot speed.	Always available
Experimental Pill	49	Increases one attribute and decreases another randomly, with the same power as normal attribute up/down pills. If taken with PHD, it will not reduce an attribute.	Always available

Gold Pills[]

Gold Pills (or Golden Pills) can be used multiple times and grant a random pill effect, even from pills not in the pill pool. Every time a Golden Pill is used it has a chance of being consumed. Its Horse Pill variant will make it give only Horse Pill Effects.

Pill	ID	Image	Effect	Unlocked by
Gold Pill	5.70.14		Gives random pill effects and disappears after a random amount of uses.	Defeat Mega Satan as Tainted Cain

Horse Pills[]

Horse Pills appear as larger versions of the standard pills with a more powerful effect, and their effects and appearances are similarly randomly chosen. All items that work with pills work identically with horse pills. A horse pill with a given effect has the same color as the normal pill does. Unlocked by: Defeat Mega Satan as Tainted Eve

Horse Pill	Effect
Bad Gas	The poison applies to the entire room.
Bad Trip	Two hearts of damage. If Isaac would not survive, the pill becomes Full Health.
Balls of Steel	Grants four soul hearts.
Bombs are Key	The number of bombs and keys is increased by 50% while swapping.
Explosive Diarrhea	Spawns more bombs, boosted with Mr. Mega and Bobby-Bomb.
Full Health	Fully heals and grants 3 soul hearts.
Health Down	Removes two heart containers. If this is not possible, the pill becomes Health Up.
Health Up	Adds two empty red heart containers.
I Found Pills	Isaac's face gets a permanent, very exaggerated expression.
Puberty	Isaac gains very fluffy hair covering his entire head and even face.
Pretty Fly	Spawns a Big Fan instead. There is no upper limit.
Range Down	-1.20 range.
Range Up	+1.50 range.
Speed Down	-0.24 speed.
Speed Up	+0.30 speed.
Tears Down	-0.56 tears.
Tears Up	+0.70 tears.
Luck Down	-2 luck.
Luck Up	+2 luck.
Telepills	Unknown
48 Hour Energy	Spawns more batteries.
Hematemesis	Spawns more hearts.
Paralysis	The effect lasts 4 seconds.
I can see forever!	In addition to the normal effect, fully reveals the map like The Mind.
Pheromones	The charm is permanent, turning the enemies friendly.
Amnesia	Unknown
Lemon Party	The puddle covers nearly the entire room.
R U a Wizard?	The effect lasts 60 seconds.
Percs	Unknown
Addicted	Unknown
Re-Lax	The effect lasts much longer, with high speed long enough to cover nearly the entire room.
???	Unknown
One makes you larger	Size increases by two steps.
One makes you small	Size decreases by two steps.
Infested!	Double the number of spiders spawned.
Infested?	Double the number of spiders spawned.
Power Pill!	In addition to the normal effect, grants Huge Growth for +7 flat damage and +3 range. The Huge Growth bonus persists after the Gamekid wears off.
Retro Vision	Lasts 90 seconds, with no breaks.
Friends 'Till The End!	Double the number of flies spawned.
X-Lax	The pool lasts much longer.
Something's wrong...	The pool lasts much longer.
I'm Drowsy...	Unknown
I'm Excited!!!	Unknown
Gulp!	Unknown
Horf!	Isaac shoots a small cluster of Horf! tears, with varying power above normal Horf!.
Feels like I'm walking on sunshine!	The effect is upgraded to The Gamekid.
Vurp!	If the last pill was a normal pill, it becomes a horse pill. No further difference on horse pills themselves.
Shot Speed Down	-0.30 shot speed.
Shot Speed Up	+0.30 shot speed.
Experimental Pill	The two effects are doubled in power.
Gold Pill	The random effects are doubled.

Consumables[]

Reversed Cards[]

