Treasure Room (Afterbirth Item Pool)

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Item Pool
Rebirth Treasure Room Shop Library Curse Room Boss Secret Room Devil Room Angel Room Golden Chest Red Chest Beggar Devil Beggar Key Master
DLC Indicator.png Afterbirth Treasure Room Shop Library Curse Room Boss Secret Room Devil Room Angel Room Golden Chest Red Chest Beggar Devil Beggar Key Master Bomb Bum
DLC Indicator.png Greed Mode Treasure Room Shop Library Curse Room Boss Secret Room Devil Room Angel Room Golden Chest
Afterbirth† Indicator.png Afterbirth † Treasure Room Shop Library Curse Room Boss Secret Room Devil Room Angel Room Golden Chest Red Chest Beggar Devil Beggar Key Master Bomb Bum
Afterbirth† Indicator.png Greed Mode Treasure Room Shop Library Curse Room Boss Secret Room Devil Room Angel Room Golden Chest

The Treasure Room item pool contains the majority of the game's items. All of the items in this pool are able to be found in the Treasure Room.

Activated Collectibles

Name Icon Description Recharge
Anarchist Cookbook
Anarchist Cookbook Icon.pngSpawns six troll bombs around the room.3
Best Friend
Best Friend Icon.pngDeploys a decoy Isaac that eventually explodes with an increased blast radius.3
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
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
Box of Spiders
Box of Spiders Icon.pngSummons 2-4 Blue Spiders.2
Butter Bean
Butter Bean Icon.pngIsaac farts and pushes back nearby enemies.3 seconds
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
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
D10
D10 Icon.pngRerolls the enemies in a room. Only rerolls enemies that are still alive (does not spawn new enemies).1
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
D20
D20 Icon.pngRerolls all pickups in the current room.6
D4
D4 Icon.pngRerolls all upgrades on the player. (Does not reroll Azazel's brimstone).6
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
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
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
How To Jump
How To Jump Icon.pngGives Isaac the ability to jump (over gaps, spikes, etc.).0
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
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
Kidney Bean
Kidney Bean Icon.pngUpon use, Isaac farts, charming all nearby enemies.2
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
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
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 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
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
Prayer Card
Prayer Card Icon.pngGrants an Eternal Heart per use.6
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
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
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
The Bean
The Bean Icon.pngIsaac releases bad gas, poisoning any enemy in close vicinity.1
The Book of Sin
The Book of Sin Icon.pngSpawns a random Pick Up, Pill, Card, or Trinket.4
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
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
The Hourglass
The Hourglass Icon.pngUpon activation, enemies and their projectiles are slowed down for a short duration.2
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 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
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
Yum Heart
Yum Heart Icon.pngRestores 1 whole Red heart.4

