Binding of Isaac: Rebirth Wiki

Character The Lost iconThe Lost has no health, dying by any damage taken. Therefore, he needs to be played with extreme care. Although possible, it is extremely difficult to finish a full playthrough without getting hit at all. Powerful item combinations are often necessary for a successful run.

General Tips[ | ]

  • Before attempting runs with The Lost, unlock any items that may be helpful for The Lost.
    • It is absolutely suggested to unlock The Lost's intrinsic Collectible Holy Mantle iconHoly Mantle greatly lowering the difficulty of his usage. This can be done by donating 879 coins to the (except in Rebirth) Greed Donation MachineGreed Donation Machine.
  • It is recommended to have advanced knowledge of all types of rooms, champions, and enemies.
  • The Lost's ability to fly can be used to hide safely above obstacles and pits, avoiding enemies and projectile contact.
  • Playing with hard mode is recommended.
    • Large part of the difficulty of hard mode comes from reduced dropping of (except in Repentance)Pickups, especially Hearts. However, hearts are useless for The Lost, (except in Repentance)and the ability to fly gives The Lost more opportunity to get pickups, making the difference between hard mode and normal mode not as much as other characters.
    • Defeating bosses with hard mode can unlock completion marks for both normal and hard mode, and hard mode is required to unlock Collectible Godhead iconGodhead. If the player have an opportunity to get good item combinations in a round, playing with hard mode can make the most of it.
    • (in Repentance)In Repentance, more mechanism are added to hard mode, and certain enemies and bosses have increased shot and movement speed. It's recommended to have some experience on hard mode before trying with the Lost.
  • Bombs can be used to escape rooms you think you cannot handle.
  • The Lost will absorb Soul HeartSoul Hearts, Black HeartBlack Hearts, and Eternal HeartEternal Hearts by picking them up, but will not gain any health from them. It is recommended to avoid picking them up in case the Collectible D20 iconD20, a Dice RoomDice Room (with 3 pips, 2 if the hearts spawn in the Dice Room), or a (except in Rebirth)Dice ShardDice Shard is found later on.
    • The same applies to useless items (except while holding the Collectible D4 iconD4, that can reroll the passive items). If an option to reroll items is found, they can be changed if not yet picked up.
  • Three orbitals of any kind absorb nearly all projectiles. It is recommended to use Slot MachineSlot Machines as much as possible to obtain Pretty Flies.
  • The Lost does not receive Bad Trip or Health Down pills. This makes pills more useful since the pill pool is more likely to have positive effects.
  • (except in Rebirth) With the Missing PosterMissing Poster, a run may be taken to the end with an easier character and finished as The Lost by dying on purpose, granting the unlock for The Lost without doing a full run.
  • (except in Rebirth) Since The Lost does not take damage from the Greed Mode button, you can dramatically limit the number of enemies you have to face at a given time by stepping back onto the button after activating it.
  • The Lost must never use a Blood Donation MachineBlood Donation Machine or a Devil BeggarDevil Beggar as Holy mantle effect won't protect him in this case, resulting in immediate death. The only exception is possessing some source of shield (e.g. Rune of AlgizRune of Algiz).

"The Still Statue"[ | ]

This strategy is very safe and easily played. It combines Collectible Gnawed Leaf iconGnawed Leaf with any automatically damaging familiar. This allows The Lost to enter a room, become invulnerable, and let its familiar clear the room. There are almost no rooms where The Lost gets hit before it enters statue form. This strategy requires a lot of patience.

Although many familiars are not able to clear all types of enemies or rooms, it is still recommended to get any type of familiar the player finds. Some examples are:

  • (in Afterbirth † and Repentance)Collectible 7 Seals icon7 Seals: Extremely powerful, as the harbingers will travel anywhere across a room while spawning locusts and leaving trails of creep. The War and Death harbingers will also chase enemies.
  • Collectible Daddy Longlegs iconDaddy Longlegs: Extremely powerful, because it reaches any enemy and will eventually clear the room against any type of hostiles.
  • Collectible Demon Baby iconDemon Baby and Collectible Gemini iconGemini: Reliably take out enemies nearby, but will not target foes far away.
  • Collectible Leech iconLeech: Can chase after enemies like Lil Haunt, but due to its poor programming, it often gets stuck, causing you to have to move to kill an enemy. It is also unable to pass over pits.
  • Collectible Lil Haunt iconLil Haunt: While not as powerful as Daddy Longlegs, it's one of the few familiars that chase enemies (and don't require you to take damage to summon).
  • Collectible Midas' Touch iconMidas' Touch: Still dealing damages when Collectible Gnawed Leaf iconGnawed Leaf is active, maybe useless against bosses who stay away from The Lost.
  • Orbitals: Provide decent damage against chasing enemies, but are useless against enemies that stay on distance.
  • Collectible The Peeper iconThe Peeper: It reaches any spot of a room and will be able to take out most enemies. A lot of time is required, though.
  • Collectible Robo-Baby 2.0 iconRobo-Baby 2.0: Shoots only horizontal and vertical, not reaching enemies that stay diagonally. Robo-Baby 2.0 will still clear most rooms. If Robo-Baby 2.0 is moved, a statue form will be exited.
  • Collectible Rotten Baby iconRotten Baby and Collectible Sissy Longlegs iconSissy Longlegs: Blue Flies and Spiders target most enemies inside a room. The flies may not attack foes far away, the spiders are unable to pass over pits.
  • (except in Rebirth)Collectible Succubus iconSuccubus: Similar to The Peeper, but with a much larger area of effect. Still has trouble with large rooms, however.
  • Collectible The Virus iconThe Virus: Similar to Midas' Touch, enemies that touch The Lost when Collectible Gnawed Leaf iconGnawed Leaf is active will be poisoned, but is useless against foes and bosses who stay away from The Lost.

Issues[ | ]

Although the strategy is quite safe, game-ending issues likely occur. Some example scenarios are:

  • The Lost fights Boss Loki ingameLoki with a PokyPoky inside the room. The boss will always stay at distance, making familiars like Collectible Distant Admiration iconDistant Admiration useless. Poky pushes constantly against The Lost, forcing him not to move.
  • The Lost fights a room full of Mask HeartMask + Heart, the Hearts being behind a pit. Familiars like Leech are useless, while The Lost is constantly attacked by a Mask.
  • The Lost fights GlobinGlobins, while his follower is not doing enough damage to finish them off after they fell into goo. One Globin is always alive at a time and attacking The Lost.