Name	ID	Unlock method	Message	Description
0 - The Fool?	5.300.56	Defeat Ultra Greedier as Tainted Lost	Let go and move on	Drops all hearts and pickups on the floor, leaving Isaac at half a heart. Will kill Isaac if he has only soul hearts and all empty red heart containers. Pickups may be spawned as items such as A Quarter and Boom!.
I - The Magician?	5.300.57	Defeat Ultra Greedier as Tainted Judas	May no harm come to you	Grants a repelling blue aura for one minute, like The Soul but stronger and with a wider area of effect.
II - The High Priestess?	5.300.58	Defeat Ultra Greedier as Tainted Lilith	Run	Mom's leg starts stomping down repeatedly for one minute, like holding Broken Shovel.
III - The Empress?	5.300.59	Defeat Ultra Greedier as Tainted Eve	May your love bring protection	Grants 2 temporary red heart containers and +1.35 tears for one minute, along with Magdalene's hairstyle. Does not stack.
IV - The Emperor?	5.300.60	Defeat Ultra Greedier as Tainted ???	May you find a worthy opponent	Teleports Isaac into an extra Boss Room from the boss pool two floors deeper than the current floor (including final bosses if the final floor is two floor ahead or less). The boss will drop a reward, but the room has no trapdoor, so Isaac cannot enter the next floor. The room has an exit door, which leads Isaac back to where he used IV - The Emperor?.
V - The Hierophant?	5.300.61	Defeat Ultra Greedier as Tainted Bethany	Two prayers for the forgotten	Spawns 2 Bone Hearts.
VI - The Lovers?	5.300.62	Defeat Ultra Greedier as Tainted Magdalene	May your heart shatter to pieces	Spawns a random item from the current room's item pool. Turns 1 red heart container or 2 soul hearts into a broken heart, potentially fatally; no downside for any character who has no health bar; Tainted Keeper locked to 1 HP.
VII - The Chariot?	5.300.63	Complete Hot Potato (challenge #42)	May nothing walk past you	Isaac becomes an invincible statue with extreme fire rate for 10 seconds. The statue can be nudged slightly by moving and is affected by knockback.
VIII - Justice?	5.300.64	Complete Cantripped (challenge #43)	May your sins come back to torment you	Spawns 2 to 4 Golden Chests.
IX - The Hermit?	5.300.65	Complete Red Redemption (challenge #44)	May you see the value of all things in life	"Sells" items and pickups in the room for their usual shop price, spawning a matching amount of coins. Does not affect grab bags. If there is nothing to sell, spawns a penny.
X - Wheel of Fortune?	5.300.66	Defeat Ultra Greedier as Tainted Cain	Throw the dice of fate	Invokes a random dice room effect.
XI - Strength?	5.300.67	Defeat Ultra Greedier as Tainted Samson	May you break their resolve	All enemies in the room are weakened, becoming slow and take double damage. The effect lasts up to one minute or until the room is left.
XII - The Hanged Man?	5.300.68	Defeat Ultra Greedier as Tainted Keeper	May your greed know no bounds	Isaac turns visually into Keeper for 30 seconds, with a triple shot, no damage bonus, and -0.1 speed. Killed enemies drop random coins.
XIII - Death?	5.300.69	Defeat Ultra Greedier as Tainted Forgotten	May life spring forth from the fallen	Invokes a Book of the Dead effect.
XIV - Temperance?	5.300.70	Complete DELETE THIS (challenge #45)	May your hunger be satiated	Forces Isaac to eat 5 random pills in quick succession.
XV - The Devil?	5.300.71	Defeat Ultra Greedier as Tainted Azazel	Bask in the light of your mercy	Invokes The Bible (which can kill Mom), and grants Isaac flight and a Seraphim familiar for 30 seconds.
XVI - The Tower?	5.300.72	Defeat Ultra Greedier as Tainted Apollyon	Creation brings destruction	Spawns 6 clusters of random rocks and other obstacles. Spawned clusters will often contain tinted rocks, with the possibility of more than one spawning in one room. The pathways between exits can't be blocked.
XVII - The Stars?	5.300.73	Defeat Ultra Greedier as Tainted Isaac	May your loss bring fortune	Removes Isaac's oldest passive item, including starting items, and spawns 2 random items from the current room's item pool. Doesn't spawn anything if Isaac has no items.
XVIII - The Moon?	5.300.74	Defeat Ultra Greedier as Tainted Jacob	May you remember lost memories	Teleports the player to the Ultra Secret Room. The pathway back to the normal rooms will be made of red rooms.
XIX - The Sun?	5.300.75	Defeat Ultra Greedier as Tainted Jacob	May the darkness swallow all around you	Gain Spirit of the Night and +1.5 damage for the current level. Turns Isaac's red hearts into bone hearts, but they revert once the effect ends. Also causes Curse of Darkness that cannot be dispelled.
XX - Judgement?	5.300.76	Defeat Ultra Greedier as Tainted Lazarus	May you redeem those found wanting	Spawns a Restock Machine.
XXI - The World?	5.300.77	Defeat Ultra Greedier as Tainted Eden	Step into the abyss	Spawns a trap door to a crawl space.

Playing Cards[]

Name	ID	Icon	Unlock method	Message	Description
Queen of Hearts	5.300.79		Defeat Mega Satan as Tainted Magdalene	<3	Spawns 1-20 full red hearts.

Other Cards[]

Name	ID	Icon	Unlock method	Message	Description
Wild Card	5.300.80		Defeat Mega Satan as Tainted Eden	Again	When used, copies the effect of the most recently used pill, card, rune, soul stone or activated item.

Runes[]

Name	ID	Icon	Unlock method	Message	Description
Rune Shard	5.300.55		Always available	It still glows faintly	Activates a random, weak rune effect: Algiz grants a 3 second shield, Ansuz reveals the map up to 3 rooms away, Berkano gives 1 blue fly and spider, Dagaz gives half a soul heart, Ehwaz makes a trapdoor, Hagalaz destroys some rocks, Jera duplicates one pickup and Perthro rerolls one item.

