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Items are an integral part of game-play in The Binding of Isaac: Rebirth. They modify Isaac's Attributes, grant or modify Tear Effects, and much more.

Items in general are classified into a number of distinct types and groups. Some items are passive, which add an effect permanently to Isaac, while others only activate when used. The original Binding of Isaac had 196 collectable items (passive and activated); this number has increased significantly in Rebirth, and the Collection pages have space for a total of 341 items. Afterbirth added 95 new items for a total of 436 items. Only 15 are considered Special, and only 13 are considered special in Afterbirth. Afterbirth † has added 68 new items for a total of 504 items.

Similar to Items are Cards and Runes, Pills, and Trinkets.

For a list of which items can potentially appear in a given Special Room, see Item Pool.

Rebirth Collectibles

Activated Collectibles

Name Icon Description Recharge
Anarchist Cookbook Anarchist Cookbook Icon.pngSpawns six troll bombs around the room.3
The Bean The Bean Icon.pngIsaac releases bad gas, poisoning any enemy in close vicinity.1
Best Friend Best Friend Icon.pngDeploys a decoy Isaac that eventually explodes with an increased blast radius.3
The Bible The Bible Icon.pngUpon activation, Isaac gains Flight, allowing him to pass over all obstacles in the current room. Instantly kills Mom, Mom's Heart, and It Lives when activated, but will kill Isaac when activated while fighting Satan.6
Blank Card Blank Card Icon.pngHas the same effect as the card or rune currently held by Isaac.4
Blood Rights Blood Rights Icon.pngDamages all enemies in the room, but deals a half-heart of damage to Isaac with each use.0
Bob's Rotten Head Bob's Rotten Head Icon.pngUpon use, Isaac holds a poison bomb which can be thrown towards any of the four cardinal points and explodes on impact.3
The Book of Belial The Book of Belial Icon.pngGuarantees a Devil Room or Angel Room will be open after beating a boss while holding it. Upon use increases damage by 2 for the current room and by a further +50% if the character also has the Blood Of The Martyr.3
Book of Revelations Book of Revelations Icon.pngAdds 1 Soul Heart and increases the chance for the next boss to be a Horseman (except on XL floors and floors with fixed bosses such as Mom).6
Book of Secrets Book of Secrets Icon.pngUpon use, gives the effect of Treasure Map, The Compass, or Blue Map for the duration of the current floor.6
Book of Shadows Book of Shadows Icon.pngUpon use, creates a protective shield nullifying all types of damage for 10 seconds.3
The Book of Sin The Book of Sin Icon.pngSpawns a random Pick Up, Pill, Card, or Trinket.4
The Boomerang The Boomerang Icon.pngThrows a short-range boomerang which does a bit of damage and has a high chance to stun the enemy for 2 seconds. Can also be used to grab pickups.4 seconds
Box of Spiders Box of Spiders Icon.pngSummons 2-4 Blue Spiders.2
Breath of Life Breath of Life Icon.pngGrants a brief moment of invincibility when the charge bar hits zero. If spacebar is held for an additional second after hitting zero, Isaac will take damage.6 seconds
Butter Bean Butter Bean Icon.pngIsaac farts and pushes back nearby enemies.3 seconds
The Candle The Candle Icon.pngThrows out a blue flame that can pass over gaps (but not through rocks). The flame damages anything in its path.4 seconds
Converter Converter Icon.pngWhen used, converts two soul hearts into a heart container.0
Crack The Sky Crack The Sky Icon.pngSummons multiple beams of light in random locations around the room, dealing a large amount of damage to any enemy that touches them.4
Crystal Ball Crystal Ball Icon.pngReveals the map (except the Super Secret Room) and drops a random Tarot Card or Soul Heart.6
D4 D4 Icon.pngRerolls all upgrades on the player. (Does not reroll Azazel's brimstone).6
The D6 The D6 Icon.pngAllows Isaac to re-roll collectible items in the current room into other items, depending on the current room's Item Pool.6
D10 D10 Icon.pngRerolls the enemies in a room. Only rerolls enemies that are still alive (does not spawn new enemies).1
D20 D20 Icon.pngRerolls all pickups in the current room.6
D100 D100 Icon.pngUpon use, rerolls all passive items on Isaac like the D4, every pedestal item in the room like the D6 and every pickup like the D20.6
Dad's Key Dad's Key Icon.pngOpens all doors in the current room when activated, including doors which require a Key to open and entrances to secret rooms. Opens the big doors in the first room of both The Chest and The Dark Room.2
Dead Sea Scrolls Dead Sea Scrolls Icon.pngTriggers the effect of a random activated item from a list of possible options (not every activated item is included).2
Deck Of Cards Deck Of Cards Icon.pngGives Isaac a random Tarot Card.6
Doctor's Remote Doctor's Remote Icon.pngSets a big red target on the ground (similar to the Epic Fetus item) which can be controlled with tear controls. After 6 seconds or by pressing space again, a huge explosive missile hits it, which damages all enemies caught in its blast radius.2
Flush! Flush! Icon.pngChanges all enemies in the room into poop. Does not work on all enemies (Knights and bosses are immune). Instantly kills Dingle, Dangle, and Brownie.6
Forget Me Now Forget Me Now Icon.pngWhen activated, the level ends and is freshly regenerated with new rooms, monsters, and items. Disappears after use.One time use
The Gamekid The Gamekid Icon.pngUpon use, turns the character into a into a Pac-Man-like creature for 5 seconds, granting invulnerability and increased speed, inflicting fear on all enemies, and replenishing half a red heart container for every two enemies killed.6
Guppy's Head Guppy's Head Icon.pngSpawns 2-4 Blue Flies to damage enemies.1
Guppy's Paw Guppy's Paw Icon.pngRemoves one Heart Container in exchange for gaining 3 Soul Hearts.0
Head Of Krampus Head Of Krampus Icon.pngFires a cross-patterned brimstone shot, just like the Fallen and Krampus shoot.6
How To Jump How To Jump Icon.pngGives Isaac the ability to jump (over gaps, spikes, etc.).0
The Hourglass The Hourglass Icon.pngUpon activation, enemies and their projectiles are slowed down for a short duration.2
Isaac's Tears Isaac's Tears Icon.pngShoots 8 tears around Isaac, which retain the damage, shot speed, and special effects of his tears. Each tear shot by Isaac increases item charge by one.6
IV Bag IV Bag Icon.pngUpon activation, Isaac loses a half-heart (one whole heart in The Womb onwards) for a random amount of coins, similar to the Blood Donation Machine.0
The Jar The Jar Icon.pngWhen at full health, up to 4 extra hearts can be stored in the jar.0
Kamikaze! Kamikaze! Icon.pngCreates an explosion in the same area as Isaac, dealing half a heart of damage to him and also damaging all enemies caught in the blast radius.0
Lemon Mishap Lemon Mishap Icon.pngCreates a small yellow pool of Creep, which damages enemies that cross it.2
Magic Fingers Magic Fingers Icon.pngFor 1 Coin, damages all enemies in the room.0
Mom's Bottle Of Pills Mom's Bottle Of Pills Icon.pngGives Isaac a random Pill, and will cause him to drop any held Q-slot item (If any). The player will only receive six different pill types in one playthrough.6
Mom's Bra Mom's Bra Icon.pngUpon use, petrifies all enemies in the current room for approximately 4 seconds.3
Mom's Pad Mom's Pad Icon.pngUpon use, inflicts fear to all enemies in the room for 5 seconds.3
Monster Manual Monster Manual Icon.pngSummons a random familiar for the current room. Can summon familiars not yet unlocked.3
Monstro's Tooth Monstro's Tooth Icon.pngMonstro jumps onto a random enemy, doing area damage. Can damage/kill the player if summoned in an room without enemies.3
Mr. Boom Mr. Boom Icon.pngDrops a large bomb.2
My Little Unicorn My Little Unicorn Icon.pngUpon use, grants invulnerability and increased speed for five seconds, removing the ability to shoot tears and instead dealing contact damage to enemies.6
The Nail The Nail Icon.pngAdds one Soul Heart and allows the breaking of Rocks and damaging enemies by simply walking over them. Increases Damage and decreases Speed. All effects except for the Soul Heart wear off upon leaving the room.6
The Necronomicon The Necronomicon Icon.pngDamages all enemies in the room significantly.6
Notched Axe Notched Axe Icon.pngIsaac holds the axe above his head for as long as the spacebar button is held (or until he leaves the room). While holding the axe, Isaac can break any rock he touches, but cannot attack or pick up other items.3
Pandora's Box Pandora's Box Icon.pngUpon use, spawns certain Pickups or Items depending on the floor it is used on. Single-use.One time use
The Pinking Shears The Pinking Shears Icon.pngSeparates Isaac's head and body for the current room. Isaac's head, which now has flight, will be under the player's control, while his body will seek out enemies to attack by contact damage.6
The Pony The Pony Icon.pngPassively grants flight and increased speed. Upon use, Isaac charges in the direction the pony is facing, becoming invulnerable during the charge and damaging enemies.4
The Poop The Poop Icon.pngSpawns a pile of poop where the character is standing and knocks nearby monsters back. May yield pickups like regular poop.1
Portable Slot Portable Slot Icon.pngUpon activation, 1 coin will be consumed, and a random Pick Up may drop, similar to the Slot Machine.0
Prayer Card Prayer Card Icon.pngGrants an Eternal Heart per use.6
Razor Blade Razor Blade Icon.pngUpon use deals one heart damage and grants +1.2 damage for the current room.0
Red Candle Red Candle Icon.pngThrows a persistent flame that deals high damage and diminishes as it damages enemies or blocks shots.4 seconds
Remote Detonator Remote Detonator Icon.pngBombs you place explode only when you use this item. Gives 5 bombs.0
Satanic Bible Satanic Bible Icon.pngUpon activation, Isaac gains a black heart.6
Scissors Scissors Icon.pngUpon use, turns Isaac's head into a stationary familiar for the current room which fires normal tears that deal 3.5 damage.NoDLC Indicator.png6
DLC Indicator.png 2
Shoop Da Whoop! Shoop Da Whoop! Icon.pngFires a laser from Isaac's mouth.2
Spider Butt Spider Butt Icon.pngDamages all enemies in the room and slows them and their projectiles down.2
Tammy's Head Tammy's Head Icon.pngShoots 10 tears in a circle around Isaac, which retain the damage, shot speed, and special effects (such as Poison) of Isaac's tears.1
Telepathy For Dummies Telepathy For Dummies Icon.pngUpon activation, grants homing tears for the current room.2
Teleport Teleport Icon.pngTeleports you to a random room on the level.2
Undefined Undefined Icon.pngTeleports Isaac to either the Secret Room, Super Secret Room, Treasure Room, or I AM ERROR.6
Unicorn Stump Unicorn Stump Icon.pngUpon use, grants invulnerability and increased speed for five seconds, but removes the ability to shoot tears.1
We Need To Go Deeper! We Need To Go Deeper! Icon.pngCreates a trapdoor to go to the next floor. If used in The Womb, it will create a trapdoor to Sheol, even if the player hasn't unlocked it.6
White Pony White Pony Icon.pngPassively grants flight and increased speed. Upon use, Isaac charges in the direction the pony is facing, becoming invulnerable during the charge and damaging enemies while also casting the effect of Crack The Sky.6
Yum Heart Yum Heart Icon.pngRestores 1 whole Red heart.4