It is required to have an emergency option if a room cannot be cleared as intended in such scenarios. Spacebar items, cards and pills can be safely activated, even if The Lost in statue form currently has enemy contact. Another option is to exit the run and reenter it by pressing the continue button. This will place the player at the start of the room but all monsters killed would have to be killed again if the player did not clear the room first.

Boss Rush[ | ]

The method may be perfect for the Boss RushBoss Rush fight itself, however, the player will probably be progressing too slow, not finishing Boss Mom ingameMom in time. Therefore this method is not recommended to attain the Boss Rush.

Execution[ | ]

The game is restarted until Collectible Gnawed Leaf iconGnawed Leaf is found in a treasure room adjacent to spawn. Then, the player has to rely on finding proper familiars later on.

"Getting Carried"[ | ]

This strategy is very general, though leading often to success. The goal is to gain a massive offensive potential, killing enemies before they can hurt The Lost. To survive game-ending mistakes, The Lost also tries to find shielding, invulnerability or reviving items. The strategy bases a lot on item luck because some of the most powerful items in the game need to be found early on.

Key Items[ | ]

  • Collectible Brimstone iconBrimstone: Grants massive power, is piercing and spectral, can be charged in the preceding room and instantly fired.
  • (except in Rebirth)Collectible Glass Cannon iconGlass Cannon: Shoots a giant damaging tear with no downside.
  • Collectible Mom's Knife iconMom's Knife: Offers massive damage, is piercing and spectral.
  • Collectible Polyphemus iconPolyphemus Increases tear damage more than most other items. If combined with other damage increasing items, it makes most enemies in the first chapters one-shot and shortens boss fights significantly.
  • The Guppy transformation increases the Lost's offensive potential significantly, and several of the items required for it are useful to the Lost in their own rights.
  • Collectible Dead Cat iconDead Cat: Gives The Lost nine lives.
  • Collectible Holy Mantle iconHoly Mantle: Absorbs the first hit in each room, nullifying a game-ending mistake once per room. It also allows the Lost to enter Curse RoomCurse Rooms and open (except in Rebirth) Spiked ChestSpiked Chests and (in Afterbirth † and Repentance) Mimic chest RepentanceMimic Chests.
    • Care must still be taken when making use of curse rooms, as any damage taken inside of it will nullify the Holy Mantle charge, trapping the Lost inside unless he has some way to generate a shield, teleport out, or extra lives.
    • (except in Rebirth) The Holy Mantle as a starting item can be unlocked by donating 879 coins to the (except in Rebirth) Greed Donation MachineGreed Donation Machine.
  • (except in Rebirth)Collectible Host Hat iconHost Hat, Collectible Infamy iconInfamy, and (in Afterbirth † and Repentance)Collectible Metal Plate iconMetal Plate: Have a chance of blocking or deflecting projectiles that come into contact with the Lost.
    • Also, (except in Rebirth)Collectible Host Hat iconHost Hat will also make the Lost immune to explosions and (except in Repentance)stomp attacks, increasing his survivability further and allowing safer use of items like Collectible Ipecac iconIpecac and Collectible Dr. Fetus iconDr. Fetus.
  • Collectible Lost Contact iconLost Contact Destroys bullets upon contact with tears. It makes "bullet-hell" boss fights like Boss It Lives ingameIt Lives significantly easier.

The goal is to obtain at least one offensive and one defensive item early in the run, additional ones later on. If they are combined with further helpful items, a run becomes very promising.

Note: Collectible Godhead iconGodhead and Collectible Sacred Heart iconSacred Heart are also major offensive key items. However, it is assumed the player has not yet unlocked Godhead. Sacred Heart can earliest be found on the third floor (except in Repentance) with very low chances, is therefore not mentioned.

Issues[ | ]

  • Although you can restart a game until you find a key item in the first treasure room, you are still dependent on item luck later in the run.
  • (except in Repentance) Many key items are special items, lowering the chances of finding such combinations.
  • Running only with key items may not be enough, therefore additional damage ups or emergency options may be necessary.

Boss Rush[ | ]

This method is well suited for the Boss RushBoss Rush because The Lost can progress quite fast with his massive damage output. The Boss Rush fight itself shall be done with extreme care because many defensive Items lose most of their value in a long fight:

  • Collectible Dead Cat iconDead Cat would revive you outside, ruining the attempt.
  • Collectible Holy Mantle iconHoly Mantle will still trigger once in the Boss Rush fight, but that may not be enough for the whole duration of the fight.

Execution[ | ]

The game is restarted until one of the key items is found in a Treasure RoomTreasure Room adjacent to spawn. Afterward, the player has to rely on finding additional key items and synergies later on.

Note that Collectible Brimstone iconBrimstone can only be found in Devil RoomDevil Rooms, and Collectible Dead Cat iconDead Cat only in Curse RoomCurse Rooms, Devil RoomDevil Rooms and Red ChestRed Chests. The player may decide if they want to check on these opportunities or rather restart instantly.

Some players enter a Curse RoomCurse Room if it is located adjacent to the start. (in Rebirth) This will usually be fatal. Rarely, though, a Collectible Dead Cat iconDead Cat can be found in it. This behavior can make sense, as the run would anyway have gotten restarted without a Treasure RoomTreasure Room next to the spawn.

"Remote Control"[ | ]

This method bases around any remotely controlled damage source, such as Collectible The Ludovico Technique iconThe Ludovico Technique, Collectible Blue Baby's Only Friend icon???'s Only Friend, or Collectible Robo-Baby 2.0 iconRobo-Baby 2.0. After entering a room, The Lost tries to find a safe hiding spot as soon as possible, like above an obstacle. After being safe, he uses his remote damage source to finish the room. Acquiring both Collectible The Ludovico Technique iconThe Ludovico Technique and Collectible Lost Contact iconLost Contact can help immensely, especially during the fights against Boss Isaac ingameIsaac and Boss ??? ingame???, as the tear can easily block all enemy shots. Acquiring Collectible The Ludovico Technique iconThe Ludovico Technique and Collectible Strange Attractor iconStrange Attractor can also be very helpful as enemies can be pulled away from The Lost.

Issues[ | ]

  • Many rooms do not contain any safe spot, quickly making the method counterproductive.
  • Flying enemies can reach any spot in the room. Jumping enemies like HopperHoppers can also jump over obstacles if they find a landing spot behind.
  • Collectible The Ludovico Technique iconThe Ludovico Technique prevents The Lost from firing normal tears, which may be fatal in rooms without hiding places.
  • The player may focus on their controlled tear/familiar, rather than watching The Lost, overlooking a deadly danger.

Boss Rush[ | ]

If the player manages to reach the Boss RushBoss Rush room, their odds of beating it are quite good. The Boss Rush room offers some rocks as hiding spots, and many bosses stay quite calm. This allows for a nice damage output with the remotely controlled familiars.