Soul Stones[]

Name	ID	Unlock method	Message	Description
Soul of Isaac	5.300.81	Defeat Hush and Boss Rush as Tainted Isaac	Reroll... or not	Rerolls the items in the room like The D6, but they cycle back to their original form after one second, repeating. If more uses are stacked, an additional item per use will be cycled through.
Soul of Magdalene	5.300.82	Defeat Hush and Boss Rush as Tainted Magdalene	Give me your love!	Surrounds Isaac with a bubbling red aura for the current room. All enemies killed drop red half hearts that disappear in 2 seconds.
Soul of Cain	5.300.83	Defeat Hush and Boss Rush as Tainted Cain	Opens the unopenable	Opens all doors in the room. Additionally, creates a red room like the Red Key for every possible red exit. This also destroys the mirror located in Downpour/ Dross II.
Soul of Judas	5.300.84	Defeat Hush and Boss Rush as Tainted Judas	Right behind you	Stops time for 3 seconds and invokes Dark Arts, turning Isaac into a phantom that can pass through enemies to paralyze them, then attack them for quickly increasing chained damage and damage bonuses.
Soul of ???	5.300.85	Defeat Hush and Boss Rush as Tainted ???	Chemical warfare	Causes 8 poison farts that leave lingering brown creep, then plants a trail of 7 Butt Bombs in quick succession. Standing on the creep gives +1.35 tears and +1 damage.
Soul of Eve	5.300.86	Defeat Hush and Boss Rush as Tainted Eve	Your very own murder	14 Dead Bird familiars fly in and attack enemies. They leave after all victims are dead or Isaac leaves the room.
Soul of Samson	5.300.87	Defeat Hush and Boss Rush as Tainted Samson	Slay a thousand	Isaac turns berserk (similar to Tainted Samson) for 10 seconds, gaining +0.4 speed, some tears and +3 flat damage along with his melee attack.
Soul of Azazel	5.300.88	Defeat Hush and Boss Rush as Tainted Azazel	Demon rage!	Activates Mega Blast for 7.5 seconds.
Soul of Lazarus	5.300.89	Defeat Hush and Boss Rush as Tainted Lazarus	Life after death	Isaac dies, and is immediately revived at half a heart remaining in the same room, with some invincibility time. The soul stone is automatically used upon taking fatal damage, functioning as a minimal extra life.
Soul of Eden	5.300.90	Defeat Hush and Boss Rush as Tainted Eden	Embrace chaos	Uses The D6 and D20. The rerolled items use random pools, as if Chaos were active.
Soul of the Lost	5.300.91	Defeat Hush and Boss Rush as Tainted Lost	Leave your body behind	Isaac "dies" and turns into a ghost (similar to The Lost) for the current room, with all The Lost's benefits and weaknesses. He returns to normal upon leaving the room. Does not allow you to take devil deals for free. Does not allow you to open the door to Mausoleum for free. The Holy Mantle effect gained from this can be stacked with multiple uses.
Soul of Lilith	5.300.92	Defeat Hush and Boss Rush as Tainted Lilith	Motherhood	Adds one permanent familiar from the Baby Shop pool, except Stitches. Unique familiars can be received only once. Appropriate familiars count towards Conjoined.
Soul of the Keeper	5.300.93	Defeat Hush and Boss Rush as Tainted Keeper	$$$	Spawns 1-25 random coins.
Soul of Apollyon	5.300.94	Defeat Hush and Boss Rush as Tainted Apollyon	Bringer of calamity	Spawns 15 random locusts.
Soul of the Forgotten	5.300.95	Defeat Hush and Boss Rush as Tainted Forgotten	Skeletal protector	Spawns The Forgotten as a temporary secondary character, controlled at the same time as Isaac. He dies if his three bone hearts run out, with no further consequence, and disappears when Isaac leaves the room.
Soul of Bethany	5.300.96	Defeat Hush and Boss Rush as Tainted Bethany	Friends from beyond	Spawns 6 Book of Virtues wisps with random properties.
Soul of Jacob and Esau	5.300.97	Defeat Hush and Boss Rush as Tainted Jacob	Bound by blood	Spawns Esau as a temporary secondary character, controlled at the same time as Isaac. He dies if his health runs out, with no further consequence, and disappears when Isaac leaves the room. Esau also has items equal to the number of items the player who spawned him has.

Other[]

Name	ID	Icon	Unlock method	Message	Description
Cracked Key	5.300.78		Open the large version of Mom's Box in Home	???	Creates a room adjacent to a viable wall, like Red Key.

Chests[]

Chest	ID	Additional Info	Unlocked By
Old Chest	5.55	Old Chests are similar in appearance to Golden Chests, but have the color of a normal Chest and a worn-down appearance. They have the same requirements as locked chests. Pulls from the Old Chest item pool.
Wooden Chest	5.56	Wooden Chests appear similar to normal Chests but have an appearance similar to wood. Pulls from the Wooden Chest item pool.	Defeat Mega Satan as Tainted Lazarus
Mega Chest	5.57	Mega chests appear similar to Golden Chests but are larger in appearance.	Defeat Mega Satan as Tainted Isaac
Haunted Chest	5.58	Haunted Chests appear nearly identical to normal Chests until Isaac gets close to them, at which point a Polty picks up the chest and throws it at Isaac, doing half a heart of damage and breaking open the chest.	Defeat Mega Satan as Tainted Lost
Mom's Chest	5.390	Mom's Chest appears in Home. Mom's chest has no requirements to open. Contains a Red Key upon the first visit. Contains a random Mom-related item or Red Key upon subsequent visits of Home.