Passive Collectibles

Name Icon Description
<3 Less Than Three Icon.pngIncreases available heart containers by 1 and restores all health.
???'s Only Friend Blue Baby's Only Friend Icon.pngSummons a big attack fly that can be controlled with the shooting direction-keys.
1up! 1up! Icon.pngGives an extra life. Upon death, you will respawn in the previous room with full health and lose the 1up!.
20/20 20 20 Icon.pngGrants double shot.
3 Dollar Bill 3 Dollar Bill Icon.pngGives Isaac a random tear effect every room. The effect given changes upon entering a room. DLC Indicator.png The effect changes every 3 seconds.
9 Volt 9 Volt Icon.pngReduces the charge of any Activated Items by 1. Any 1 charge items instead have timed recharges.
Abaddon Abaddon Icon.pngIncreases damage and speed, removes all red heart containers, grants six black hearts, and adds a chance to shoot fear tears.
Abel Abel Icon.pngA familiar that mirrors the player's movements and shoots in the opposite direction.
Anemic Anemic Icon.png+5 Range. After Isaac is damaged, a trail of red creep will be left behind Isaac until he leaves the current room.
Ankh Ankh Icon.pngUpon death, the player will respawn as Blue Baby with 3 Soul Hearts.
Anti-Gravity Anti-Gravity Icon.pngTears up. Tears float in position until firing ceases, after which they will fly off in the direction they were shot in.
Aquarius Aquarius Icon.pngA trail of blue creep is left behind Isaac, which damages enemies.
Aries Aries Icon.png+0.25 Speed. Running into enemies while at a high speed will deal 18 points of damage. Does not prevent contact damage.
Ball Of Bandages Ball Of Bandages Icon.pngOrbiting familiar that deals damage to enemies. If collected while already having one, makes the familiar evolve. Only drops from Horsemen. Similar to Cube of Meat.
Ball Of Tar Ball Of Tar Icon.pngAdds a chance to shoot slowing tears and the character leaves a trail of slowing creep behind as he moves, impeding enemies' speed.
The Battery The Battery Icon.pngActivated Items can be "overcharged" to allow for an additional use.
The Belt The Belt Icon.pngIncreases speed by 0.3.
Best Bud Best Bud Icon.pngWhen hit, summons a white attack fly similar to Distant Admiration for the current room.
BFFS! BFFS! Icon.pngIncreases the size and damage of familiars.
BBF BBF Icon.pngSpawns a familiar that flies around the room in a manner similar to the Boom Fly and explodes on contact with an enemy. Respawns after ten seconds.
Big Fan Big Fan Icon.pngSpawns a large orbital familiar that blocks enemy projectiles and deals slight contact damage to enemies.
The Black Bean The Black Bean Icon.pngWhen taking damage, Isaac farts, causing poison damage to all enemies in range.
Black Candle Black Candle Icon.pngPrevents Curses. Grants one black heart. If obtained on a floor with a Curse, it will remove the Curse.
Black Lotus Black Lotus Icon.pngGrants the player one red heart container, one soul heart, and one black heart.
Blood Bag Blood Bag Icon.pngGrants 1 heart container, restores 5 red hearts, and increases speed.
Blood Clot Blood Clot Icon.pngIncreases damage by 1 and range by 5 for tears fired from the left eye.
Blood Of The Martyr Blood Of The Martyr Icon.pngIncreases Damage by 1, and turns Isaac's tears into blood tears.
Bloody Lust Bloody Lust Icon.pngIncreases damage as Isaac receives damage. Damage increase stays for the whole floor.
Blue Cap Blue Cap Icon.pngGrants 1 heart container and increases tears, but decreases shot speed.
Blue Map Blue Map Icon.pngShows secret and super secret room locations on the map.
Bob's Brain Bob's Brain Icon.pngSpawns a familiar that charges forward when shooting tears, explodes upon contact with an enemy and poisons them. Respawns after few seconds.
Bob's Curse Bob's Curse Icon.pngGives 5 bombs and grants all bombs poison effect.
Bobby-Bomb Bobby-Bomb Icon.pngGives Isaac 5 Bombs, and causes all dropped bombs to home towards the closest enemy.
The Body The Body Icon.pngAdds 3 Heart Containers.
Bogo Bombs Bogo Bombs Icon.pngAll standard bomb pickups become 1+1 bomb pickups.
Bomb Bag Bomb Bag Icon.pngIsaac is followed by a small bag that drops a Bomb, 1+1 Free, or a Troll Bomb every 3 rooms.
Boom! Boom! Icon.pngGives 10 bombs.
Box Box Icon.pngSpawns 1 of each (non-collectible) item: 1 coin, 1 key, 1 bomb, 1 heart, 1 card, 1 pill, 1 trinket.
Breakfast Breakfast Icon.pngAdds 1 Heart Container.
Brimstone Brimstone Icon.pngTears are replaced by a laser beam that pierces through all enemies and obstacles in its path and deals high damage. Can only be fired after a short charge-up period.
Broken Watch Broken Watch Icon.pngChance upon entering a room to slow down or speed up every enemy and their attacks. The chance to slow enemies is quite higher than the chance to speed them up.
Brother Bobby Brother Bobby Icon.pngFollows Isaac around shooting normal tears.
Bucket Of Lard Bucket Of Lard Icon.pngGrants two empty heart containers and heals Isaac by half a heart, but decreases speed by 0.2.
Bum Friend Bum Friend Icon.pngA portable Beggar who follows Isaac, picks up coins for himself, and occasionally drops a Pickup after collecting a coin. Does not spawn Collectibles.
Butt Bombs Butt Bombs Icon.pngGives +5 Bombs and makes all bombs Butt Bombs that fill the room with gas, damaging and Confusing all enemies.
Caffeine Pill Caffeine Pill Icon.pngIncreases speed and reduces character size. Also gives a random pill.
Cain's Other Eye Cain's Other Eye Icon.pngSpawns a familiar that floats slowly around the room on a zig-zag pattern similar to The Peeper and shoots normal tears in the same direction as Isaac.
Cancer Cancer Icon.pngAdds 3 Soul Hearts. Grants The Wafer effect for the current room upon taking damage.
Capricorn Capricorn Icon.pngAll stats up.
Cat-O-Nine-Tails Cat-O-Nine-Tails Icon.pngIncreases Shot Speed and damage.
Celtic Cross Celtic Cross Icon.pngGrants a chance to trigger the Book Of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 7 seconds.
Ceremonial Robes Ceremonial Robes Icon.pngAdds 3 Black Hearts and increases Damage by 1.
Champion Belt Champion Belt Icon.pngIncreases damage, but also increases the chance of Champion enemies appearing.
Charm Of The Vampire Charm Of The Vampire Icon.pngHeals the character for half of a red heart for every 13 monsters killed.
Chemical Peel Chemical Peel Icon.pngTears fired from left eye do increased damage.
Chocolate Milk Chocolate Milk Icon.pngGrants charged tears that deal greater damage when fully charged.
The Common Cold The Common Cold Icon.pngAdds a chance to shoot poison tears, dealing damage over time when inflicted.
The Compass The Compass Icon.pngReveals all special rooms (except secret rooms of any kind).
Contract From Below Contract From Below Icon.pngDoubles the number of pickups and chests spawned after clearing a room or performing some other triggering action (such as using a Blood Donation Machine), but reduces the chance for any pickups to spawn at all.
Cricket's Body Cricket's Body Icon.pngIncreases Tears and reduces Range. When tears hit an object or deplete their range, they spawn 4 smaller tears, whose Range and Damage scale with Isaac's.
Cricket's Head Cricket's Head Icon.pngIncreases damage by 0.5, and multiplies it by 1.5x.
Cube of Meat Cube of Meat Icon.pngOrbiting familiar that blocks enemy shots and deals damage to enemies. If collected while already having one, makes the familiar evolve. Only drops from Horsemen. Similar to Ball of Bandages.
Cupid's Arrow Cupid's Arrow Icon.pngGrants Isaac piercing tears that travel through enemies (but not obstacles) instead of breaking on impact with them.
Cursed Eye Cursed Eye Icon.pngGrants charged tears that can be fired in a tight burst of four. Getting hit while charging will teleport Isaac into another room.
