The Binding of Isaac: Afterbirth

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Issues: Incomplete list of additions and changes.

The Binding of Isaac: Afterbirth is the expansion to The Binding of Isaac: Rebirth. The DLC was released on October 30, 2015 and costs $10.99/£7.99. It was released on May 10, 2016 on Xbox One and PS4.

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

Features[edit | edit source]

Additions[edit | edit source]

Player[edit | edit source]

Characters[edit | edit source]

Character Lilith App.png
Lilith
Keeper App.png
Keeper
Health Stat Icon.png Health Red HeartBlack HeartBlack Heart Coin HeartCoin Heart
Damage Stat Icon.png Damage 3.5 (*1.00) 3.5 (*1.20)
Tears Stat Icon.png Tears Blindfolded App.png Blindfolded
(+0)
+18
Shot Speed Stat Icon.png Shot Speed Blindfolded App.png Blindfolded
(1)
1
Range Stat Icon.png Range Blindfolded App.png Blindfolded
(23.75)
23.75
Speed Stat Icon.png Speed 1.0 0.85
Luck Stat Icon.png Luck 0 -2
Starting Item Icon.png Starting Pickup(s) None x1 bombs
Needs to be unlocked x1 coins
Needs to be unlocked Added in Afterbirth Store Key Store Key
Store Key Icon.pngAutomatically opens all Shops.
Starting Item Icon.png Starting Item(s) Added in Afterbirth Incubus 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.

Needs to be unlocked Added in Afterbirth Cambion Conception Cambion Conception
Cambion Conception Icon.pngAfter taking damage a certain amount of times, a permanent demonic familiar spawns.

Added in Afterbirth Box of Friends Box of Friends
Box of Friends Icon.png4 roomsUpon use, duplicates all of Isaac's familiars for the current room.
Triple shot
Needs to be unlocked Added in Afterbirth Wooden Nickel Wooden Nickel
Wooden Nickel Icon.png1 roomsWhen used, has a 50% chance to drop one random type of coin (penny, nickel, or dime).

Transformations[edit | edit source]

Name Appearance Description Items
Bob Bob Bob's Rotten Head Bob's Rotten Head
Bob's Rotten Head Icon.png3 roomsUpon use, Isaac holds a poison bomb which can be thrown towards any of the four cardinal points and explodes on impact.

Bob's Brain Bob's Brain
Bob's Brain Icon.pngSpawns a familiar that charges forward when shooting tears and explodes upon contact with an enemy, damaging and poisoning them. The familiar respawns after a few seconds.

Bob's Curse Bob's Curse
Bob's Curse Icon.pngGives 5 bombs and grants all bombs poison effect.

Ipecac Ipecac
Ipecac Icon.pngReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth.

Conjoined Conjoined
  • When attacking, the tumor faces shoot tears diagonally outwards, similar to the effect of The Wiz.
  • -0.3 damage.
  • Slightly decreases tears.
Brother Bobby Brother Bobby
Brother Bobby Icon.pngFollows Isaac around shooting normal tears.

Harlequin Baby 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
Headless Baby Icon.pngFamiliar that follows Isaac, leaving blood creep on the ground.

Little Steven Little Steven
Little Steven Icon.pngSpawns a familiar that follows Isaac around and fires homing tears.

Mongo Baby Mongo Baby
Mongo Baby Icon.pngSummons a familiar that copies the tears of Isaac's other familiars.

Rotten Baby Rotten Baby
Rotten Baby Icon.pngA familiar that spawns blue flies.

Sister Maggy Sister Maggy
Sister Maggy Icon.pngA familiar that follows Isaac around shooting blood tears.

Fun Guy Fun Guy 1up! 1up!
1up! Icon.pngGives an extra life. Upon death, you will respawn in the previous room with full health and lose the 1up!.

Blue Cap Blue Cap
Blue Cap Icon.pngGrants 1 heart container and increases tears, but decreases shot speed.