Flying, fast or mobile bosses, like Boss Fistula ingameFistula, may still become problematic, and therefore treated with extreme care. Also, the variety of Collectible Brimstone iconBrimstone and explosive attacks are very dangerous.

Execution[ | ]

The game is restarted until one of the above items is found in a Treasure RoomTreasure Room adjacent to spawn.

Emergency Options[ | ]

The Lost should always be prepared for the unexpected by having an emergency option.
Note: Collectible 9 Volt icon9 Volt ,Collectible The Battery iconThe Battery and (in Repentance)Collectible 4.5 Volt icon4.5 Volt allow a much more flexible use of active items and are generally recommended.

Shield and Invulnerability[ | ]

Becoming invulnerable is often avoiding deadly situations, therefore having such a card or active item is highly recommended.

  • Rune of AlgizRune of Algiz offers a shield for (except in Repentance)30 seconds (in Repentance)20 seconds. Combined with the (except in Repentance)Collectible Blank Card iconBlank Card (in Repentance)Collectible Clear Rune iconClear Rune, it forms one of the best defensive item combinations.
  • Collectible Book of Shadows iconBook of Shadows offers a shield for 10 seconds.
  • Collectible The Gamekid iconThe Gamekid fears all enemies, deals contact damage and offers invulnerability for five seconds.
  • Collectible My Little Unicorn iconMy Little Unicorn and VII - The ChariotVII - The Chariot grant invulnerability and contact damage for five seconds. Collectible Taurus iconTaurus has a similar effect, but is not completely controllable.
  • Collectible Unicorn Stump iconUnicorn Stump grants a 5-second invulnerability, letting The Lost reposition himself safely. It comes with only one charge, thus can be used often.
  • (except in Rebirth)Collectible Car Battery iconCar Battery double-activates 'invulnerable' active items, which means doubling invulnerable durations.
  • (in Repentance)Collectible Mega Mush iconMega Mush turns The Lost into an invulnerable killing machine for 30 seconds.
  • (in Repentance)Collectible Echo Chamber iconEcho Chamber copies all 'invulnerable' cards and runes to the last 3 cards, pills and runes used.
  • (in Repentance)Collectible 4.5 Volt icon4.5 Volt makes The Lost able to recharge the active item and uses them multiple times during a hard fight.
  • (in Repentance)Panic ButtonPanic Button will always automatically activate the active item (If it's available to use) when The Lost is about to take damage, which makes good synergies with all 'invulnerable' items (Including Collectible Butter Bean iconButter Bean and Collectible How to Jump iconHow to Jump).

Teleport[ | ]

Teleportation can be used to avoid run-ending situations by just leaving the room on demand. However, depending on the method used and on the floor the item is used, the player may end up in a random, more dangerous room. Teleporting into a Curse RoomCurse Room can potentially end a run, as under normal conditions they cannot be exited without taking damage. There is also a chance of landing in the I AM ERRORI AM ERROR room, which forces the player to leave items and pickups behind and potentially forces the player to skip an unlock.

Hard Removal[ | ]

Hard Removal describes the option to clear a dangerous room instantaneously on demand. Items offering hard removal are:

  • Chaos CardChaos Card kills any enemy in its path, including bosses (not including (in Afterbirth † and Repentance) Boss Delirium ingameDelirium and (in Repentance) Boss The Beast ingameThe Beast), in one hit. It is very useful for single-targets but doesn't have the area of effect for massive enemy horde rooms.
  • Collectible Flush! iconFlush! clears a room instantly, but doesn't work against bosses, except (except in Rebirth) Boss Brownie ingameBrownie, (in Repentance) Boss Clog ingameClog, Boss Dingle ingameDingle, and (except in Rebirth) Boss Dangle ingameDangle.
  • Collectible Head of Krampus iconHead of Krampus deals massive damage in a cross-pattern, killing all non-boss enemies in its path, and severely damaging bosses.
  • Collectible Magic Fingers iconMagic Fingers can clear a whole room extremely fast if the item is spammed, the damage is high enough and if enough coins are available.
  • Collectible The Necronomicon iconThe Necronomicon and XIII - DeathXIII - Death kill most non-boss enemies in a room.
  • (except in Rebirth)Collectible Toxic Shock iconToxic Shock deals 2x tear damage to all enemies when entering a room.

Resurrection Items[ | ]

These items do still work with The Lost, (except in Repentance) although the life number does not appear on the HUD. They give the player another chance if a fatal mistake was made.

Angel & Devil Rooms[ | ]

Devil RoomDevil Rooms and Angel RoomAngel Rooms appear quite frequently to The Lost because he is not allowed to take damage. (except in Repentance)The Lost can take Devil deals for free. However, Angel RoomAngel Rooms offer some of the most helpful items for The Lost.

(in Repentance)The Lost can only choose one of the available Devil deals.

It is generally recommended to go for Devil deals, and thus hinder Angel Rooms to appear, though the player is free to pursue Angel Rooms if they find them more attractive. Collectible Goat Head iconGoat Head is a strong item to obtain early as it will ensure that The Lost can visit a Devil or Angel Room on every floor except for BasementBasement/CellarCellar/(except in Rebirth)Burning BasementBurning Basement I and everything past WombWomb/UteroUtero/(except in Rebirth)Scarred WombScarred Womb II. (in Rebirth)Collectible The Book of Belial iconThe Book of Belial fulfills a similar effect, however, another spacebar item may be preferred.

Devil Room[ | ]

Although the Devil Room may only contain Black HeartBlack Hearts or Red ChestRed Chests that only contain Soul HeartSoul Hearts, Troll BombTroll Bombs or enemy SpiderSpiders, it usually has helpful items, though some such as (except in Repentance)Collectible Dark Bum iconDark Bum/(in Repentance)Collectible Bloody Lust iconBloody Lust or (except in Repentance)Collectible Razor Blade iconRazor Blade/(in Repentance)Collectible Blood Rights iconBlood Rights can be either useless or dangerous. Some of the most valuable are:

For a full list of Devil Room items see Devil Room item pool.

Angel Room[ | ]

The Angel Room often contains Soul HeartSoul Hearts or Eternal HeartEternal Hearts, being useless for the Lost. Many items that can be obtained are of no use, too, such as Collectible Prayer Card iconPrayer Card or Collectible Celtic Cross iconCeltic Cross, and some such as Collectible Dead Sea Scrolls iconDead Sea Scrolls or Collectible Breath of Life iconBreath of Life can actually be dangerous. However, with luck, one may find a very valuable item, such as:

For all Angel Room items see Angel Room item pool.