Sacks[]

Sack	ID	Image	Additional Info	Unlocked By
Black Sack	5.69.2		Spawns 2-3 pills, black or bone hearts and/or bombs when collected.	Defeat Mega Satan as Tainted Judas

As well, Sacks can spawn in shops for 7 coins.

Monsters[]

Bosses[]

Enemies[]

Entity	ID	Description
Deep Gaper	811.0	Emerges off the floor once all previous enemies have been killed, then proceeds to chase Isaac like a normal Gaper.
Blurb	813.0	Walks slowly towards Isaac. After taking some damage or getting close to Isaac, it fires a chaotic burst of tears at him and chases him more quickly.
Crackle	87.1	Walks toward Isaac, spitting balls of fire that create lines of fire in the cardinal directions on impact.
Wraith	807.0	Walks toward Isaac, dealing contact damage. Can only be seen through its reflection and ripples it leaves in the water as it moves.
Rotten Gaper	10.3	Walks toward Isaac, dealing contact damage. Its behavior varies slightly depending on its facial expression.
Dead Isaac	912.20	Summoned by Mother at the bottom of the arena, and walks up towards Mother. Releases a burst of blood shots upon being killed by Mother, while she launches their corpses towards Isaac.
Twitchy	851.0	Alternates between walking towards and rapidly leaping at Isaac.
Level 2 Gaper	850.0	Walks towards Isaac, dealing contact damage. Splits into a Level 2 Horf and Level 2 Gusher upon death.
Faceless	827.0	Wanders around the room, rarely firing a radial burst of six shots. Chases Isaac and fires shots more frequently after taking damage.
Fanatic	832.1	Transformed into from Exorcists. Chases Isaac and occasionally fires two purple, rotating shots.
Exorcist	832.0	Summons The Heretic before transforming into Fanatics.
Dump	876.0	Slides toward Isaac, leaving a trail of slippery brown creep. After taking enough damage, its head slides off and quickly bounces around the room and its body spews out brown shots until it empties.
Dump Head	876.1	Quickly slides toward Isaac, leaving a trail of slippery brown creep. Can spawn on its own or be created by a Dump after it takes enough damage.
Level 2 Gusher	850.2	Runs aimlessly around the room, spitting up Small Maggots.
Sub Horf	812.0	Stationary enemy that spins and fires shots while being moved around or knocked back.
Necro	828.0	Stationary enemy that summons unlimited-ranged bones to attack Isaac.
Tainted Sub Horf	812.1	Will only shoot when hit. Takes heavy knockback and rotates when hit. Shoots a lot faster and has bigger projectiles than its normal variant.
Level 2 Horf	850.1	Slowly floats toward Isaac, spitting Small Maggots at him.
Army Fly	868.0	Chases Isaac, moving along the cardinal directions. Forms a line with other Army Flies in the room. Deals contact damage.
Willo	808.0	Flies in a circle around Isaac (in formation with other Willos if available), keeping an exact distance away from him. One Willo at a time will occasionally light up and fire a shot at Isaac.
Ultra Famine Fly	951.11	Charges at Isaac at a delay. Deals contact damage. Spawned by Ultra Famine.
Ultra Pestilence Fly	951.21	Flies in swarms around Ultra Pestilence, blocking shots and dealing contact damage.
Fly Bomb	819.0	Flies toward Isaac, circling around him as it does. Turn into a tiny bomb upon death.
Eternal Fly Bomb	819.1	Orbits Boom Flies spawned by The Horny Boys. Once its Boom Fly has been killed, turns into a tiny Bomb.
Ink	61.2	Flies slowly towards Isaac. Fires four tar shots in the ordinal directions and leaves a puddle of slowing Black Creep upon death.
Tainted Sucker	61.7	Flies slowly towards Isaac. Upon death, fires a radial burst of six blood shots that each also fires a radial burst of six blood shots.
Bulb	61.5	Flies in erratic, angled movements toward Isaac if his active item has charges. Drains active item charges instead of dealing damage.
Bloodfly	61.6	Flies in erratic, angled movements toward Isaac. Fires four blood shots in the cardinal directions upon death.
Tainted Pooter	14.2	Slowly drifts toward Isaac, occasionally firing four blood shots at him that split into two smaller ones when they hit a wall or obstacle.
Mama Fly	61.4	Wanders aimlessly around the room, occasionally creating Pustules.
Grilled Clotty	15.3	Quickly and randomly wanders around the room, firing four flame shots in the cardinal directions at a slight angle.
Cloggy	872.0	Randomly wanders around the room, firing four curved brown shots in the cardinal directions. These shots alternate between rotating clockwise and counterclockwise with each shot.
Prey	817.0	Wanders around the room, avoiding Isaac and spawning Small Leeches if he gets close. Spawns 3 Small Leeches upon death.
Fartigan	874.0	Chases Isaac, periodically coughing up gas clouds. On death, fires an explosive shot that can detonate gas clouds it hits.
Holy Mulligan	22.2	Wanders around the room, avoiding Isaac and spawning Small Angelic Babies if he gets close. Spawns 1-2 Embryos upon death.