God's Flesh 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.

Magic Mushroom Magic Mushroom
Magic Mushroom Icon.pngIncreases all stats and enlargens Isaac.

Mini Mush Mini Mush
Mini Mush Icon.pngIncreases Speed and Shot Height and decreases Isaac's size, but lowers Range.

Odd Mushroom Odd Mushroom
Odd Mushroom (Large) Icon.pngGrants an empty heart container. Increases damage, range and shot height while reducing speed.

Odd Mushroom Odd Mushroom
Odd Mushroom (Thin) Icon.png+1.7 tears, +0.3 speed, reduces damage.

Leviathan Leviathan The Nail The Nail
The Nail Icon.png6 roomsAdds 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.

Abaddon Abaddon
Abaddon Icon.pngIncreases damage and speed, removes all red heart containers, grants six black hearts, and adds a chance to shoot fear tears.

Brimstone 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.

The Mark The Mark
The Mark Icon.pngIncreases Damage and Speed, plus adds one Soul Heart.

Maw of the Void Maw of the Void
Maw of the Void Icon.png+1.0 Damage Up. After continuously firing tears for 2.5 seconds, a red cross appears on Isaac's head that, upon releasing the fire button, creates a black ring that rapidly deals damage equal to Isaac's tear damage to any enemies in contact with it.

The Pact The Pact
The Pact Icon.pngIncreases damage by 0.5, tears by 0.7 and grants two soul hearts upon pickup.

Pentagram Pentagram
Pentagram Icon.pngIncreases damage and increases the chance for a Devil or Angel Room to appear.

Spirit of the Night Spirit of the Night
Spirit of the Night Icon.pngGrants spectral tears and flight.

Oh Crap Oh Crap
  • Whenever a pile of poop is destroyed, health is replenished by half a heart.
Flush! Flush!
Flush! Icon.png6 roomsChanges all enemies in the room into poop. Does not work on all enemies (Knights and bosses are immune). Instantly kills Dingle, Dangle, and Brownie.

The Poop The Poop
The Poop Icon.png1 roomsSpawns a pile of poop where the character is standing and knocks nearby monsters back. May yield pickups like regular poop.

E Coli E Coli
E Coli Icon.pngGives "Turdy Touch" Effect. Enemies that touch Isaac are changed into poop.

Seraphim Seraphim The Bible The Bible
The Bible Icon.png6 roomsUpon 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.

Dead Dove Dead Dove
Dead Dove Icon.pngGrants spectral tears and flight.

Guardian Angel 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.

The Halo 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.

Holy Grail Holy Grail
Holy Grail Icon.pngGrants flight and one heart container.

Holy Mantle Holy Mantle
Holy Mantle Icon.pngAutomatically negates first taken damage in every room.

Mitre Mitre
Mitre Icon.pngGrants a chance of converting any red hearts pickups into soul hearts instead.

Rosary Rosary
Rosary Icon.pngAdds 3 Soul Hearts and increases the chance for The Bible to appear in any item pool.

Sworn Protector Sworn Protector
Sworn Protector Icon.pngAn orbital angel which does 7 contact damage per tick and blocks enemy shots. Upon blocking 10 shots in a room it drops an eternal heart.

Spun Spun Added in Afterbirth † Adrenaline Adrenaline
Adrenaline Icon.pngIncreases damage based on how many empty heart containers Isaac has.

Added in Afterbirth † Euthanasia Euthanasia
Euthanasia Icon.pngAdds a chance to fire needles. If a needle kills an enemy, it bursts into more needles.

Experimental Treatment 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.

Growth Hormones Growth Hormones
Growth Hormones Icon.pngIncreases damage by 1 and speed by 0.4.

Roid Rage Roid Rage
Roid Rage Icon.pngIncreases speed by 0.6, range by 5.25, and tear height by 0.5.

Speed Ball Speed Ball
Speed Ball Icon.pngIncreases speed by 0.3 and shot speed by 20%.