Items[ | ]

Positive Items[ | ]

Aside from the already mentioned items, the following are of great use:

  • The Collectible Stop Watch iconStop Watch, unlocked by donating 999 coins to the Donation MachineDonation Machine slows down all enemies in the room, all projectiles, and makes enemies that charge for an attack charge forward very slowly.
    • (except in Rebirth) The Stopwatch was nerfed to only work upon taking damage, although, in a recent update, it now works when the Holy Mantle's shield is depleted.
      • (in Repentance)Although not as powerful as before, Stopwatch still slows everything down to a great degree, allowing more room for error.
  • Collectible Lil Brimstone iconLil Brimstone is similarly beneficial, like Collectible Brimstone iconBrimstone itself.
    • (in Repentance) Lil Brimstone was nerfed and is not as beneficial as before.
  • Items that inflict crowd control status effects such as fear, slow or petrification can be useful. On the other hand, some players dislike these items because they can make enemies move in unpredictable ways.
  • Collectible Black Candle iconBlack Candle removes curses.
  • The Collectible Red Candle iconRed Candle's properties make it one of the most useful items for defeating the waves of mobs and bosses in Greed Mode. Filling the room with flames before pushing the button to start a new wave, although very time-consuming, virtually guarantees a swift victory with very little risk.
    • (in Repentance) This is no longer effective in Repentance because Red Candle's flames now extinguish after a couple of seconds.
    • After multiple re-rolls, the D4 and D100 can be counterproductive. If the item pools are depleted, they will only give The Lost Collectible Breakfast iconBreakfast.
  • Collectible There's Options iconThere's Options and (except in Rebirth)Collectible More Options iconMore Options increase the chances of the Lost finding useful items.
  • Collectible Pyromaniac iconPyromaniac and (except in Rebirth)Collectible Host Hat iconHost Hat grant immunity to explosions, making them especially useful if the player have explosive items such as Collectible Ipecac iconIpecac or Collectible Epic Fetus iconEpic Fetus.
  • Items revealing the map are very useful to avoid unnecessary rooms.
  • Collectible Whore of Babylon iconWhore of Babylon is always active.
  • (except in Rebirth)Collectible Crown Of Light iconCrown Of Light is essentially permanent double damage, as it cannot be deactivated.
  • (except in Rebirth)Collectible Glass Cannon iconGlass Cannon can greatly increase The Lost's damage output without any negative effects.
  • (except in Rebirth)Missing PosterMissing Poster effectively acts as a 1-Up on The Lost.
  • (except in Rebirth)Collectible Empty Vessel iconEmpty Vessel is always active for The Lost. The Lost will benefit from the periodic invincibility it grants.
  • (except in Rebirth)Safety ScissorsSafety Scissors neutralizes the threat of Troll BombTroll Bombs and grants additional bomb pickups.
  • (in Afterbirth † and Repentance)Collectible Void iconVoid can convert health ups or otherwise useless items into stat boosts.
  • (in Afterbirth † and Repentance)Collectible Little Horn iconLittle Horn can destroy almost all 'invulnerable' enemies, PokyPoky and Stone GrimaceStone Grimace before they can hurt The Lost. (in Repentance) Ball and ChainBall and Chain are still invulnerable and dangerous.
  • (in Afterbirth † and Repentance)Collectible Sulfuric Acid iconSulfuric Acid and (in Repentance)Collectible Terra iconTerra can destroy Spiked Rocks without making explosions.
  • (in Repentance)Flat FileFlat File retracts almost all spikes.
  • (in Repentance)Apple of SodomApple of Sodom converts red hearts into blue spiders.
    • Despite red heart-dropping items normally being useless for The Lost, they can be synergized with this item to farm for blue spiders.
  • (in Repentance)PerfectionPerfection is essentially a free +10 Luck, as taking any damage results in death, making the loss of Perfection a non-issue. This can synergize with many Luck-based items:
    • Collectible Tough Love iconTough Love: At 9+ Luck, all tears are replaced with teeth, essentially giving a 3.2x damage multiplier.
    • (in Afterbirth † and Repentance)Collectible Ghost Pepper iconGhost Pepper or (in Repentance)Collectible Bird's Eye iconBird's Eye: At 11+ Luck, The Lost is guaranteed to shoot fires, which effectively damage enemies and block enemy projectiles.
  • (in Repentance)VI - The Lovers?VI - The Lovers? has no downside for The Lost, generating free items with no loss of durability or risk of death.
  • (in Repentance)Collectible Birthright iconBirthright allows Character The Lost iconThe Lost to remove useless item from item pool similar to Character Tainted Lost iconTainted Lost, but still allows the player to find strong defensive items like Collectible Dead Cat iconDead Cat.
  • (in Repentance)Collectible Psy Fly iconPsy Fly helps greatly with protecting The Lost from bullets, making bullet-heavy bosses like Boss Hush ingameHush and Boss Mother secondphase ingameMother much more bearable.
  • (in Repentance)Collectible Paschal Candle iconPaschal Candle stays at maximum level, as it cannot be deactivated.
  • (in Repentance)Collectible Heartbreak iconHeartbreak prevents The Lost from fatal damage for 4 times.
  • (in Repentance)Collectible Spirit Shackles iconSpirit Shackles, along with a way to generate soul hearts like Collectible Book of Revelations iconBook of Revelations can essentially act as an extra life with a room charge and also make soul hearts no longer useless.
  • (in Repentance)Collectible Berserk! iconBerserk! and (in Repentance)Soul of SamsonSoul of Samson allow the Lost to survive taking damage.
  • (in Repentance)Collectible Binge Eater iconBinge Eater makes HP ups useful as each will give one stat up depending on the item and temporary damage up at a cost of a very small speed down.
  • (in Repentance)Collectible Knockout Drops iconKnockout Drops: At 8+ luck, all tears will knock enemies back, which is useful for keeping contact damage enemies away from The Lost.

Useless Items[ | ]

The following list includes items and trinkets that only affect health, only grant flight, only grant spectral tears, use damage as a trigger or contain a combination of what's listed with no other positive effect. It's advised to pick them after a floor has been explored in case a Collectible D4 iconD4, Collectible D100 iconD100, or a Dice RoomDice Room (with 1 or 6 dots) are found later on during the run.