Mullighoul	817.1	Wanders around the room, avoiding Isaac and spawning Willos if he gets close. Spawns 1-2 Willos upon death.
Bouncer	822.0	Wanders around the room, avoiding Isaac. If Isaac stays close to one for long enough, it inflates and starts chasing him, gaining a chance to deflect shots and causing it to explode into lingering blood shots on death.
Tainted Mulligan	22.3	Wanders around the room, avoiding Isaac and spawning 6 Ring Flies if he gets close. Spawns a plethora of fly enemies upon death.
Danny	820.0	Walks toward Isaac and spits chaotic bursts of rocks at him, some of which may be Rock Spiders.
Coal Boy	820.1	Walks toward Isaac and spits hot coals at him, some of which may be Coal Spiders.
Blaster	821.0	Slowly wanders around and occasionally shoots Fly Bombs at Isaac.
Small Maggot	853.0	Slowly crawls toward Isaac, dealing contact damage.
Level 2 Charger	855.0	Slowly moves around the room, charging at Isaac when he gets in its line of sight. Can slowly change its trajectory while charging.
Carrion Princess	23.3	Slowly moves around the room, charging at Isaac when he lines up diagonally with it. Can only be damaged by hitting its tail.
Small Leech	810.0	Chases Isaac continuously, not stopping at walls. Able to swim over gaps.
Elleech	855.1	Slowly moves around the room. After Isaac gets in its line of sight, continuously charges at him in the closest cardinal direction.
Blood Puppy	802.0	Quickly moves around the room, attacking and charging at other monsters and Isaac when they get in its line of sight.
Tainted Spitty	31.1	Slowly moves around the room, firing chaotic bursts of blood shots in all directions and occasionally spitting a line of blood shots in the direction it's facing. Fires two rotating rings of blood shots upon death.
Cursed Globin	24.3	Chases Isaac, dealing a full heart of contact damage. Upon taking enough damage, it collapses into 1-2 piles of goo, each of which can be killed and regenerate after a short period of time if not killed quickly. These goo piles have less health the more times the Cursed Globin splits.
Clickety Clack	889.0	Walks towards Isaac and turn into a pile of bones when killed. Regenerates a few seconds after killed. Will only despawn if all Clickety Clacks in the room are killed.
Cohort	857.0	Acts similarly to Monstro, hopping towards Isaac and can either spit a large projectile towards Isaac that bursts into 8 smaller projectiles or cough up a burst of arcing projectiles and a pile of Globin goo. Spawns 4 piles of Globin goo upon death.
Gasbag	856.0	Occasionally summons Army Flies to chase Isaac. Is surrounded by a ring of toxic gas that hurts Isaac if he stands in it for too long.
Dragon Fly	25.3.0	Flies around the room diagonally, dealing contact damage. Upon death, creates four lines of fire in the cardinal directions.
Dragon Fly X	25.3.1	Flies around the room diagonally, dealing contact damage. Upon death, creates four lines of fire in the ordinal directions.
Bone Fly	25.4	Flies around the room diagonally, dealing contact damage. Fires bones at Isaac if he lines up with it in the cardinal directions. Fires a radial burst of 3 bones upon death.
Sick Boom Fly	25.5	Flies around the room diagonally, dealing contact damage and trailing poisonous gas. Upon death, explodes into a gas cloud and fires a ring of 6 green shots.
Tainted Boom Fly	25.6	Flies around the room diagonally, dealing contact damage. Upon death, sends explosions in a cross-shaped marker across the room.
Hard Host	27.3	Stationary enemy that is normally invulnerable. Raises its head up when Isaac gets close, revealing a fleshy stem that can be damaged. Shortly after raising its head, it slams its head down and fires a rock wave towards Isaac.
Floating Host	859.0	Floats diagonally around the room and is normally invulnerable. When Isaac gets close, reveals a fleshy stem that can be damaged and fires 3 blood shots in an angle at him before hiding its stem again.
Sticky Leaper	34.1	Hops around the room, dealing contact damage. Occasionally jumps high into the air, dropping down onto Isaac's position while creating a chaotic burst of tar shots in all directions and a puddle of slowing black creep.
Eggy	29.2	Hops aimlessly around the room, spawning slowing white creep wherever it hops. Spawns a group of Swarm Spiders upon death.
Tainted Hopper	29.3	Jumps and twirls around the room, shooting 4 rings of projectiles that increase in size with each shot.
Pustule	861.0	Slowly increases in size over time, spawning Small Maggots and damaging red creep depending on its size upon death. If it grows to full size, it transforms into a Bloodfly.
Pon	840.0	Hops around the room, leaving damaging red creep wherever it lands. Upon death, its associated Brainless Knight dies with it.
Gyro	824.0	Rolls around like a wheel. Charges at Isaac when he is in line of sight, bouncing off of walls and obstacles as it does.
Grilled Gyro	824.1	Rolls around like a wheel. Charges at Isaac when he is in line of sight, bouncing off of walls and obstacles and creating fires behind itself as it does.