Daddy Longlegs Daddy Longlegs Icon.pngDaddy Long Legs' shadow follows Isaac and stomps on enemies.
Dark Bum Dark Bum Icon.pngSpawns a familiar that follows Isaac around and collects Red Hearts. For every one-and-a-half red hearts collected, Dark Bum will generate one Soul Heart, one hostile Spider or one friendly Blue Spider.
Dark Matter Dark Matter Icon.pngIncreases Damage by 1 and adds a chance to shoot fear tears.
Dead Bird Dead Bird Icon.pngSpawns a flying familiar for the current room that chases enemies whenever Isaac takes damage.
Dead Cat Dead Cat Icon.pngSets the amount of red heart containers to 1, but gives Isaac 9 extra lives. After dying, Isaac is teleported to the last safe room. New heart containers can be obtained after picking up this item, but after each death, the number of heart containers is set to 1 again.
Dead Dove Dead Dove Icon.pngGrants spectral tears and flight.
Dead Onion Dead Onion Icon.pngGrants piercing and spectral tears. Increases tear size (without increasing damage) while greatly reducing range and shot speed.
Death's Touch Death's Touch Icon.pngIncreases Damage by 1.5, reduces Tears by 0.3 and increases tear size. Grants piercing tears. Tears are replaced by Death's scythes, which is a cosmetic effect only.
Demon Baby Demon Baby Icon.pngFollows Isaac and automatically fires at enemies in its reach.
Dessert Dessert Icon.pngAdds 1 Heart Container.
Dinner Dinner Icon.pngAdds 1 Heart Container.
Distant Admiration Distant Admiration Icon.pngA red attack fly circles further out than the Halo of Flies / Pretty Flies, but closer than Forever Alone. Deals more damage than Forever Alone.
A Dollar A Dollar Icon.pngGives Isaac 99 coins. Can be found multiple times in a single playthrough.
Dr. Fetus Dr. Fetus Icon.pngTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
Dry Baby Dry Baby Icon.pngSpawns a familiar that follows Isaac around and blocks enemy projectiles. Upon blocking a shot it has a chance of triggering The Necronomicon effect.
E Coli E Coli Icon.pngGives "Turdy Touch" Effect. Enemies that touch Isaac are changed into Poop.
Epic Fetus Epic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
Eve's Mascara Eve's Mascara Icon.pngDoubles damage, halves tears stat, and greatly reduces shot speed.
Experimental Treatment Experimental Treatment Icon.pngRandomly increases and decreases some of the character's stats. There will always be at least one stat increase and one decrease and the same stats can be increased/decreased multiple times.
Fanny Pack Fanny Pack Icon.pngHas a chance to drop a random pickup when Isaac takes damage.
Fate Fate Icon.pngGrants flight and one Eternal Heart.
Fire Mind Fire Mind Icon.pngGrants flaming tears that deal burning damage over time. Tears have a chance to explode on impact with an enemy, which creates a fire at the location of the explosion.
Forever Alone Forever Alone Icon.pngSpawns a blue attack fly that orbits a long distance from Isaac.
Gemini Gemini (Item) Icon.pngSuture becomes attached to Isaac, and does touch damage to enemies within its attacking range.
Ghost Baby Ghost Baby Icon.pngSpawns a familiar that follows Isaac around and fires spectral tears.
Gimpy Gimpy Icon.pngHas a chance of spawning a soul heart or black heart when taking damage. Enemies have a chance to drop a Half Red Heart after being killed.
Gnawed Leaf Gnawed Leaf Icon.pngAfter standing still and not shooting for a short time, Isaac turns invincible until he moves or shoots.
Goat Head Goat Head Icon.pngA Devil Room /Angel Room Door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.
Godhead Godhead Icon.pngIncreases damage and range while reducing tears and shot speed. Grants homing tears and tears gain a damaging halo.
Growth Hormones Growth Hormones Icon.pngIncreases damage by 1 and speed by 0.4.
Guardian Angel Guardian Angel Icon.pngSpawns an orbital familiar that blocks enemy projectiles, deals contact damage to enemies and increases the speed of all orbital familiars.
Guillotine Guillotine Icon.pngIsaac's head is removed from his body and floats around him. Increases Damage by 1 and Tears by 0.16.
Guppy's Collar Guppy's Collar Icon.pngPermanent 50% chance to respawn with 1/2 heart after death.
Guppy's Hair Ball Guppy's Hair Ball Icon.pngLoosely follows behind Isaac. Can be swung like a flail by rapidly spinning Isaac in a circle. Grows bigger by killing enemies.
Guppy's Tail Guppy's Tail Icon.pngIncreases chance of finding gold chests and normal chests, but reduces chance of finding pickups.
Habit Habit Icon.pngWhen Isaac is hit, 1 point of an item's charge is filled.
The Halo The Halo Icon.pngGrants one Heart Container, +0.3 Damage, +0.2 Tears, +0.25 Range, +0.3 Speed, and +0.5 Tear Height.
Halo of Flies Halo of Flies Icon.pngSpawns two pretty fly familiars that block enemy shots and deal contact damage to enemies.
Harlequin Baby Harlequin Baby Icon.pngSpawns a familiar that follows Isaac around and fires two tears at once in a V-pattern.
Headless Baby Headless Baby Icon.pngFamiliar that follows Isaac, leaving blood creep on the ground.
Hive Mind Hive Mind Icon.pngIncreases the size of Blue Spiders and Blue Flies and doubles the amount of damage they deal.
Holy Grail Holy Grail Icon.pngGrants flight and one heart container.
Holy Mantle Holy Mantle Icon.pngAutomatically negates first taken damage in every room.
Holy Water Holy Water Icon.pngWhen Isaac receives damage, the bottle breaks and a puddle of blue Creep forms, which damages non-flying enemies, similar to Lemon Mishap. The bottle is reformed upon entering a different room.
Hot Bombs Hot Bombs Icon.pngGrants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact.
Humbling Bundle Humbling Bundle Icon.pngGives one extra pickup (1+1 Free version) of Red Hearts, pennies, bombs and Keys. Does not work with blue, black and half red hearts, nickels and dimes.
Infamy Infamy Icon.pngChance to block projectiles coming from any direction.
Infestation Infestation Icon.png1-3 Blue Flies randomly spawn every time Isaac gets hit.
Infestation 2 Infestation 2 Icon.pngSpawns allied blue spiders from killed enemies.
The Inner Eye The Inner Eye Icon.pngGrants triple shot but decreases tears.
Ipecac Ipecac Icon.pngReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth.
Iron Bar Iron Bar Icon.pngIncreases damage by 0.3 and adds a chance to shoot concussive tears, causing enemies to walk around randomly.
Isaac's Heart Isaac's Heart Icon.pngIsaac himself is now immune to all damage, and a heart familiar appears and follows Isaac. If the heart is hurt, Isaac is hurt.
Jesus Juice Jesus Juice Icon.pngIncreases Damage and Range.
Judas' Shadow Judas' Shadow Icon.pngAdds an extra life; upon death, it respawns Isaac as Black Judas with only two black hearts.
Juicy Sack Juicy Sack Icon.pngA Familiar that follows behind Isaac. It drips a trail of creep, which slows enemies, and spawns 1-2 Blue Spiders after each room.
Key Piece 1 Key Piece 1 Icon.pngCombined with Key Piece 2, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.
Key Piece 2 Key Piece 2 Icon.pngCombined with Key Piece 1, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.
The Ladder The Ladder Icon.pngAllows Isaac to walk across gaps one square across by automatically placing a ladder between the two walkable sections.
Latch Key Latch Key Icon.pngIncreases Luck by 1, grants 1 Soul Heart and spawns 2 Keys.
Lazarus' Rags Lazarus' Rags Icon.pngUpon dying, resurrect as Revived Lazarus with one heart container and Anemic item.
Leech Leech Icon.pngSpawns a friendly familiar leech on the ground that hunts down enemies and heals you for half a heart each time it eats one.