Synthoil Synthoil
Synthoil Icon.pngIncreases damage by 1, range by 5.25, and tear height by 0.5.

The Virus The Virus
The Virus Icon.pngInflicts poison to enemies who make contact with Isaac. Speed down.

Yes Mother? Yes Mother?
  • Isaac gains a stationary knife that trails directly behind him. It synergizes like Mom's Knife would.
Mom's Bottle of Pills Mom's Bottle of Pills
Mom's Bottle of Pills Icon.png6 roomsGives 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.

Mom's Bra Mom's Bra
Mom's Bra Icon.png3 roomsUpon use, petrifies all enemies in the current room for approximately 4 seconds.

Mom's Pad Mom's Pad
Mom's Pad Icon.png3 roomsUpon use, inflicts fear to all enemies in the room for 5 seconds.

Added in Afterbirth † Mom's Shovel Mom's Shovel
Mom's Shovel Icon.png4 roomsSpawns a trapdoor that leads to the next floor upon activation. Unlocks The Forgotten when used on a mound of dirt that appears in The Dark Room.

Mom's Coin Purse Mom's Coin Purse
Mom's Coin Purse Icon.pngSpawns 4 random pills around Isaac.

Mom's Contacts 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
Mom's Eye Icon.pngAllows Isaac to fire tears from the back of his head.

Mom's Eyeshadow Mom's Eyeshadow
Mom's Eyeshadow Icon.pngTears have a chance to charm enemies.

Mom's Heels Mom's Heels
Mom's Heels Icon.pngIncreases range.

Mom's Key Mom's Key
Mom's Key Icon.pngSpawns 2 keys. Generates additional pickups from chests.

Mom's Knife 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
Mom's Lipstick Icon.pngIncreases range and shot height.

Mom's Pearls Mom's Pearls
Mom's Pearls Icon.png+1.25 Range Up. +0.5 Tear Height. +1 Luck Up.

Mom's Perfume Mom's Perfume
Mom's Perfume Icon.pngAdds a chance to shoot fear tears and decreases tear delay by 1.

Mom's Purse Mom's Purse
Mom's Purse Icon.pngAllows Isaac to hold 1 additional trinket.

Added in Afterbirth † Mom's Razor 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.

Mom's Underwear Mom's Underwear
Mom's Underwear Icon.pngIncreases range.

Mom's Wig Mom's Wig
Mom's Wig Icon.pngAdds a chance to spawn blue spiders when firing tears. Restores 1 red heart.

Super Bum Super Bum Bum Friend 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.

Dark Bum 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.

Key Bum Key Bum
Key Bum Icon.pngSpawns a portable key master that follows Isaac and collects keys, giving random chests in return.

1: Image depicts the familiar. This transformation does not alter Isaac's appearance.

Co-op[edit | edit source]

Special Babies

These Babies have special bonuses that will aid the player in some way.