Angelic Baby (small)	38.1.1	Slowly floats towards Isaac and fires a blood shot at him. Occasionally teleports and reappears elsewhere. Can only be spawned by Holy Mulligans.
Wrinkly Baby	38.3	Dashes towards Isaac at high speed and fires three blood shots in his direction once stopped.
Baby Begotten	883.0	Floats toward Isaac, avoiding his shots. After getting close, fires a short Brimstone laser in the closest cardinal direction and propels itself away from him.
Unborn	860.0	Floats quickly towards Isaac, and occasionally teleports to another position near him.
Vis Versa	836.0	Randomly wanders around the room. Pauses to charge and fire a homing Brimstone laser when Isaac gets in its line of sight.
Evis	865.0	Randomly wanders around the room. Launches a string of guts when Isaac gets close to it, which it uses to pull Isaac toward itself.
Slog	40.2	Attaches itself to a wall or obstacle and rolls around it, charging at Isaac when he is in sight.
Cyst	862.0	Attaches itself to a wall or obstacle and rolls around it, regularly firing blood shots at Isaac.
Loose Knight	41.2	Moves erratically around the room, charges toward Isaac when in line of sight. When its health is depleted, it turns into a Brainless Knight and a Pon.
Brainless Knight	41.3	Alternates between running around the room along the cardinal directions and aimlessly walking in circles. Charges at Isaac when in line of sight. Dies when its corresponding Pon dies.
Black Knight	41.4	Moves erratically around the room, charges toward Isaac when in line of sight. Unleashes waves of fire in all cardinal directions upon charging into an obstacle. Shots that hit it from the front are deflected back at Isaac.
Whipper	834.0	Runs around the room, sprinting at Isaac when he gets in its line of sight and lashing at him when it gets close.
Snapper	834.1	Runs around the room, sprinting at Isaac when he gets in its line of sight and throwing out its whip when he gets in range.
Flagellant	834.2	Runs around the room. When Isaac gets in its line of sight, continuously chases him and lashes its whip, occasionally deflecting Isaac’s shots.
Adult Leech	854.0	Wanders around the room, quickly charging at Isaac when he lines up diagonally with him and releasing a ring of blood shots upon colliding with a wall. Occasionally burrows into the ground and reappears out of a wall or from above Isaac.
Dead Meat	57.2	Slowly moves around the room, occasionally hopping and firing 8 large blood shots in all directions that bounce off the walls. Splits into 2 Cysts upon death.
Holy Eye	60.2	Rapidly summons several beams of light around Isaac every few seconds.
Strider	814.0	Erratically swims around the room. If it sees Isaac, it chases him, trying to deal contact damage.
Swarm Spider	884.0	Very erratically hops toward Isaac in large groups, dealing contact damage.
Rock Spider	818.0	Slowly crawls around the room. If it sees Isaac, it crawls at him, trying to deal contact damage. Turns into a Spider upon death. Turns into a Coal Spider if it touches fire.
Tinted Rock Spider	818.1	Quickly crawls around the room. If it sees Isaac, it crawls at him, trying to deal contact damage. Turns into a Soul Heart upon death. Can only spawn by breaking tinted rocks on Mines or Ashpit.
Coal Spider	818.2	Quickly crawls around the room. If it sees Isaac, it crawls at him, trying to deal contact damage. Turns into a hot coal upon death that blocks shots and deals contact damage, but can be destroyed.
Butt Slicker	878.0	Moves erratically around the room unless attached to another Butt Slicker. Grouped Butt Slickers drag themselves towards Isaac, and when an individual is killed they leave black creep, and shoot out black projectiles. The amount of projectiles released and the size of the pool of Black Creep is determined by the amount of Butt Slickers attached.
Mask II + 1/2 Heart	92.1	The Mask is invulnerable and moves around erratically, charging at Isaac when he lines up with it. The Heart avoids Isaac and fires 4 blood shots in the ordinal directions when Isaac gets near. Killing the Heart will automatically kill the Mask. If there are more than one 1/2 Heart in the room, they will fire blood shots between each other.
Peeping Fatty	835.0	Has two indestructible Peeping Fatty Eyes that are out of their sockets but attached by muscles. Wanders around the room randomly, or toward Isaac if its eyes see him. Occasionally farts and fires a radial burst of 6 blood shots.
Bloaty	879.0	Lumbers around, occasionally spitting green shots and a line of damaging green creep in a random direction.
Bubbles	806.0	Slowly walks towards Isaac, firing back shots upon taking damage. Occasionally farts, which pushes Isaac and adjacent enemies away and creates a chaotic burst of shots. Creates a geyser of water shots upon death.