Leo Leo Icon.pngAllows you to crush rocks when you walk over them.
Libra Libra Icon.pngGives 6 coins, 6 bombs and 6 keys and balances out all attributes.
Lil' Brimstone Lil' Brimstone Icon.pngA Familiar that shoots a small Brimstone beam. Must charge like the Brimstone Item before shooting.
Lil' Haunt Lil' Haunt Icon.pngA familiar that damages enemies by chasing them as well as inducing the fear effect.
Little Baggy Little Baggy Icon.pngIsaac can hold 2 pills at once and all cards are replaced by pills.
Little C.H.A.D. Little C.H.A.D. Icon.pngA Familiar who will drop a half Heart every 2 rooms.
Little Chubby Little Chubby Icon.pngA Familiar that charges forward and deals touch damage to any enemies in its path.
Little Gish Little Gish Icon.pngSpawns a familiar that follows Isaac around and fires slowing tears, impeding enemies' speed.
Little Steven Little Steven Icon.pngSpawns a familiar that follows Isaac around and fires homing tears.
Loki's Horns Loki's Horns Icon.pngGives a random chance for projectiles to fire in all 4 cardinal directions.
Lord of the Pit Lord of the Pit Icon.pngGrants flight and increases speed.
Lost Contact Lost Contact Icon.pngEvery tear has a small shield which will allow it to block one enemy projectile.
Lucky Foot Lucky Foot Icon.png+1 Luck. Increases chance of winning Shell Game Beggar. (Independent of luck stat)
The Ludovico Technique The Ludovico Technique Icon.pngInstead of firing tears, Isaac controls one floating tear that hover over obstacles. This tear deals constant damage when held in place over an enemy.
A Lump Of Coal A Lump Of Coal Icon.pngThe more distance tears travel, the more damage they will do.
Lunch Lunch Icon.pngAdds 1 Heart Container.
Maggy's Bow Maggy's Bow Icon.pngGives one heart container and doubles the healing provided by red hearts.
Magic 8 Ball Magic 8 Ball Icon.pngIncreases Shot Speed, and drops a Tarot Card when picked up.
Magic Mushroom Magic Mushroom Icon.pngIncreases all stats and enlargens Isaac
Magic Scab Magic Scab Icon.pngIncreases luck and HP by 1.
Magneto Magneto Icon.pngPulls Pickups towards Isaac.
The Mark The Mark Icon.pngIncreases Damage and Speed, plus adds one Soul Heart.
Match Book Match Book Icon.pngGrants Isaac 1 Black Heart and 3 bombs. Can also give troll bombs.
MEAT! MEAT! Icon.pngAdds a heart container, and increases damage.
Midas' Touch Midas' Touch Icon.pngEnemies that touch you are stunned and turn gold. Any enemy killed while in this state will drop a coin.
The Mind The Mind Icon.pngGrants the combined effects of the Blue Map, Treasure Map and The Compass, revealing the floor layout and all special rooms, including Secret Rooms and Super Secret Rooms.
Mini Mush Mini Mush Icon.pngIncreases Speed and Shot Height and decreases Isaac's size, but lowers Range.
Missing Page 2 Missing Page 2 Icon.pngGives 1 black heart. Upon taking damage that reduces Isaac's health to one heart or less, activates The Necronomicon effect, dealing 40 damage to all enemies in the room.
Missing No. Missing No. Icon.pngRandomizes all passive items upon pickup and at the start of each succeeding floor.
Mitre Mitre Icon.pngGrants a chance of converting any red hearts pickups into soul hearts instead.
Mom's Coin Purse Mom's Coin Purse Icon.pngSpawns 4 random Pills around Isaac.
Mom's Contacts Mom's Contacts Icon.pngAdds a chance to shoot petrifying tears, which stop enemies in place and prevent them from moving or attacking. Range up.
Mom's Eye Mom's Eye Icon.pngAllows Isaac to fire tears from the back of his head.
Mom's Eyeshadow Mom's Eyeshadow Icon.pngTears have a chance to charm enemies.
Mom's Heels Mom's Heels Icon.pngIncreases range.
Mom's Key Mom's Key Icon.pngSpawns 2 keys. Generates additional pickups from chests.
Mom's Knife Mom's Knife Icon.pngIsaac's tears are replaced by a knife that pierces enemies, can travel through obstacles, and can hurt enemies while Isaac is holding it. Holding down the fire button before firing increases its range and power.
Mom's Lipstick Mom's Lipstick Icon.pngIncreases range and shot height.
Mom's Perfume Mom's Perfume Icon.pngAdds a chance to shoot fear tears and increases Tears by 0.16.
Mom's Purse Mom's Purse Icon.pngAllows Isaac to hold 1 additional trinket.
Mom's Underwear Mom's Underwear Icon.pngIncreases range.
Mom's Wig Mom's Wig Icon.pngAdds a chance to spawn Blue Spiders when firing tears. Restores 1 red heart.
Money = Power Money = Power Icon.pngIncreases damage by 0.04 for every coin Isaac has up to +3.96 damage at 99 coins.
Mongo Baby Mongo Baby Icon.pngSummons a familiar that copies the tears of Isaac's other familiars.
Monstro's Lung Monstro's Lung Icon.pngIncreases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.
Mr. Mega Mr. Mega Icon.pngGives Isaac 5 bombs, and makes all dropped bombs larger, which have an increased blast radius and increased damage.
The Mulligan The Mulligan Icon.pngTears have a 1/6 chance of spawning allied blue flies when they hit an enemy.
Mutant Spider Mutant Spider Icon.pngGrants quadruple shot but decreases tears.
My Reflection My Reflection Icon.pngGives Isaac's tears a boomerang effect, and increases range and shot speed.
Mysterious Liquid Mysterious Liquid Icon.pngTears leave a small, short lasting pool of creep on impact or when their range is depleted.
Mystery Sack Mystery Sack Icon.pngSpawns a familiar that follows Isaac around and has a chance to drop a heart, coin, bomb, or key after clearing a room.
Number One Number One Icon.pngTears range is heavily decreased, but the fire rate is greatly increased.
Odd Mushroom (Large) Odd Mushroom (Large) Icon.pngGrants an empty heart container. Increases damage, range and shot height while reducing speed.
Odd Mushroom (Thin) Odd Mushroom (Thin) Icon.pngIncreases Tears and Speed while reducing Damage.
Old Bandage Old Bandage Icon.pngAdds one empty heart container. Whenever Isaac takes damage there's a chance that a Red Heart may drop.
Ouija Board Ouija Board Icon.pngGrants spectral tears that travel through obstacles (but not enemies) instead of breaking on impact with them.
The Pact The Pact Icon.pngIncreases damage by 0.5, tears by 0.7 and grants two soul hearts upon pickup.
Pageant Boy Pageant Boy Icon.pngSpawns several coins around Isaac.
The Parasite The Parasite Icon.pngIsaac's tears split in two when they hit something.
The Peeper The Peeper Icon.pngSpawns a familiar that floats slowly around the room on a zig-zag pattern similar to boom flies damaging enemies it passes through.
Pentagram Pentagram Icon.pngIncreases Damage and increases chances of the Devil Room appearing.
PHD PHD Icon.pngConverts all bad pills into good pills, spawns one pill pickup and restores health. Identifies all pills upon pickup.
Pisces Pisces Icon.pngIncreases tears, adds knock-back shots and increases tear size.
Piggy Bank Piggy Bank Icon.pngGives 3 pennies on pick-up. Every time Isaac is damaged, he will drop one additional penny.
Placenta Placenta Icon.pngGrants a full heart container, and a chance to regenerate a half-heart of health every minute of gameplay.
Polyphemus Polyphemus Icon.pngMakes Isaac shoot one huge tear. Also reduces Tears to minimum. Damage increased . If tear does more damage than an enemy's life, the tear continues to travel with the extra remaining damage.
Proptosis Proptosis Icon.pngTears start out massive with high damage, and then shrink down and become weaker over a short range.
Punching Bag Punching Bag Icon.pngSpawns a Mulligan Familiar that will wander the room randomly. Enemies will attack the Mulligan if it's closer.
Pyro Pyro Icon.pngAdds 99 bombs.
Pyromaniac Pyromaniac Icon.pngIsaac heals 1 heart instead of taking damage by a explosive blast from source. Adds 5 bombs.
A Quarter A Quarter Icon.pngAdds 25 to Isaac's coin count, capping at 99.