Passive Collectibles

Name Icon Description
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.
8 Inch Nails
8 Inch Nails Icon.png+1.5 Damage Up. Replaces Isaac's tears with nails, which have increased knockback.
<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.
A Quarter
A Quarter Icon.pngAdds 25 to Isaac's coin count, capping at 99.
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.
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.
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.
Best Bud
Best Bud Icon.pngWhen hit, summons a white attack fly similar to Distant Admiration for the current room.
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.
Big Fan
Big Fan Icon.pngSpawns a large orbital familiar that blocks enemy projectiles and deals slight contact damage to enemies.
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.
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.
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.
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.
Boom!
Boom! Icon.pngGives 10 bombs.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Dead Bird
Dead Bird Icon.pngSpawns a flying familiar for the current room that chases enemies whenever Isaac takes damage.
Dead Eye
Dead Eye Icon.pngIsaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.
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.
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.
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.
Eden's Blessing
Eden's Blessing Icon.pngTears up. Grants a random item at the start of the next run.
Epic Fetus
Epic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
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.
Eve's Mascara
Eve's Mascara Icon.pngDoubles damage, halves tears stat, and greatly reduces shot speed.
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.
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.
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.
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.
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.
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.
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.
Gnawed Leaf
Gnawed Leaf Icon.pngAfter standing still and not shooting for a short time, Isaac turns invincible until he moves or shoots.
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.
Guillotine
Guillotine Icon.pngIsaac's head is removed from his body and floats around him. Increases Damage by 1 and Tears by 0.16.
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.
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.
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.
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.
Hot Bombs
Hot Bombs Icon.pngGrants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact.
Infamy
Infamy Icon.pngChance to block projectiles coming from any direction.
Infestation 2
Infestation 2 Icon.pngSpawns allied blue spiders from killed enemies.
Infestation
Infestation Icon.png1-3 Blue Flies randomly spawn every time Isaac gets hit.
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.
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 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.
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' 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.
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 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.
Lost Contact
Lost Contact Icon.pngEvery tear has a small shield which will allow it to block one enemy projectile.
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.
Lucky Foot
Lucky Foot Icon.png+1 Luck. Increases chance of winning Shell Game Beggar. (Independent of luck stat)
Lusty Blood
Lusty Blood Icon.pngEach time Isaac kills an enemy, Isaac's damage increases for the current room.
Maggy's Bow
Maggy's Bow Icon.pngGives one heart container and doubles the healing provided by red hearts.
Magic Mushroom
Magic Mushroom Icon.pngIncreases all stats and enlargens Isaac
Magneto
Magneto Icon.pngPulls Pickups towards Isaac.
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.
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.
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.
Mini Mush
Mini Mush Icon.pngIncreases Speed and Shot Height and decreases Isaac's size, but lowers Range.
Mitre
Mitre Icon.pngGrants a chance of converting any red hearts pickups into soul hearts instead.
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 Eyeshadow
Mom's Eyeshadow Icon.pngTears have a chance to charm enemies.
Mom's Eye
Mom's Eye Icon.pngAllows Isaac to fire tears from the back of his head.
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 Perfume
Mom's Perfume Icon.pngAdds a chance to shoot fear tears and increases Tears by 0.16.
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.
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.
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.
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.
Number One
Number One Icon.pngTears range is heavily decreased, but the fire rate is greatly increased.
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.
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.
Ouija Board
Ouija Board Icon.pngGrants spectral tears that travel through obstacles (but not enemies) instead of breaking on impact with them.
PHD
PHD Icon.pngConverts all bad pills into good pills, spawns one pill pickup and restores health. Identifies all pills upon pickup.
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.
Piggy Bank
Piggy Bank Icon.pngGives 3 pennies on pick-up. Every time Isaac is damaged, he will drop one additional penny.
Pisces
Pisces Icon.pngIncreases tears, adds knock-back shots and increases tear size.
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.
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.
Pyromaniac
Pyromaniac Icon.pngIsaac heals 1 heart instead of taking damage by a explosive blast from source. Adds 5 bombs.
Pyro
Pyro Icon.pngAdds 99 bombs.
Rainbow Baby
Rainbow Baby Icon.pngSpawns a familiar that follows Isaac around and fires tears with random effects.
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
Robo-Baby
Robo-Baby Icon.pngFollows Isaac around, shooting enemies with an eye laser similar to Technology.
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.
Rubber Cement
Rubber Cement Icon.pngTears bounce off walls and obstacles (including enemies).
Rune Bag
Rune Bag Icon.pngA bag that follows Isaac and drops a random mystic rune every 3 rooms.
SMB Super Fan
SMB Super Fan Icon.pngIncreases all stats.
Sack of Pennies
Sack of Pennies Icon.pngIsaac is followed by a small bag that drops a coin every 2 rooms.
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.
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.
Scatter Bombs
Scatter Bombs Icon.pngAdds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs.
Scorpio
Scorpio Icon.pngGrants poison tears, which deal damage over time when inflicted.
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.
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.
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.
Soy Milk
Soy Milk Icon.pngTears shrink and do much less damage, but fire in very rapid succession.
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.
Spoon Bender
Spoon Bender Icon.pngGrants Isaac homing tears.
Stem Cells
Stem Cells Icon.pngAdds one filled Heart Container and increases Shot Speed.
Sticky Bombs
Sticky Bombs Icon.png+5 bombs. Bombs stick to enemies and spawn 2-4 Blue Spiders if they kill an enemy.
Stigmata
Stigmata Icon.pngIncreases damage, and adds 1 heart container.
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.
Taurus
Taurus Icon.pngSpeed down, gains speed while in a room with enemies until gaining My Little Unicorn effect for a few seconds.
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.
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 2
Technology 2 Icon.pngDecreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.
Technology
Technology Icon.pngReplaces tears with a piercing laser with unlimited range.
The Black Bean
The Black Bean Icon.pngWhen taking damage, Isaac farts, causing poison damage to all enemies in range.
The Body
The Body Icon.pngAdds 3 Heart Containers.
The Common Cold
The Common Cold Icon.pngAdds a chance to shoot poison tears, dealing damage over time when inflicted.
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.
The Inner Eye
The Inner Eye Icon.pngGrants triple shot but decreases tears.
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.
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.
The Mulligan
The Mulligan Icon.pngTears have a 1/6 chance of spawning allied blue flies when they hit an enemy.
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.
The Relic
The Relic Icon.pngIsaac is followed by a small blue cross that will drop a Soul Heart every 4 rooms.
The Sad Onion
The Sad Onion Icon.pngIncreases Tears by 0.7.
The Soul
The Soul Icon.pngGrants two Soul Hearts. Isaac now repels enemy projectiles.
The Virus
The Virus Icon.pngInflicts poison to enemies who make contact with Isaac. Speed down.
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.
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.
Thunder Thighs
Thunder Thighs Icon.pngDestroys rocks upon contact with Isaac. Adds one heart container, and lowers Speed.
Tiny Planet
Tiny Planet Icon.pngRange up and makes shot tears revolve around Isaac until they drop.
Tough Love
Tough Love Icon.pngAdds a chance to shoot a tooth instead of a tear, which deals greater damage than regular tears.
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.
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".
X-Ray Vision
X-Ray Vision Icon.pngReveals and opens all Secret Room and Super Secret Room entrances.
Zodiac
Zodiac Icon.pngZodiac will give Isaac a random zodiac item effect that changes after every floor.