Shady	888.0	Walks slowly toward Isaac, occasionally firing a shot that creates shots perpendicular to itself while traveling and splits into a ring of shots upon hitting a wall or obstacle. Also occasionally jumps, creating lines of explosions in the cardinal directions.
Quakey	823.0	Walks slowly toward Isaac, occasionally attempting to jump on Isaac, shooting out 8 rock shots when it hits the ground and causing rocks to fall from the ceiling.
Big Bony	830.0	Walks slowly toward Isaac, and will occasionally fire a bone that bounces around the room for a few moments. The bone can be broken if shot enough.
Vis Fatty	886.0	Spawns with a Fetal Demon attached to it and slowly walks towards Isaac. Will occasionally fart, briefly pushing the demon away and spawning creep around itself and the demon. If the demon is killed first, the Fatty will shoot out Brimstone in the diagonal direction closest to Isaac. It will then fly around the room diagonally, bumping off of walls and tall blocks all while continuously firing Brimstone behind it.
Fetal Demon	886.1	Usually encountered tethered to Vis Fatties. When tethered it makes short lunges towards Isaac if he gets close. If the Vis Fatty is killed or when encountered alone it will chase Isaac similarly to Gemini's Suture.
Gutted Fatty	831.0	Slowly lumbers around the room, occasionally spawning Festering Guts. Its eyes dislocate as it takes damage, which are invincible and follow the Gutted Fatty but chase Isaac if he gets close to them. Creates a geyser of blood projectiles upon death.
Festering Guts	279.20	Spawned by Gutted Fatties, Festering Guts randomly slide around the room and occasionally spawn a Charger.
Tainted Faceless	827.1	Wanders around the room, rarely firing a radial burst of six shots. Chases Isaac and fires shots very frequently after taking damage.
Cursed Death's Head	212.2	Invulnerable enemy that moves diagonally around the room, dealing contact damage. If Isaac enters its purple aura, he will be inflicted with fear and be temporarily unable to shoot. Dies when the room is cleared.
Brimstone Death's Head	212.3	Invulnerable enemy that moves diagonally around the room, pausing to fire a Brimstone laser when Isaac lines up with it in the cardinal directions. Dies when the room is cleared.
Dusty Death's Head	887.0	Invulnerable enemy that moves across the room in a waving motion in large quantities. Dies when the room is cleared.
Redskull	212.4	Moves diagonally around the room, creating a ring of fire around itself if Isaac gets close to it. Can be killed, but also dies when the room is cleared.
Ultra Death Head	951.42	Invulnerable enemy spawned by Ultra Death that moves across the room in a waving motion in large quantities as a part of one of his attacks. Dies upon the completion of the attack.
Level 2 Willo	838.0	Orbits enemies and shoots tears at Isaac. If the enemy it is orbiting dies, it will orbit another enemy. However, if all enemies are dead, it will chase Isaac, while still occasionally shooting at Isaac.
Migraine	869.0	Crawls around the room erratically, following Isaac and dealing contact damage. Can jump small distances. Releases multiple Troll Bombs upon death.
Big Corn	217.3	Quickly dashes in random directions, dealing contact damage. Shoots one piece of corn upon death.
Drip	870.0	Quickly rolls around in diagonal directions, dealing contact damage.
Splurt	871.0	Dashes towards Isaac twice and deals contact damage. Spawns 2 Drips upon death.
Hardy	826.0	Dashes toward Isaac and deals contact damage creating rock projectiles when it hits a wall/obstacle. It spawns more rock projectiles the more times it crashes into obstacles, dying after doing so a third time.
Revenant	841.0	Slowly wanders around the room, stopping to fire a large line of fire at the player.
Quad Revenant	841.1	Wanders around the room slowly, stopping to fire lines of flames in the cardinal or ordinal directions, rotating in an attempt to hit Isaac.
Maze Roamer	890.0	Wanders around the room and shoots an eyeball at Isaac when he is in sight. Has a clone of itself on the other side of the room that mimics its movement and shots. If one dies, the other starts actively pursuing Isaac.
Holy Bony	227.1	Wanders around the room, throwing a bone at Isaac when he is in sight. The thrown bone leaves behind a blue flame that deals contact damage, blocks Isaac’s shots, and despawns after some time.
Planetoid	229.1	Moves around the room diagonally, occasionally firing blood shots that orbit itself. Fires more shots and has a chance to send its ring of shots outward upon taking damage.
Poofer	892.0	Slowly floats toward Isaac, swells up and fire 6 blood shots in all direction upon taking damage. Explodes upon death, healing nearby enemies and leaving a big puddle of red creep.
Bishop	805.0	Shields all enemies in the room, preventing them from taking damage. Fires shots in the cardinal directions when it takes damage.
Goat	891.0	Wanders around the room. Occasionally moves toward Isaac, either firing blood shots at him or charging if he lines up on either side of it.