Rainbow Baby Rainbow Baby Icon.pngSpawns a familiar that follows Isaac around and fires tears with random effects.
Raw Liver Raw Liver Icon.pngGrants 2 Heart Containers and completely restores health.
The Relic The Relic Icon.pngIsaac is followed by a small blue cross that will drop a Soul Heart every 4 rooms.
Robo-Baby Robo-Baby Icon.pngFollows Isaac around, shooting enemies with an eye laser similar to Technology.
Robo-Baby 2.0 Robo-Baby 2.0 Icon.pngFires lasers at any enemy in its line of sight and moves based on the direction Isaac is firing tears
Roid Rage Roid Rage Icon.pngIncreases speed by 0.6, range by 5.25, and tear height by 0.5.
Rosary Rosary Icon.pngAdds 3 Soul Hearts and increases the chance for The Bible to appear in any item pool.
Rotten Baby Rotten Baby Icon.pngA familiar that spawns Blue Flies.
Rotten Meat Rotten Meat Icon.pngAdds one heart container.
Rubber Cement Rubber Cement Icon.pngTears bounce off walls and obstacles (including enemies).
Sack Of Pennies Sack Of Pennies Icon.pngIsaac is followed by a small bag that drops a coin every 2 rooms.
Sacred Heart Sacred Heart Icon.pngIncreases damage and range while reducing shot speed and grants homing tears. Grants a Heart Container and replenishes all Red Hearts.
Sacrificial Dagger Sacrificial Dagger Icon.pngDagger orbits Isaac, dealing very high damage.
Sad Bombs Sad Bombs Icon.png+5 Bombs. Upon exploding, bombs shoot 8 tears off in every direction, similar to Tammy's Head. The tears are affected by any tear modifiers Isaac has on his own tears.
The Sad Onion The Sad Onion Icon.pngIncreases Tears by 0.7.
Safety Pin Safety Pin Icon.pngIncreases range and shot speed, while adding 1 Black Heart.
Sagittarius Sagittarius Icon.pngIncreases speed by +0.2 and grants piercing tears.
Samson's Chains Samson's Chains Icon.pngPull a chain and ball behind you that will damage enemies on contact and is able to break stones.
Scapular Scapular Icon.pngOnce per room, when Isaac is reduced to his last half red Heart, the aura around his head temporarily vanishes and he is granted one Soul Heart.
Scorpio Scorpio Icon.pngGrants poison tears, which deal damage over time when inflicted.
Screw Screw Icon.pngTears and shot speed up.
Sharp Plug Sharp Plug Icon.pngUsing an activated item while it's not charged will charge it and Sharp Plug does 2 full heart damage to Isaac
Sissy Longlegs Sissy Longlegs Icon.pngWanders about the room, occasionally spawning Blue Spiders.
Sister Maggy Sister Maggy Icon.pngA Familiar that follows Isaac around shooting blood tears.
Skatole Skatole Icon.pngAll types of fly except Boom Fly and Red Boom Fly become passive and slowly move towards Isaac. Does not prevent contact damage.
Skeleton Key Skeleton Key Icon.pngSets your key count to the maximum of 99.
The Small Rock The Small Rock Icon.pngIncreases damage by 1, increases tears by 0.2, and decreases speed by 0.1.
Smart Fly Smart Fly Icon.pngAfter Isaac takes damage, this fly will deal continuous touch damage to whatever enemy caused the damage until it is dead. The fly will then systematically attack 1 enemy at a time until the room is cleared.
SMB Super Fan SMB Super Fan Icon.pngIncreases all stats.
A Snack A Snack Icon.pngAdds 1 Heart Container.
Soy Milk Soy Milk Icon.pngTears shrink and do much less damage, but fire in very rapid succession.
The Soul The Soul Icon.pngGrants two Soul Hearts. Isaac now repels enemy projectiles.
Speed Ball Speed Ball Icon.pngIncreases speed by 0.3 and shot speed by 20%.
Spelunker Hat Spelunker Hat Icon.pngReveals type of adjacent rooms, including location for secret rooms and super secret rooms.
Spider Bite Spider Bite Icon.pngAdds a chance to shoot slowing tears, reducing speed of enemy movement and any projectile fired by them.
Spider Baby Spider Baby Icon.pngWhen hit, spawns up to 2 Blue Spiders.
Spirit Of The Night Spirit Of The Night Icon.pngGrants spectral tears and flight.
Spoon Bender Spoon Bender Icon.pngGrants Isaac homing tears.
Squeezy Squeezy Icon.pngIncreases tears by 0.4, and spawns 2 Soul Hearts pickups.
Starter Deck Starter Deck Icon.pngIsaac can hold 2 cards at once and all pills are replaced by cards.
Steam Sale Steam Sale Icon.pngReduces all Shop prices by 50%, rounded down to 7 coins for an item, rounded up to 2-3 coins for a pickup.
Stem Cells Stem Cells Icon.pngAdds one filled Heart Container and increases Shot Speed.
Steven Steven (Item) Icon.pngIncreases Damage by 1.
Stigmata Stigmata Icon.pngIncreases damage, and adds 1 heart container.
Stop Watch Stop Watch Icon.pngNoDLC Indicator.png Automatically inflicts slow to all enemies in every room.
DLC Indicator.png Upon taking damage, inflicts slow to all enemies for the current room.
Strange Attractor Strange Attractor Icon.pngPickups, Trinkets and Monsters are magnetically attracted to Isaac's tears.
Super Bandage Super Bandage Icon.pngGrants one Heart Container and gives 2 Soul Hearts.
Synthoil Synthoil Icon.pngIncreases damage by 1, range by 5.25, and tear height by 0.5.
Taurus Taurus Icon.pngSpeed down, gains speed while in a room with enemies until gaining My Little Unicorn effect for a few seconds.
Tech.5 Tech.5 Icon.pngGrants a unlimited range piercing laser with random rate of fire that does not replace tears. The laser might occasionally fire with the effect of a random item or trinket, such as Hook Worm, Spoon Bender or Tiny Planet.
Technology Technology Icon.pngReplaces tears with a piercing laser with unlimited range.
Technology 2 Technology 2 Icon.pngDecreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.
Tiny Planet Tiny Planet Icon.pngRange up and makes shot tears revolve around Isaac until they drop.
The Negative The Negative Icon.pngIf the character has half a red heart or no red hearts after taking damage, it triggers The Necronomicon effect, damaging all enemies in the room. Also allows entrance into the Dark Room.
The Polaroid The Polaroid Icon.pngIf the character has half a red heart or no red hearts after taking damage, it triggers the Book Of Shadows effect, creating a shield that nullifies all types of damage for 5 seconds. Also allows entrance into The Chest.
There's Options There's Options Icon.pngThere will be 2 items available to choose from after defeating a boss. Choosing 1 item causes the other to disappear.
Thunder Thighs Thunder Thighs Icon.pngDestroys rocks upon contact with Isaac. Adds one heart container, and lowers Speed.
Toothpicks Toothpicks Icon.pngIncreases tears and shot speed.
Torn Photo Torn Photo Icon.pngTears + Shot speed up.
Tough Love Tough Love Icon.pngAdds a chance to shoot a tooth instead of a tear, which deals greater damage than regular tears.
Transcendence Transcendence Icon.pngGrants flight.
Treasure Map Treasure Map Icon.pngReveals all rooms for every floor. However, it does not reveal icons or secret rooms.
Trinity Shield Trinity Shield Icon.pngIsaac gains a shield that protects him from enemy shots.
The Wafer The Wafer Icon.pngAll sources of damage that would cause more than one half heart of damage are reduced to one half heart instead.
Whore Of Babylon Whore Of Babylon Icon.pngIncreases damage and speed whenever the character health is half red heart or less (one red heart for Eve).
Wire Coat Hanger Wire Coat Hanger Icon.pngIncreases Tears by 0.7.
Wooden Spoon Wooden Spoon Icon.pngIncreases speed by 0.3.
Virgo Virgo Icon.pngGrants a chance to trigger the Book Of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 10 seconds. Also converts "bad pills" into "good pills".
The Virus The Virus Icon.pngInflicts poison to enemies who make contact with Isaac. Speed down.
X-Ray Vision X-Ray Vision Icon.pngReveals and opens all Secret Room and Super Secret Room entrances.