Name ID Icon Quote Description (in Repentance) Quality
Blood Rights 5.100.186
Blood Rights
Mass enemy damage at a cost Upon use, takes a full heart of health and deals 40 damage to all enemies in the room. (in Repentance) Repeated uses in the same room only take half a heart. 0
Converter 5.100.296
3 rooms
Convert your soul (except in Repentance) Converts two Soul HeartSoul Hearts or Black HeartBlack Hearts into one filled Red HeartRed Heart Container.
(in Repentance) Converts one Soul HeartSoul Heart or Black HeartBlack Heart into one filled Red HeartRed Heart Container.
IV Bag 5.100.135
IV Bag
Portable blood bank Upon use, Isaac loses half a heart of health (or a full heart in Chapter 4 onward) for a random amount of coins, similar to a Blood Donation MachineBlood Donation Machine. 1
Prayer Card 5.100.146
Prayer Card
6 rooms
Reusable eternity Gives an Eternal HeartEternal Heart per use. 3
Razor Blade 5.100.126
Razor Blade
Feel my pain Takes one Red HeartHeart of health and grants +1.2 damage for the current room. (in Repentance) Repeated uses in the same room only take half a heart. 0
The Jar 5.100.290
The Jar
Save your life When at full health, up to 4 extra Red HeartRed Hearts can be stored in The Jar. Activating drops the stored hearts on the ground. 0
Yum Heart 5.100.45
Yum Heart
4 rooms
Reusable regeneration Restores one full Red HeartRed Heart. 1
(in Afterbirth † and Repentance) Potato Peeler 5.100.487
Potato Peeler
A pound of flesh Removes a Heart Container, increases damage and range, and grants a Collectible Cube of Meat iconCube of Meat. 2
(in Repentance) Sumptorium 5.100.713
10 seconds
Blood to blood Removes half a heart and creates a Clot familiar that mimics Isaac's movements and tear effects. As Character Tainted Eve iconTainted Eve, passively converts health into Clots while firing. Activating returns all Clots to health. 3
(in Repentance) Yuck Heart 5.100.639
Yuck Heart
4 rooms
Gross! Gives Isaac a Rotten HeartRotten Heart. 1
Name ID Icon Quote Description (in Repentance) Quality
<3 5.100.15 <3 HP up Grants Isaac one Red Heart container and fully restores Isaac's health. 2
A Snack 5.100.346 A Snack HP up Grants one full Red Heart container. (in Repentance) Heals 1 additional Red HeartRed Heart. 1
Black Lotus 5.100.226 Black Lotus HP up x3! Grants one Red Heart Container, one Soul HeartSoul Heart, and one Black HeartBlack Heart. 2
Bloody Lust 5.100.157 Bloody Lust RAGE! Increases Isaac's damage whenever he takes damage, up to six times. The bonus resets when entering a new floor. 2
Breakfast 5.100.25 Breakfast HP up Grants one full Red Heart container. (in Repentance) Heals 1 additional Red HeartRed Heart. 1
Cancer 5.100.301 Cancer HP up + you feel protected Adds 3 Soul HeartSoul Hearts. Grants Collectible The Wafer iconThe Wafer effect for the current room after taking damage. 3
Celtic Cross 5.100.162 Celtic Cross Blessing of protection Grants a chance to trigger the Collectible Book of Shadows iconBook of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 7 seconds. 1
Charm of the Vampire 5.100.62 Charm of the Vampire DMG up + kills heal Heals Isaac for a Half Red HeartHalf Red Heart for every 13 enemies killed. (in Repentance) +0.3 damage. 1
Dead Bird 5.100.117 Dead Bird Protective buddy After Isaac takes damage, spawns a flying familiar that chases enemies for the current room, dealing ~4 damage per second. 0
Dead Dove 5.100.185 Dead Dove Flight + spectral tears Grants spectral tears and flight. 3
Dessert 5.100.24 Dessert HP up Grants one full Red Heart container. (in Repentance) Heals 1 additional Red HeartRed Heart. 1
Dinner 5.100.23 Dinner HP up Grants one full Red Heart container. (in Repentance) Heals 1 additional Red HeartRed Heart. 1
Fanny Pack 5.100.204 Fanny Pack Filled with goodies Has a chance to drop a random pickup when Isaac takes damage. 1
Fate 5.100.179 Fate Flight eternal Grants flight and one Eternal HeartEternal Heart. 3
Gimpy 5.100.225 Gimpy Sweet suffering Gives chance of spawning a Soul HeartSoul Heart when taking damage. Enemies have a chance to drop a Half Red HeartHalf Red Heart after being killed. 2
Habit 5.100.156 Habit Item martyr When Isaac is hit, his active item gains 1 room's worth of charge. 2
Holy Grail 5.100.184 Holy Grail Flight + HP up Grants flight and one Red Heart container. (in Repentance) Heals 1 additional Red HeartRed Heart. 3
Infestation 5.100.148 Infestation Fly revenge (except in Repentance) 1-3 Blue Flies randomly spawn every time Isaac gets hit.
(in Repentance) 2-6 Blue Flies
Little C.H.A.D. 5.100.96 Little C.H.A.D. Gives kisses Spawns a familiar who drops a Half Red HeartHalf Red Heart every 3 rooms. 2
Lunch 5.100.22 Lunch HP up Grants one full Red Heart container. (in Repentance) Heals 1 additional Red HeartRed Heart. 1
Maggy's Bow 5.100.312 Maggy's Bow HP up + you feel healthy Gives one Red Heart Container and doubles the healing provided by Red HeartRed Hearts. (in Repentance) Also heals 1 Red Heart when obtained. 2
Missing Page 2 5.100.262 Missing Page 2 Evil up. Your enemies will pay! Grants one Black HeartBlack Heart. Upon taking damage that reduces Isaac's health to one heart or less, deals damage to all enemies in the room. (in Repentance) Increases the damage of Black HeartBlack Hearts and Collectible The Necronomicon iconThe Necronomicon-like effects by 40. 0
Mitre 5.100.173 Mitre Blessing of purity Grants a chance of converting any Red HeartRed Heart pickups into Soul HeartSoul Hearts instead. 3
Old Bandage 5.100.219 Old Bandage HP up Grants an empty Red Heart container. Adds a chance of dropping a Red HeartRed Heart after taking damage. 2
Ouija Board 5.100.115 Ouija Board Spectral tears + tears up Grants spectral tears that travel through obstacles (but not enemies). (in Repentance) +0.5 tears. 2
Placenta 5.100.218 Placenta Regeneration + HP up Grants one full Red Heart container, and a chance to regenerate a Half Red HeartHalf Red Heart of health every minute of gameplay. 2
Raw Liver 5.100.16 Raw Liver HP up Grants 2 Red Heart containers and completely restores health. 2