ID Appearance Name Description
27 027 baby black.png Black Baby Spawns with an extra black heart.
Black Baby Defeat Mega Satan as Azazel
Black BabyBlack Baby
to unlock it.
28 028 baby red.png Red Baby Spawns with an extra red heart.
Red Baby Defeat Mega Satan as Magdalene
Red BabyRed Baby
to unlock it.
29 029 baby white.png White Baby Gives Isaac an eternal heart when it spawns.
White Baby Defeat Mega Satan as The Lost
White BabyWhite Baby
to unlock it.
30 030 baby blue.png Blue Baby Spawns with an extra soul heart.
Blue Baby Defeat Mega Satan as ???
Blue BabyBlue Baby
to unlock it.
31 031 baby rage.png Rage Baby Occasionally briefly increases Isaac's damage.
Rage Baby Defeat Mega Satan as Samson
Rage BabyRage Baby
to unlock it.
32 032 baby cry.png Cry Baby Occasionally briefly increases Isaac's tears.
Cry Baby Defeat Mega Satan as Isaac
Cry BabyCry Baby
to unlock it.
33 033 baby yellow.png Yellow Baby Occasionally briefly increases Isaac's speed by 0.15.
Yellow Baby Defeat Mega Satan as Eden
Yellow BabyYellow Baby
to unlock it.
34 034 baby long.png Long Baby Occasionally briefly increases Isaac's range, shot speed, and tear height.
Long Baby Defeat Mega Satan as Lazarus
Long BabyLong Baby
to unlock it.
35 035 baby green.png Green Baby Occasionally briefly increases Isaac's luck by 2.
Green Baby Defeat Mega Satan as Cain
Green BabyGreen Baby
to unlock it.
36 036 baby lil.png Lil' Baby Occasionally briefly decreases Isaac's size.
Lil' Baby Defeat Mega Satan as Eve
Lil' BabyLil' Baby
to unlock it.
37 037 baby big.png Big Baby Occasionally briefly increases Isaac's size.
Big Baby Defeat Mega Satan as Lilith
Big BabyBig Baby
to unlock it.
38 038 baby brown.png Brown Baby Occasionally briefly gives Isaac the effect. While it is active, picking up a coin will make Isaac fart, knocking back nearby enemies.
Brown Baby Defeat Mega Satan as Judas
Brown BabyBrown Baby
to unlock it.
39 039 baby noose.png Noose Baby Occasionally briefly gives Isaac the Transcendence Transcendence
Transcendence Icon.pngGrants flight.
effect, granting flight.
Noose Baby Defeat Mega Satan as Keeper
Noose BabyNoose Baby
to unlock it.
40 040 baby hive.png Hive Baby Occasionally briefly gives Isaac the Hive Mind Hive Mind
Hive Mind Icon.pngIncreases the size of blue spiders and Blue Flies and doubles the amount of damage they deal.
effect, doubling the damage dealt by blue spiders and blue flies.
Hive Baby Earn all hard mode completion marks as ???
Hive BabyHive Baby
to unlock it.
41 041 baby buddy.png Buddy Baby Occasionally briefly gives Isaac the Guillotine Guillotine
Guillotine Icon.pngIsaac's head is removed from his body and floats around him. Increases Damage by 1 and grants -1 Tear Delay.
effect, detaching Isaac's head and increasing damage and tears.
Buddy Baby Earn all hard mode completion marks as Isaac
Buddy BabyBuddy Baby
to unlock it.
42 042 baby colorful.png Colorful Baby Upon joining, fully heals Isaac, similar to the rainbow poop effect.
Colorful Baby Earn all hard mode completion marks as Magdalene
Colorful BabyColorful Baby
to unlock it.
43 043 baby whore.png Whore Baby Occasionally briefly gives Isaac the Whore of Babylon Whore of Babylon