Afterbirth Collectibles

Activated Collectibles

Name Icon Description Recharge
Box Of Friends Box Of Friends Icon.pngUpon use, duplicates all of Isaac's familiars for the current room.4
D12 D12 Icon.pngRe-rolls all rocks in the current room into other random objects, such as bomb rocks, metal blocks, TNT, or poop.3
D7 D7 Icon.pngRestarts the current room and brings back all enemies, allowing more rewards to be acquired by completing the room.3
D8 D8 Icon.pngRe-rolls all of Isaac's stats.4
Diplopia Diplopia Icon.pngDuplicates all pickups and item pedestals in the room.One time use
Friendly Ball Friendly Ball Icon.pngThrowing the ball at an enemy instantly kills it and captures it. The captured enemy can later be released and will be charmed until it dies, persisting between floors.3
Glass Cannon Glass Cannon Icon.pngWhen used, reduces Isaac's health to half a heart (including soul and black hearts) and fires one large piercing spectral tear that does a lot of damage. The damage done by Glass Cannon scales with Isaac's damage (at base damage it does 45 damage).4 seconds
Glowing Hour Glass Glowing Hour Glass Icon.pngWhen used, this item will rewind time, put Isaac back in the previous room, and undo anything that happened in the current room. Any health, pickups, or items gained or lost will be reset back to the previous state.2
Jar Of Flies Jar Of Flies Icon.pngEvery time Isaac kills an enemy, a fly will be added to the jar, up to a maximum of 20. Using the Jar of Flies will release all the flies that are currently in the jar as friendly Blue Flies that will damage enemies.0
Kidney Bean Kidney Bean Icon.pngUpon use, Isaac farts, charming all nearby enemies.2
Mega Bean Mega Bean Icon.pngWhen used, the Mega Bean will freeze all enemies in the current room for a couple of seconds, deal 5 damage and poison any enemies near Isaac, and send a wave of spikes that deals 10 damage across the room in the direction Isaac is facing.3
Mega Blast Mega Blast Icon.pngUpon use, Isaac fires a laser similar to the one used by Mega Satan. This laser deals massive damage, lasts for approximately 15 seconds, and persists between rooms. Isaac is pushed backwards by the force of the laser while it is active.12
Mine Crafter Mine Crafter Icon.pngWhen used, places an explosive TNT barrel that can be pushed and used to destroy rocks or damage enemies. If used a second time in the same room while the previous TNT barrel is still intact, it will remotely explode the TNT.1
Mom's Box Mom's Box Icon.pngWhen used, Mom's Box will drop a random trinket on the ground. While held, increases luck by 1 and doubles the effects of trinkets.4
Placebo Placebo Icon.pngWhen used, copies the effect of the pill Isaac is currently holding without consuming it. Does not copy the effects of cards or runes.4
Tear Detonator Tear Detonator Icon.pngWhen used, will detonate any tears currently on the screen and cause each one to split into 6 more tears which will fire in a circle, similar to Tammy's Head.1
Teleport 2.0 Teleport 2.0 Icon.pngWhen used, teleports Isaac to a random room that has not been explored yet. If all rooms are explored, including secret rooms, it will teleport Isaac to the Devil or Angel room. If all rooms are explored, including the Devil or Angel room, it will teleport Isaac to the I AM ERROR room. If used in a room with enemies, it will teleport Isaac out and back into the exact same room.4
Ventricle Razor Ventricle Razor Icon.pngCan be used to place an orange trapdoor and a blue trapdoor. Upon entering a trapdoor, Isaac is teleported to the other trapdoor.0
Wooden Nickel Wooden Nickel Icon.pngWhen used, has a 50% chance to drop one random type of coin (penny, nickel or dime)1