Rotten Meat 5.100.26 Rotten Meat HP up Grants one full Red Heart container. (in Repentance) Heals 1 additional Red HeartRed Heart. 1
Scapular 5.100.142 Scapular Pray for a miracle Once per room, when Isaac is reduced to his last half heart, he is granted one Soul HeartSoul Heart. 2
Sharp Plug 5.100.205 Sharp Plug Infinite charge... at a cost Damages Isaac in exchange for fully recharging Isaac's current activated item. 2
Spirit of the Night 5.100.159 Spirit of the Night Scary Grants spectral tears and flight. 3
Super Bandage 5.100.92 Super Bandage +2 hearts Grants one full Red Heart container and 2 Soul HeartSoul Hearts. 2
The Body 5.100.334 The Body I feel all Adds 3 Red Heart Containers. 3
The Ladder 5.100.60 The Ladder Building bridges Allows Isaac to walk across gaps one square across by automatically placing a ladder between the two walkable sections. 1
The Relic 5.100.98 The Relic Soul generator Spawns a cross familiar that drops a Soul HeartSoul Heart after clearing enough rooms. 3
The Wafer 5.100.108 The Wafer Damage resistance Most sources of damage that would cause more than one-half heart of damage are reduced to one-half heart instead. 4
Transcendence 5.100.20 Transcendence We all float down here... Grants flight. 3
(except in Rebirth) Athame 5.100.408 Athame Call to the void (except in Repentance) When Isaac takes damage, a damaging black ring briefly appears around him. This ring can cause enemies to drop Black HeartBlack Hearts.
(in Repentance) After Isaac kills an enemy, adds a luck-based chance to spawn a damaging black ring around them.
(except in Rebirth) Betrayal 5.100.391 Betrayal Turn your enemy (except in Repentance) Charms all enemies in the room when Isaac takes damage.
(in Repentance) Enemies are able to damage each other. If an enemy is damaged by another enemy, they will attack that enemy instead of Isaac.
(except in Rebirth) Cambion Conception 5.100.412 Cambion Conception Feed them hate After taking damage a certain amount of times, a permanent demonic familiar spawns. 2
(except in Rebirth) Curse of the Tower 5.100.371 Curse of the Tower Embrace chaos Upon taking damage, spawns six Troll BombTroll Bombs around the room, similar to the effect of XVI - The TowerXVI - The Tower. 0
(except in Rebirth) Milk! 5.100.436 Milk! Don't cry over it... Spawns a glass familiar that spills on the floor upon taking damage. (except in Repentance) After the milk spills, Isaac's tear delay is decreased by 2 for the current room. (in Repentance) After the milk spills, Isaac's fire rate is increased by 1 for the current room. 1
(except in Rebirth) My Shadow 5.100.433 My Shadow Me! And my shaaaadow! (except in Repentance) Inflicts fear on all enemies in the room upon taking damage and spawns black friendly ChargerChargers that attack enemies.
(in Repentance)Spawns a shadow familiar that closely follows behind Isaac. It spawns a black friendly ChargerCharger whenever an enemy touches it.
(except in Rebirth) PJs 5.100.428 PJs You feel cozy Grants 4 Soul HeartSoul Hearts and fully restores Isaac's health. 2
(in Afterbirth † and Repentance) Dark Prince's Crown 5.100.442 Dark Prince's Crown Loss is power (except in Repentance) When at exactly one Red HeartRed Heart, +0.75 tears, +1.5 range, and +0.2 shot speed.
(in Repentance) When at exactly one Red HeartRed Heart, +2 fire rate, +1.5 range, and +0.2 shot speed.
(in Afterbirth † and Repentance) Greed's Gullet 5.100.501 Greed's Gullet Money = health! Grants a Red Heart container for every 25 PennyCoins Isaac has. 1
(in Afterbirth † and Repentance) Hallowed Ground 5.100.543 Hallowed Ground Portable sanctuary Spawns a white poop familiar, which turns into a White PoopWhite Poop when Isaac is hurt. White poop has an aura that increases tear fire rate and can block enemy shots. (in Repentance) The aura also increases damage by 20% and gives homing. 1
(in Afterbirth † and Repentance) Leprosy 5.100.525 Leprosy You're tearing me apart! Upon taking damage, grants a body part as an orbital, which blocks enemy shots and deals 7 damage per tick to enemies it comes in contact with. The orbitals will be destroyed if they take enough damage from enemies or enemy shots. 1
(in Afterbirth † and Repentance) Marrow 5.100.541 Marrow HP up? Grants one Bone HeartBone Heart and spawns three Red HeartRed Hearts. 1
(in Afterbirth † and Repentance) Midnight Snack 5.100.456 Midnight Snack HP up Grants one full Red Heart container. (in Repentance) Heals 1 additional Red HeartRed Heart. 1
(in Afterbirth † and Repentance) Mystery Egg 5.100.539 Mystery Egg Sacrificial insemination Spawns an egg familiar, which hatches a random friendly monster when Isaac is hurt once per room. The power of the monster improves for each consecutive room cleared without taking damage. 1
(in Afterbirth † and Repentance) Shard of Glass 5.100.448 Shard of Glass Blood and guts! (except in Repentance) Upon taking damage, Isaac has a chance to drop a full red heart, gain 5 range, and leave a trail of damaging red creep for the current room.
(in Repentance) Taking damage causes Isaac to bleed, spraying a volley of blood in the direction he fires. Bleeding will eventually damage him, but it can be stopped by picking up a Red HeartRed Heart.
(in Afterbirth † and Repentance) Varicose Veins 5.100.452 Varicose Veins I'm leaking... Taking damage releases a ring of 10 high damage tears. 1
(in Repentance) Astral Projection 5.100.677 Astral Projection 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
(in Repentance) Bird Cage 5.100.610 Bird Cage 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 Collectible Dead Bird iconDead Bird. 1
(in Repentance) Blood Oath 5.100.569 Blood Oath Bleed me dry Stabs Isaac at the beginning of each floor, draining his Red HeartRed Hearts. Increases damage and speed for the floor based on the amount drained. 1
(in Repentance) Bloody Gust 5.100.695 Bloody Gust May your rage bring haste The first 6 times Isaac takes damage on a given floor, he gains Speed and Fire Rate for the rest of the floor, up to a maximum of +1.02 and +3.00, respectively. 2