Whore of Babylon Icon.pngIncreases damage and speed whenever Isaac has half a red heart or less (one red heart for Eve), ignoring any soul or black hearts.
effect, increasing damage and speed.
Whore Baby Earn all hard mode completion marks as Eve
Whore BabyWhore Baby
to unlock it.
44 044 baby cracked.png Cracked Baby
Cracked Baby Earn all hard mode completion marks as Eden
Cracked BabyCracked Baby
to unlock it.
45 045 baby dripping.png Dripping Baby Occasionally briefly gives Isaac Anemic 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.
, increasing range by 5 and causing Isaac to leave a trail of blood that damages enemies.
Dripping Baby Earn all hard mode completion marks as Lazarus
Dripping BabyDripping Baby
to unlock it.
46 046 baby blinding.png Blinding Baby Upon death, activates the effect of the , fully restoring Isaac's red hearts, deals 100 damage to all enemies in the room, and revealing the map for the current floor.
Blinding Baby Use Blank Card while holding XIX - The Sun
Blinding BabyBlinding Baby
to unlock it.
47 047 baby sucky.png Sucky Baby Has an aura around itself that damages enemies while they are inside, similar to Succubus 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.
.
Sucky Baby Earn all hard mode completion marks as Azazel
Sucky BabySucky Baby
to unlock it.
48 048 baby dark.png Dark Baby Occasionally provides a brief boost to all of Isaac's stats.
Dark Baby Earn all hard mode completion marks as Lilith
Dark BabyDark Baby
to unlock it.
49 049 baby picky.png Picky Baby
Picky Baby Earn all hard mode completion marks as Cain
Picky BabyPicky Baby
to unlock it.
50 050 baby revenge.png Revenge Baby Occasionally briefly increases Isaac's damage.
Revenge Baby Earn all hard mode completion marks as Samson
Revenge BabyRevenge Baby
to unlock it.
51 051 baby belial.png Belial Baby Occasionally briefly gives Isaac the The Book of Belial The Book of Belial
The Book of Belial Icon.png3 roomsUpon use increases damage by 2 for the current room and by a further +50% if the character also has the Blood of the Martyr.
Removed in Afterbirth Guarantees a Devil Room or Angel Room will be open after beating a boss while holding it, or Added in Afterbirth increases the chance by 12.5%.
effect, increasing damage.
Belial Baby Earn all hard mode completion marks as Judas
Belial BabyBelial Baby
to unlock it.
52 052 baby sale.png Sale Baby Occasionally briefly gives Isaac the Steam Sale 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.
effect, halving the prices of all shop items.
Sale Baby Earn all hard mode completion marks as Keeper
Sale BabySale Baby
to unlock it.
53 053 baby goatbaby.png Goat Head Baby Occasionally briefly gives Isaac the Goat Head 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.
effect, guaranteeing that a Devil room or angel room will open if a boss room is completed while the effect is active.
Goat Head Baby Defeat Mom's Heart on hard mode as Lilith
Goat Head BabyGoat Head Baby
to unlock it.
54 054 baby supergreedbaby.png Super Greed Baby Has the Head of the Keeper effect, firing coin tears that have a chance to spawn a coin upon hitting an enemy.
Super Greed Baby Defeat Mom's Heart on hard mode as Keeper
Super Greed BabySuper Greed Baby
to unlock it.