Passive Collectibles

Name Icon Description
8 Inch Nails 8 Inch Nails Icon.png+1.5 Damage Up. Replaces Isaac's tears with nails, which have increased knockback.
Athame Athame Icon.pngWhenever Isaac takes damage, a black ring briefly appears around Isaac, dealing damage to all nearby enemies.
Betrayal Betrayal Icon.pngEvery time Isaac takes damage, a charm effect is applied to every enemy in the room, causing them to attack each other rather than Isaac.
Binky Binky Icon.pngTears up, adds 1 soul heart, and decreases Isaac's size.
Black Powder Black Powder Icon.pngIsaac leaves a trail of black powder on the floor. Walking in a circle will spawn a pentagram symbol on the floor, which deals 10 damage per tick to any enemies inside it.
Bomber Boy Bomber Boy Icon.png+5 bombs. Isaac's bombs will now explode in a large cross-shaped pattern (roughly 5 bombs explosions wide). This also affects troll bombs.
Bumbo Bumbo Icon.pngSpawns a beggar familiar which floats around the room and picks up any nearby coins, leveling up after collecting several coins. At level 2, Bumbo gains a body. At level 3, it begins to fire tears. At level 4, Bumbo chases enemies slowly, dealing contact damage.
Bursting Sack Bursting Sack Icon.pngSpider enemies no longer target or deal contact damage to Isaac.
Cambion Conception Cambion Conception Icon.pngAfter taking damage a certain amount of times, a permanent demonic familiar spawns.
Car Battery Car Battery Icon.pngCauses Isaac's activated item to activate twice on each use.
Censer Censer Icon.pngGives Isaac a golden censer familiar which creates a huge aura of light that slows down any enemies inside it.
Chaos Chaos Icon.pngChaos causes items to be chosen from random item pools. When picked up, drops between 1-6 random pickups on the floor.
Charged Baby Charged Baby Icon.pngA familiar baby that drops a battery every 4 rooms. Has a small chance to freeze all enemies in the room when hit.
Circle Of Protection Circle Of Protection Icon.pngGives Isaac a large white halo around him, that deals a bit of damage to any enemies in contact with the ring. Every time an enemy bullet enters the ring, there is a chance it will reflect a homing tear back at the enemy.
Continuum Continuum Icon.png+2.25 Range Up. +1.5 Tear Height. Isaac's tears travel through walls and appear out of the opposite wall. Isaac's tears also travel over rocks and objects.
Crack Jacks Crack Jacks Icon.pngAdds one heart container and drops a random Trinket.
Crown Of Light Crown Of Light Icon.pngGives Isaac a crown that glows blue when active, and turns gray when inactive. While Isaac has no empty red heart containers, Isaac's tears are replaced with blue diamond tears that deal double damage. Regardless of health, the crown will deactivate for the current room when Isaac takes damage.
Curse Of The Tower Curse Of The Tower Icon.pngCauses Isaac to spawn 6 troll bombs on the floor every time he gets hit, similar to the Anarchist Cookbook mechanic.
Dead Eye Dead Eye Icon.pngIsaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.
Deep Pockets Deep Pockets Icon.pngAllows Isaac to carry two cards or pills (or a combination of both) at the same time.
Eden's Blessing Eden's Blessing Icon.pngTears up. Grants a random item at the start of the next run.
Empty Vessel Empty Vessel Icon.pngWhile Isaac has no red hearts, this item grants flight and a random chance to activate an invincibility shield for a few seconds. If Isaac gains any red hearts, these benefits will disappear.
Epiphora Epiphora Icon.pngShooting in one direction increases Isaac's rate of fire until the cap is reached. As soon as Isaac changes direction or stops shooting, rate of fire is reset to its normal amount.
Evil Eye Evil Eye Icon.pngWhile firing tears, Isaac has a chance to fire an eye across the screen with a very slow shot speed, which will fire tears of its own in the same direction as Isaac. The eye will be destroyed if it comes into contact with an enemy or obstacle.
Explosivo Explosivo Icon.pngIsaac's tears have a chance to stick to enemies and explode.
Farting Baby Farting Baby Icon.pngA familiar that follows Isaac and blocks tears. If a tear hits Farting Baby, there is a high chance for it to fart, which will either knock back, poison, or charm all nearby enemies.
Fate's Reward Fate's Reward Icon.pngA blue head familiar that will follow Isaac and fire tears copying his tear effects and damage.
Friend Zone Friend Zone Icon.pngA white orbiting fly which deals 3 contact damage per tick to enemies. This familiar orbits Isaac at a middle length distance somewhere between Distant Admiration and Forever Alone.
Fruit Cake Fruit Cake Icon.pngIsaac's tears gain a random effect that changes every shot.
GB Bug GB Bug Icon.pngA glitch familiar that bounces around the room and applies a random status effect to any enemies it comes into contact with and has a chance to re-roll pickups that it passes over.
Glitter Bombs Glitter Bombs Icon.pngGives Isaac 5 bombs, and makes Isaac's bombs have a chance to drop random pickups or charm enemies when they explode.
God's Flesh God's Flesh Icon.pngTears now have a random chance to apply a shrinking effect, causing enemies to shrink in size and also run away from Isaac. Shrunk enemies can be crushed and killed by walking over them.
Head Of The Keeper Head Of The Keeper Icon.pngIsaac's tears become coins and now have a chance to drop pennies on the floor upon successfully hitting an enemy.
Holy Light! Holy Light! Icon.pngIsaac has a random chance to fire a Holy tear, which when it hits an enemy, will spawn a Crack The Sky style light beam on the same enemy, dealing damage.
Host Hat Host Hat Icon.pngA host familiar that sits on Isaac's head and has a random chance to block enemy shots and retaliate with 3 tears. Grants immunity to explosions.
Immaculate Conception Immaculate Conception Icon.pngUpon picking up a certain amount of health, spawn a permanent angelic familiar.
Incubus Incubus Icon.pngA demonic familiar that follows Isaac and shoots tears identical to Isaac's in terms of damage, range, fire rate, and effects.
Key Bum Key Bum Icon.pngSpawns a portable Key Master that follows Isaac and collects keys, giving random chests in return.
Kidney Stone Kidney Stone Icon.pngRandomly while firing tears, Isaac will stop firing and turn red, where he will charge and release a lot of 'tears' in one go. In the burst of tears is a kidney stone which deals a lot of damage.
Lil' Chest Lil' Chest Icon.pngSpawns a chest familiar that follows Isaac and drops a random pickup every few rooms.
Lil Gurdy Lil Gurdy Icon.pngGives Isaac a Gurdy familiar that will charge around the room dealing contact damage to enemies. Lil Gurdy is charged by holding down a fire button and letting go. The longer the button is held, the faster Lil Gurdy will fling itself across the screen. Lil Gurdy can pass over objects and obstacles in the room.
Lil' Loki Lil' Loki Icon.pngA Loki familiar that follows Isaac and shoots 4 tears in a cross pattern.
Lost Fly Lost Fly Icon.pngA familiar fly that moves in a straight line and attaches itself to the first obstacle or wall it comes into contact with in each room. If any enemies walk into its path, it will deal 7 contact damage per tick. If the obstacle it is attached to is destroyed then it will continue rolling in the direction it was previously travelling until it meets another wall or obstacle.
Lusty Blood Lusty Blood Icon.pngEach time Isaac kills an enemy, Isaac's damage increases for the current room.
Marked Marked Icon.pngIsaac will now fire tears automatically directed at a red target on the ground which is controlled by the player. This allows for a full 360 degree tear firing radius. Can be overridden by other tear modifiers such as Mom's Knife or Brimstone.
Maw Of The Void Maw Of The Void Icon.png+1.0 Damage Up. After continuously firing tears for 3 seconds, a red cross appears on Isaac's head that, upon releasing the fire button, creates a black ring which deals a lot of damage to any enemies inside it. The ring rapidly deals damage equal to Isaac's tear damage to any enemies in contact with it.
Milk! Milk! Icon.pngA glass of milk follows Isaac and spills on the floor upon taking damage. After the milk spills, Isaac gains a tears up that lasts for the rest of the room.
Mom's Pearls Mom's Pearls Icon.png+1.25 Range Up. +0.5 Tear Height. +1 Luck Up.
More Options More Options Icon.pngTwo items spawn in every Treasure Room. Only one can be taken; the other will disappear.
Mr. Dolly Mr. Dolly Icon.pngTears and Range up. Spawns 3 random types of hearts on the floor when picked up
Multidimensional Baby Multidimensional Baby Icon.pngSpawns a familiar that will follow Isaac's movements on a 2.5 second delay. Tears that pass through the baby will be doubled and increase in damage.
My Shadow My Shadow Icon.pngEach time Isaac takes damage, inflicts Fear on all enemies in the room and spawns a black Charger familiar that will attack enemies. The Charger will be killed if it is damaged too much.
Night Light Night Light Icon.pngA cone of light shines in the direction Isaac is moving that slows enemies and enemy shots.
No. 2 No. 2 Icon.pngContinuously firing tears for several seconds causes Isaac to drop a Butt Bomb. Butt Bombs explode for 50 damage like normal bombs, but also deal 10 damage to all enemies in the room and daze them for a short period of time.
Papa Fly Papa Fly Icon.pngA blue fly familiar follows Isaac's movements on a 3 second delay. Papa Fly will fire tears at nearby enemies.
Pay To Play Pay To Play Icon.pngThis item turns all doors that require a key into doors which need a coin to enter instead. This affects shops, item rooms, libraries and other key doors.
PJs PJs Icon.pngAdds 4 Soul Hearts and fully restores Isaac's red health.
Pupula Duplex Pupula Duplex Icon.pngTransforms Isaac's tears into a wide arc shape which gives them a much larger hitbox. Gives Isaac spectral tears which allows them to travel through objects in the environment (i.e. rocks).
Purity Purity Icon.pngThis item will boost one of Isaac's stats depending on the color of the aura around him. The aura will disappear upon taking damage and will reappear with a random color upon entering a new room. A red aura boosts damage, a blue aura boosts rate of fire, a yellow aura boosts speed, and an orange aura boosts range.
Obsessed Fan Obsessed Fan Icon.pngA purple fly familiar that follows Isaac's movements on a 3 second delay and deals contact damage to enemies.
Restock Restock Icon.pngCauses shops to instantly restock their items when they are bought. Granted by default for every character in Greed Mode.
Rune Bag Rune Bag Icon.pngA bag that follows Isaac and drops a random mystic rune every 3 rooms.
Sack Head Sack Head Icon.pngGreatly increases the chance to find sacks.
Scatter Bombs Scatter Bombs Icon.pngAdds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs.
Seraphim Seraphim Icon.pngAn angel familiar which follows Isaac and fires homing tears which deal 10 damage at -25% shot speed and a reduced fire rate.
Serpent's Kiss Serpent's Kiss Icon.pngTears now have a random chance to apply a poison effect, causing 4 or 6 damage per tick to enemies (Similar to The Common Cold item). Isaac now deals poison damage on contact with enemies similar to The Virus item (Damage over time 4 or 6 per tick). Enemies that were poisoned have a chance to drop a black heart when killed.
Sticky Bombs Sticky Bombs Icon.png+5 bombs. Bombs stick to enemies and spawn 2-4 Blue Spiders if they kill an enemy.
Spear Of Destiny Spear Of Destiny Icon.pngIn addition to tears, Isaac now holds a spear in front of him which deals damage equal to 2 times his tear damage, and occasionally inflicts Fear. The spear cannot be thrown, but deals damage while it is in contact with an enemy.
Spider Mod Spider Mod Icon.pngDisplays Isaac's tear damage and enemy health bars. Spawns a gray spider familiar that wanders around and inflicts a random status effect on any enemies it comes into contact with. Occasionally spawns a blue spider upon clearing a room.
Succubus Succubus Icon.pngSpawns a flying familiar that bounces around the room with a black aura, dealing rapid damage to any enemies inside it. While standing in the aura, Isaac gains a 1.5x tear damage multiplier.
Sworn Protector Sworn Protector Icon.pngAn orbital angel which does 7 contact damage per tick and blocks enemy shots. When it blocks a shot, it has a very small chance to drop an eternal heart.
Tech X Tech X Icon.pngTears are replaced with laser rings that pierce through enemies and deal damage to enemies within them. Can be charged to increase the size of the ring.
The Wiz The Wiz Icon.pngTears simultaneously fire out of both eyes diagonally, similar to the effect of the R U A Wizard? pill. Isaac's tears also travel above all obstacles.
Toxic Shock Toxic Shock Icon.pngUpon entering a room, poisons all enemies, dealing double Isaac's tear damage. Killing enemies leaves a small, short lasting pool of green creep on the ground.
Tractor Beam Tractor Beam Icon.pngIsaac emits a beam from his face. Isaac's tears travel in the path of the beam.
Zodiac Zodiac Icon.pngZodiac will give Isaac a random zodiac item effect that changes after every floor.