Black Goat	891.1	Wanders around the room. Occasionally moves toward Isaac, either firing blood shots at him or charging if he lines upon either side of it. Can also fire thin Brimstone lasers in the cardinal directions, along with all other Black Goats in the room.
Cultist	885.0	Creates an indestructible, homing Purple Ball at the start of the room and follows it around, occasionally leaving it to revive enemies that have died in the current room.
Blood Cultist	885.1	Wanders around the room and fires a line of blood shots and creep if Isaac is on either side of it. Can summons bone traps that temporarily ensnare Isaac if he walks into them.
Soy Creep	240.1	Slowly crawls along walls to try to line up with Isaac and shoots a stream of shots seemingly affected by Soy Milk.
Tainted Soy Creep	240.3	Slowly crawls along walls to try to line up with Isaac and shoots a 4 diagonal streams of Soy Milk shots.
Fire Worm	825.0	Pops out of the ground in random locations and fires one flame at Isaac.
Tainted Round Worm	244.2	Pops out of the ground in random locations alongside several tail ends. The head fires a large blood shot that splits into a radial burst of 8 blood shots, while the tail ends shoot normal blood shots.
Tainted Tube Worm	244.3	Pops out of the ground in random locations, spitting 4 explosive shots towards Isaac.
Mole	829.0	Burrows towards Isaac and jumps out the ground to fire 3 blood shots at him.
Tainted Mole	829.1	Dig towards Isaac and release a ring of rock waves. Fires 3 blood shots at Isaac 4 times.
Polty	816.0	Picks up and throws rocks and props at Isaac.
Kineti	816.1	Uses telekinesis to pick up and throw rocks and obstacles at Isaac.
Dust	882.0	Follows Isaac, and is only visible when close to Isaac. Will begin to speed up when they are visible. Teleports away after taking enough damage.
Fly Trap	873.0	Floats towards Isaac, with 3 Attack Flies circling around it. Coughs up additional Attack Flies and releases gas to launch the Attack Flies outwards.
Poot Mine	875.0	Creates a gas cloud and propels itself away from Isaac when it gets hit. Explodes on death, detonating all the gas clouds it created.
Bombgagger	844.0	Spits up a Giga Bomb and runs away from it.
Flesh Maiden	880.0	Vaguely flies towards Isaac in curved swooping motions.
Morningstar	863.0	Floats toward Isaac to deal contact damage while Isaac is moving, gaining speed the longer Isaac continues moving. Stops moving when Isaac stops moving.
Needle	881.0	Pops out of the ground and lunges towards Isaac, dealing contact damage.
Pasty	881.1	Pops out of the ground and lunges toward Isaac, dealing contact damage and firing four shots in the ordinal directions.
Fissure	815.0	Jumps out of pits and bounces around the room. Spawns endlessly from pits until room clear. Do not need to be killed to clear room.
Lil Portal	306.1	Spawns fly and spider enemies until it is destroyed.
Henry	837.0	Flushes itself away shortly after Isaac enters the room.
Triple Grimace	42.2	Stationary and invulnerable monster that occasionally fires a triple shot at Isaac. Stops firing when room is cleared.
Quake Grimace	804.0	Stationary and invulnerable monster that jumps and fires a line of rocks in one direction upon landing.
Bomb Grimace	809.0	Stationary and invulnerable monster that keeps a single Throwable Bomb spawned.
Mockulus	864.0	Invulnerable enemy that rapidly floats diagonally over obstacles and bounces off of walls, blocking tears and dealing contact damage. They can only move while Isaac is shooting.
Grudge	877.0	Quickly slides towards Isaac when he gets in its line of sight. Cannot be destroyed.
Ball and Chain	893.0	Spike balls that rotate at the end of a chain attached to an obstacle. If the obstacle is destroyed, the ball will fly free around the room for a while.
Spikeball	852.0	Spike balls that fly in a line either horizontally or vertically, bouncing off walls and obstacles.
Singe's Ball	915.1	Spawned exclusively as apart Singe's boss fight and used in his attacks. They can be pushed around and launched with explosions.
Ultra Death Scythe	951.41	Stays stationary for a moment, then travels in straight lines towards Ultra Death.
Siren Minion	3.220	Spawned in automatically charmed by The Siren. Orbits the boss and fires projectiles towards Isaac.
Siren Helper	966.0	Spawned in by The Siren and takes the form and control of all of her charmed familiars.
Visage Plasma	903.20	Floats in diagonal directions, doing contact damage. Spawned by The Visage and used in its phase 3 attacks.

Champions[]


ID	Appearance	Effect	Drop	Rarity	Notes
24	Brown	Trails poop behind it as it walks.	Nothing	Unknown
25	Rainbow	Combines the effects of champion types 0, 2, 5, 10, 11, 13 and 17.	A coin, a bomb, a key, a heart, a pill, a card and a trinket.	Unknown

Audio[]

The Music is once again composed by Ridiculon.
- Whilst not being in the official release, a fully updated Antibirth soundtrack may be released by Mudeth as a mod.