(in Repentance) Candy Heart 5.100.671 Candy Heart Power of love Gives Isaac a permanent stat boost whenever he heals with Red HeartRed Heart pickups. 1
(in Repentance) Cracked Orb 5.100.675 Cracked Orb Shards of knowledge Unlocks doors and reveals a random room on the map when Isaac takes damage. 1
(in Repentance) Empty Heart 5.100.676 Empty Heart It multiplies If Isaac has one red heart or fewer at the beginning of a floor, he gains an empty red heart container. 1
(in Repentance) Giant Cell 5.100.658 Giant Cell Micro friends Causes Isaac to spawn Minisaac familiars when he takes damage, which chase and shoot at nearby enemies. 1
(in Repentance) Hypercoagulation 5.100.724 Hypercoagulation Thick blooded After Isaac takes damage from an enemy or donates health, launches Red HeartRed Hearts from Isaac that despawn after 1.5 seconds. 2
(in Repentance) It Hurts 5.100.560 It Hurts No it doesn't... Releases a ring of tears and increases fire rate for the current room when Isaac takes damage. 1
(in Repentance) Orphan Socks 5.100.571 Orphan Socks Speed up + your feet feel stronger Prevents creep and floor spikes from damaging Isaac. Also gives Isaac +0.3 speed and 2 Soul HeartSoul Hearts. 2
(in Repentance) Sanguine Bond 5.100.692 Sanguine Bond He awaits your offering Spawns a special set of spikes in the Devil RoomDevil Room. Taking damage from the spikes has a chance to grant a reward. 1
(in Repentance) Supper 5.100.707 Supper HP up Grants one full Red Heart container. Heals 1 additional Red HeartRed Heart. 1
(in Repentance) Vengeful Spirit 5.100.702 Vengeful Spirit 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. 1
Name ID Icon Quote Description
A Missing Page 5.350.48 A Missing Page It glows with power 5% chance to induce Collectible The Necronomicon iconThe Necronomicon's effect upon taking damage. (in Repentance) Adds +40 damage to Black HeartBlack Hearts and The Necromonicon-like effects.
Bloody Penny 5.350.49 Bloody Penny Wealth of health Gives a chance to drop a Half Red HeartHalf Red Heart when a coin is collected.
Callus 5.350.14 Callus Your feet feel stronger Prevents damage from creep and spikes.
Child's Heart 5.350.34 Child's Heart It calls out to its brothers Increases the chance of a Red HeartHeart dropping after clearing a room, and the chance of finding a heart when opening a ChestChest.
Cursed Skull 5.350.43 Cursed Skull Cursed? If Isaac has less than one full Red HeartRed Heart after taking damage, he will be immediately teleported to a random room.
Fish Head 5.350.29 Fish Head It stinks Spawns a Blue Fly every time Isaac takes damage.
Isaac's Fork 5.350.46 Isaac's Fork Consume thy enemy Isaac has a chance to heal for a Half Red HeartHalf Red Heart upon clearing a room.
Judas' Tongue 5.350.56 Judas' Tongue Payment Received Items in the Devil RoomDevil Room only cost 1 heart. Soul HeartSoul Heart trades still cost 3 soul hearts.
Maggy's Faith 5.350.55 Maggy's Faith Faith's reward Gives an Eternal HeartEternal Heart at the start of every floor.
Mom's Pearl 5.350.38 Mom's Pearl It emanates purity Grants a secondary 10% chance of any non-specific heart drop turning into a Soul HeartSoul Heart.
Monkey Paw 5.350.20 Monkey Paw Wish granted If Isaac has half a heart after taking damage, drops a Black HeartBlack Heart. The effect can trigger up to three times, after which the trinket will disappear.
Mysterious Paper 5.350.21 Mysterious Paper ??? Has a chance to replicate the effects of A Missing PageA Missing Page, Collectible The Polaroid iconThe Polaroid, Collectible The Negative iconThe Negative, or Missing PosterMissing Poster.
Red Patch 5.350.40 Red Patch Your rage grows Grants a chance to gain +1.8 damage for the current room upon taking damage.
Swallowed Penny 5.350.1 Swallowed Penny Gulp! Upon taking damage, Isaac drops a coin.
Umbilical Cord 5.350.33 Umbilical Cord Fetal Protection When brought down to only a Half Red HeartHalf Red Heart, spawns a Collectible Little Steven iconLittle Steven familiar for the current room. (in Repentance) Adds a high chance to spawn a Collectible Gemini iconGemini familiar for the current room after taking damage.
(except in Rebirth) Blind Rage 5.350.81 Blind Rage Blind to damage Increases invincibility time after getting hit.
(except in Rebirth) Cracked Dice 5.350.67 Cracked Dice You feel cursed... kinda. Activates the effect of Collectible The D6 iconThe D6, Collectible D8 iconD8, (in Repentance)Collectible D10 iconD10, Collectible D12 iconD12, or Collectible D20 iconD20 (chosen randomly) whenever Isaac takes damage.
(except in Rebirth) Mom's Locket 5.350.87 Mom's Locket You feel her love Grants a Half Red HeartHalf Red Heart each time a KeyKey is used. Converts Half Red HeartHalf Red Heart pickups into Red HeartRed Hearts.
(in Afterbirth † and Repentance) Bag Lunch 5.350.105 Bag Lunch I wonder what it is Taking damage has a small chance to destroy the trinket and spawn Collectible Lunch iconLunch.
(in Afterbirth † and Repentance) Crow Heart 5.350.107 Crow Heart Drain me Red HeartRed Heart damage will be taken before Soul HeartSoul Heart, Black HeartBlack Heart, and (in Repentance) Rotten HeartRotten Heart damage.
(in Afterbirth † and Repentance) Finger Bone 5.350.128 Finger Bone It looks brittle Grants a chance to gain a Bone HeartBone Heart upon taking damage.
(in Afterbirth † and Repentance) Walnut 5.350.108 Walnut That's a hard nut to crack! Being hit by explosions will eventually destroy the trinket and spawn various pickups.
(in Afterbirth † and Repentance) Wish Bone 5.350.104 Wish Bone Make a wish Taking damage has a small chance to destroy the trinket and spawn a random item.
(in Repentance) Hollow Heart 5.350.168 Hollow Heart A brittle blessing Grants an empty Bone HeartBone Heart upon entering a new floor.
(in Repentance) Mother's Kiss 5.350.156 Mother's Kiss HP up Grants one heart container.
(in Repentance) Swallowed M80 5.350.178 Swallowed M80 Bang! Isaac explodes upon taking damage.
(in Repentance) Torn Pocket 5.350.158 Torn Pocket A hole in your pocket Upon taking damage, Isaac drops 2 random Pickups from among those he's currently holding.