Afterbirth † Collectibles

Activated Collectibles

Name Icon Description Recharge
Brown Nugget Brown Nugget Icon.pngSpawns a stationary fly familiar that fires tears at nearby enemies.7 seconds
Clicker Clicker Icon.pngTransforms Isaac into another random character.6
Compost Compost Icon.pngSpawns a blue spider or fly. Turns pickups in the room into blue spiders or flies.2
Crooked Penny Crooked Penny Icon.pngSpawns a penny and has a 50% chance to double all items and pickups in the room. If the effect fails, the items and pickups disappear.4
D1 D1 Icon.pngDuplicates a random pickup in the room.4
D Infinity D Infinity Icon.pngGrants a random dice item that changes each use.2
Dataminer Dataminer Icon.pngDisplaces enemy sprites for the current room and increases or decreases a random stat.4
Delirious Delirious Icon.pngSpawns a random charmed boss.12
Dull Razor Dull Razor Icon.pngHurts Isaac without depleting health, activating any items that trigger upon taking damage.2
Eden's Soul Eden's Soul Icon.pngSpawns two item pedestals.12 (One time use)
Mama Mega! Mama Mega! Icon.pngDamages all enemies and destroys all obstacles. The effect occurs every time a new room is entered for the rest of the floor. Opens doors to the floor's secret and super secret rooms.One time use
Metronome Metronome Icon.pngGrants a random item effect for the current room.1
Plan C Plan C Icon.pngKills all enemies in the room, then kills Isaac three seconds later.One time use
Potato Peeler Potato Peeler Icon.pngRemoves a heart container, increases damage and range, and grants a Cube of Meat.0
Pause Pause Icon.pngFreezes all enemies until a fire button is pressed.2
Sharp Straw Sharp Straw Icon.pngDamages all enemies in the room.8 seconds
Smelter Smelter Icon.pngConsumes Isaac's currently held trinket and applies its effect permanently.6
Void Void Icon.pngConsumes all pedestal items in the room. Active items will have their effects added to Void, and passive items will grant stat upgrades.6
Wait What? Wait What Icon.pngIsaac farts, sending out rock waves.2

Passive Collectibles

Name Icon Description
Acid Baby Acid Baby Icon.pngSpawns a familiar that drops random pills every 2 rooms cleared. Upon using a pill, all enemies in the room are poisoned.
Adrenaline Adrenaline Icon.pngIncreases damage based on how many empty heart containers Isaac has.
Analog Stick Analog Stick Icon.pngDecreases tear delay. Allows Isaac to fire tears diagonally.
Apple! Apple! Icon.pngIncreases tears. Adds a chance to fire a high-damage razor blade.
Backstabber Backstabber Icon.pngHas a chance to fire tears that inflict bleeding on enemies, causing them to slowly take damage over time.
Belly Button Belly Button Icon.pngDrops a random trinket. Grants an extra trinket slot.
Big Chubby Big Chubby Icon.pngSpawns a familiar that slowly charges forward and damages enemies in its path.
Bloodshot Eye Bloodshot Eye Icon.pngSpawns an orbiting eye familiar that fires tears every 2 seconds.
Camo Undies Camo Undies Icon.pngIsaac becomes camouflaged at the beginning of each room. Enemies will not attack Isaac until he starts firing tears.
Compound Fracture Compound Fracture Icon.pngIncreases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.
Cone Head Cone Head Icon.pngGrants a soul heart. Adds a chance to block enemy shots.
Contagion Contagion Icon.pngThe first enemy killed in a room explodes and poisons nearby enemies. Poisoned enemies will also explode upon death.
Dad's Lost Coin Dad's Lost Coin Icon.pngIncreases range by 1.5. Drops a Lucky Penny. Other Effects Unknown
Dark Prince's Crown Dark Prince's Crown Icon.pngIncreases range, tears, and shot speed when at exactly one red heart.
Dead Tooth Dead Tooth Icon.pngWhile firing, Isaac gains a green aura that poisons nearby enemies.
Depression Depression Icon.pngSpawns a cloud familiar that leaves a trail of tears that damages enemies. Has a chance to spawn damaging beams of light onto enemies that touch the cloud.
Dog Tooth Dog Tooth Icon.pngIncreases damage and speed. Upon entering a room adjacent to a secret room, a howl sound effect will play.
Duality Duality Icon.pngWhenever a Devil or Angel Room would spawn after defeating a boss, both rooms spawn. Only one can be entered.
Eucharist Eucharist Icon.pngAn Angel Room door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.
Euthanasia Euthanasia Icon.pngAdds a chance to fire needles. If a needle kills an enemy, it bursts into more needles.
Eye Of Belial Eye Of Belial Icon.pngGrants piercing tears. After piercing one enemy, tears start homing and deal double damage.
Eye Of Greed Eye Of Greed Icon.pngAdds a chance to fire tears that temporarily stun enemies and turn them into gold. Any enemy killed while in this state will drop coins.
Finger! Finger! Icon.pngSpawns a finger familiar that points at enemies, dealing constant damage.
Ghost Pepper Ghost Pepper Icon.pngAdds a chance to shoot a fire that damages enemies and remains in place until it deals enough damage or the room is left.
Glaucoma Glaucoma Icon.pngAdds a chance to shoot concussive tears, causing enemies to walk around randomly.
Glyph Of Balance Glyph Of Balance Icon.pngGrants 2 soul hearts, Other Effects Unknown
Greed's Gullet Greed's Gullet Icon.pngGrants a heart container for every 25 coins Isaac has.
Hushy Hushy Icon.pngSpawns a Hush familiar that bounces around the room and deals contact damage. While firing tears, it stops moving.
Jacob's Ladder Jacob's Ladder Icon.pngTears fire sparks of electricity in random directions upon hitting an obstacle or enemy.
King Baby King Baby Icon.pngSpawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, it stops moving.
Large Zit Large Zit Icon.pngAdds a chance to fire a creep shot that deals double damage and leaves a trail of slowing white creep.
Lead Pencil Lead Pencil Icon.pngAfter every 15 tears fired, Isaac will fire a high-damage cluster of tears.
Lil Monstro Lil Monstro Icon.pngSpawns a familiar that fires clusters of tears. Must be charged before shooting.
Linger Bean Linger Bean Icon.pngAdds a chance to fire a gas cloud that damages nearby enemies.
Little Horn Little Horn (item) Icon.pngAdds a chance to fire a piercing tear that instantly kills any enemy that it touches.
Metal Plate Metal Plate Icon.pngAdds a chance to reflect enemy shots. Grants one soul heart.
Moldy Bread Moldy Bread Icon.pngGrants a heart container.
Mom's Razor Mom's Razor Icon.pngSpawns an orbiting razor that damages enemies it touches and inflicts bleeding on enemies, causing them to slowly take damage over time.
Parasitoid Parasitoid Icon.pngAdds a chance to fire an egg sack which spawns slowing creep and spawns a blue fly or spider upon hitting an enemy.
Poke Go Poke Go Icon.pngUpon entering a room with enemies in it, has a chance to spawn a random charmed enemy that persists across rooms.
Polydactyly Polydactyly Icon.pngAllows Isaac to carry two cards, pills, or any combination of both at the same time. Drops a random card or pill.
Sack Of Sacks Sack Of Sacks Icon.pngSpawns a sack familiar that has a chance to drop a sack upon clearing a room.
Shade Shade Icon.pngSpawns a shadow familiar that follows Isaac's movements on a 3 second delay and deals contact damage to enemies.
Shard Of Glass Shard Of Glass Icon.pngUpon taking damage, Isaac has a chance to drop a pickup, gain 5 range, and leave a trail of damaging red creep for the current room.
Sinus Infection Sinus Infection Icon.pngAdds a chance to fire a booger which sticks to enemies and poisons them.
Sulfuric Acid Sulfuric Acid Icon.pngIncreases damage. Adds a chance to fire acidic tears which can destroy obstacles.
Tarot Cloth Tarot Cloth Icon.pngDrops a random card or rune. Doubles the effects of cards and runes.
Varicose Veins Varicose Veins Icon.pngTaking damage releases a ring of 10 high damage tears.
YO LISTEN! YO LISTEN! Icon.pngIncreases luck. Spawns a fairy familiar that points out secret room entrances and tinted rocks.

SmallIsaac.png The Binding of Isaac: Rebirth SmallIsaac.png

MainPageAchievements.png Achievements MainPageAttributes.png Attributes MainPageBosses.png Bosses TarotCard.png Cards and Runes MainPageChallenges.png Challenges MainPageChapters.png Chapters
Isaac App.png Characters MainPageBabies.png Co-op Magic Mushroom Icon.png Items Isaac's Tears Icon.png Item Pools MainPageMonsters.png Monsters MainPageObjects.png Objects
Red heart.png Pickups BlueBlue.png Pills MainPageRooms.png Rooms MainPageSeeds2.png Seeds Guppy App.png Transformations The Left Hand Icon.png Trinkets