Notes on item selection

  • Collectible Best Bud iconBest Bud, Collectible Guppy's Paw iconGuppy's Paw, Collectible Infestation iconInfestation and (in Afterbirth † and Repentance)Collectible Adrenaline iconAdrenaline are not included because while they do not provide any passive benefit, they do count for transformations.
  • Listed items that generate heart pickups of any kind are useless in most scenarios, but can be converted to other types of pickups if The Lost is holding the Collectible D20 iconD20 or Collectible D100 iconD100.
  • Collectible Bloody Lust iconBloody Lust will increase damage if The Lost has multiple lives.
  • Items that activate a Collectible The Necronomicon iconThe Necronomicon-like effect upon getting hit have a very limited use, as they can deal the last bit of damage needed to kill a boss, or clear a room if The Lost has multiple lives.
  • Collectible Rosary iconRosary is mostly useless, but not completely, as it raises the chance of finding Collectible The Bible iconThe Bible.
    • (in Repentance) Rosary now gives a tears up as well, making it more useful.
  • (except in Rebirth)Missing PosterMissing Poster is no longer useless for the Lost. So is Mysterious PaperMysterious Paper as it has a small chance to trigger its effect.
  • (except in Rebirth)Collectible Ouija Board iconOuija Board, Collectible Dead Dove iconDead Dove and Collectible Spirit of the Night iconSpirit of the Night are useless in Afterbirth because The Lost now starts with spectral tears. They are still useful items in Rebirth.
    • (in Repentance) Ouija Board now gives a tears up as well, making it actually useful.
  • (except in Rebirth)Blind RageBlind Rage is only useless if the player has not unlocked Collectible Holy Mantle iconHoly Mantle as The Lost's starting item.
  • (except in Rebirth)Items that increase your chances of finding Soul Hearts or Black Hearts gain some use when combined with (except in Rebirth)Collectible Immaculate Conception iconImmaculate Conception.
  • (in Repentance)Collectible Charm of the Vampire iconCharm of the Vampire is no longer useless as it now gives a small damage up.
  • (in Repentance)(except in Rebirth)Collectible Athame iconAthame, (except in Rebirth)Collectible My Shadow iconMy Shadow and (except in Rebirth)Collectible Betrayal iconBetrayal are no longer useless since they don't require getting hit to activate anymore.

Negative items[ | ]

  • (in Afterbirth and Afterbirth †) The Collectible D4 iconD4 and the Collectible D100 iconD100 will reroll the Holy Mantle The Lost starts with after giving the Greed Machine 879 coins.
  • Collectible Ankh iconAnkh, Broken AnkhBroken Ankh, Collectible Judas' Shadow iconJudas' Shadow and Collectible Lazarus' Rags iconLazarus' Rags grant extra lives but respawn The Lost as Character ??? (Character) icon???, Character Dark Judas iconDark Judas, or Character Lazarus Risen iconLazarus Risen respectively, which will cause the game to treat them as these characters instead of The Lost. It is suggested to avoid these three items altogether if the player is interested in gaining The Lost exclusive achievements and/or completion marks.
  • Collectible Dark Bum iconDark Bum no longer maintains its main benefit of providing Soul HeartSoul Hearts as they are now useless. While it may spawn a friendly spider, it is also likely to spawn an enemy spider, which can instantly kill The Lost if the player is not careful.
    • (in Repentance) Dark Bum now has a 20% chance to spawn a random pill, card or rune, making it slightly more useful for The Lost.
    • With (except in Rebirth)Collectible Immaculate Conception iconImmaculate Conception, Dark Bum will be useful to convert useless Red Hearts to useful Soul Hearts. However, the player must still be careful of SpiderSpiders.
  • Collectible Isaac's Heart iconIsaac's Heart, while having many useful synergies (in Rebirth) as well as the added benefit of immunity to Brimstone lasers, makes dodging more difficult in many scenarios, leading many players to take damage when they otherwise would not have. It is also very difficult to avoid a stray laser from an EyeEye, as The Lost cannot block this shot and protect Isaac's Heart from it. Also, there is a chance it can spawn atop an Eye in the It Lives fight, leading to a very cheap and unavoidable death.
  • Any explosive items, such as Collectible Anarchist Cookbook iconAnarchist Cookbook, (except in Rebirth)Collectible Curse of the Tower iconCurse of the Tower, or Collectible Ipecac iconIpecac should be used with extreme care.
    • If the player chooses to pick up Collectible Ipecac iconIpecac, they should not pick up Collectible Loki's Horns iconLoki's Horns or Collectible Mom's Eye iconMom's Eye, as an unexpected shot against a wall will lead to instant death. Collectible Lost Contact iconLost Contact is also problematic as it can cause explosions to happen in closer proximity to the player than desired.
  • Items that work by causing self-damage, such as the Collectible IV Bag iconIV Bag, Collectible Blood Rights iconBlood Rights or Collectible Razor Blade iconRazor Blade will end the run if used and must be avoided. Collectible Dead Sea Scrolls iconDead Sea Scrolls also has the potential to prematurely end a run if Collectible Kamikaze! iconKamikaze! is triggered and the player doesn't have its Holy Mantle active. (except in Repentance)Collectible Isaac's Heart iconIsaac's Heart will allow The Lost to use these items without taking damage.
  • Collectible Bucket of Lard iconBucket of Lard reduces speed by 0.2 and does not provide any benefit.
  • (in Repentance)Collectible Glyph of Balance iconGlyph of Balance will replace all room clear and champion drops with soul hearts, resulting in much less pickups throughout the run.
  • Collectible Leo iconLeo and Collectible Thunder Thighs iconThunder Thighs are not great as they remove The Lost's ability to use obstacles to his advantage, as they can break these obstacles. Also, stepping on a poisonous mushroom, or carelessly stepping on a Bomb Rock can end a run. The only benefit is the small chance of finding a trapdoor or items like Collectible Dry Baby iconDry Baby or Collectible The Small Rock iconThe Small Rock when breaking said obstacles.
  • Collectible Strange Attractor iconStrange Attractor: Unpredictably pulls enemies towards The Lost, especially floating enemies like Boom FlyBoom Flies. It's advised to avoid this item unless The Lost has Collectible The Ludovico Technique iconThe Ludovico Technique, as both items combined may create a powerful synergy.
    • (in Repentance) Strange Attractor now pulls enemies towards where the magnetic tear lands, making it safer to take.
  • Collectible Proptosis iconProptosis may seem useful because it doubles your damage, but it requires you to get closer to enemies, resulting in you being more likely to get hit.
  • (in Repentance)Collectible Ocular Rift iconOcular Rift, as it can uncontrollably pull enemies around, especially with items like Collectible Loki's Horns iconLoki's Horns or Collectible Mom's Eye iconMom's Eye, though it can also be very useful in avoiding damage when played right.