Normal Babies

These Babies are purely cosmetic and do not have any special behaviors.

ID Appearance Name Description
233 233 baby punkboy.png Punkboy Baby A baby dressed as a punk rocker boy.
234 234 baby punkgirl.png Punkgirl Baby A baby dressed as a punk rocker girl.
235 235 baby computer.png Computer Baby A baby with a computer for a head.
236 236 baby mask.png Mask Baby A baby wearing a mask.
237 237 baby gem.png Gem Baby A baby that looks like it's made of crystal.
238 238 baby shark.png Shark Baby A baby that looks like a shark.
239 239 baby beret.png Beret Baby A baby that's wearing a beret.
240 240 baby blisters.png Blisters Baby A baby covered in blisters.
241 241 baby radioactive.png Radioactive Baby A sickly green baby.
242 242 baby beast.png Beast Baby A baby that looks like a beast.
243 243 baby dark.png Dark Baby A very dark baby.
244 244 baby snail.png Snail Baby A baby that looks like a snail.
245 245 baby blood.png Blood Baby A baby that looks like a drop of blood.
246 246 baby 8ball.png 8 Ball Baby A baby with an 8 ball for a head.
247 247 baby wisp.png Wisp Baby A wispy baby.
248 248 baby cactus.png Cactus Baby A baby that looks like a cactus.
249 249 baby loveeye.png Love Eye Baby A pink baby with a heart for an eye.
250 250 baby medusa.png Medusa Baby A baby that resembles Medusa.
251 251 baby nuclear.png Nuclear Baby A baby that looks like a mushroom cloud.
252 252 baby purple.png Purple Baby A strange purple baby.
253 253 baby wizard.png Wizard Baby A baby with a wizard hat.
254 254 baby earth.png Earth Baby A baby whose head looks like planet Earth.
255 255 baby saturn.png Saturn Baby A baby with a ring around its head.
256 256 baby cloud.png Cloud Baby A baby made of cloud.
257 257 baby tube.png Tube Baby A baby with a tube connecting both eyes.
258 258 baby rocker.png Rocker Baby A baby dressed as a rock fan.
259 259 baby king.png King Baby A baby with a crown.
260 260 baby coat.png Coat Baby A baby wearing a winter coat.
261 261 baby viking.png Viking Baby A baby with a Viking helmet.
262 262 baby panda.png Panda Baby A baby that looks like a panda.
263 263 baby raccoon.png Raccoon Baby A baby that looks like a raccoon.
264 264 baby bear.png Bear Baby A baby that looks like a grizzly bear.
265 265 baby polarbear.png Polar Bear Baby A baby that looks like a polar bear.
266 266 baby lovebear.png Lovebear Baby A baby that looks like a Care Bear.
267 267 baby hare.png Hare Baby A baby that looks like a rabbit.
268 268 baby squirrel.png Squirrel Baby A baby that looks like a squirrel.
269 269 baby tabby.png Tabby Baby A baby that looks like a cat.
270 270 baby porcupine.png Porcupine Baby A baby that looks like a porcupine.
271 271 baby puppy.png Puppy Baby A baby that looks like a puppy.
272 272 baby parrot.png Parrot Baby A baby that looks like a parrot.
273 273 baby chameleon.png Chameleon Baby A baby that looks like a Chameleon.
274 274 baby boulder.png Boulder Baby A baby made of rocks.
275 275 baby aqua.png Aqua Baby An aqua-blue baby.
276 276 baby gargoyle.png Gargoyle Baby A baby that resembles a gargoyle.
277 277 baby spikydemon.png Spiky Demon Baby A baby that looks like a spiky demon.
278 278 baby reddemon.png Red Demon Baby A baby that looks like a red demon.
279 279 baby orangedemon.png Orange Demon Baby A baby that looks like an orange demon.
280 280 baby eyedemon.png Eye Demon Baby A baby with an eye for a head.
281 281 baby fangdemon.png Fang Demon Baby A baby with big fangs.
282 282 baby ghost.png Ghost Baby A baby that looks like a ghost.
283 283 baby arachnid.png Arachnid Baby A baby that looks like a spider.
284 284 baby bony.png Bony Baby A baby that looks like a Bony.
285 285 baby bigtongue.png Big Tongue Baby A baby with a big tongue.
286 286 baby 3d.png 3D Baby A baby wearing 3D glasses.
287 287 baby suit.png Suit Baby A baby in a nice suit.
288 288 baby butt.png Butt Baby A baby with a butt for a face.
289 289 baby cupid.png Cupid Baby A baby that looks like Cupid.
290 290 baby heart.png Heart Baby A baby with a heart-shaped head.
291 291 baby killer.png Killer Baby A baby that looks like Jason Voorhees from the "Friday the 13th" horror movie series.
292 292 baby lantern.png Lantern Baby A baby that looks like Ash Williams from the Evil Dead series.
293 293 baby banshee.png Banshee Baby A baby that looks like a banshee.
294 294 baby ranger.png Ranger Baby A baby that looks like a Red Power Ranger.
295 295 baby rider.png Rider Baby A baby that looks like a Kamen Rider.
296 296 baby choco.png Choco Baby A baby made of chocolate.
297 297 baby woodsman.png Woodsman Baby A baby dressed as a hiker.
298 298 baby brunette.png Brunette Baby A baby with brown hair
299 299 baby blonde.png Blonde Baby A baby with blonde hair.
300 300 baby bluehair.png Blue Hair Baby A baby with blue hair
301 301 baby bloodied.png Bloodied Baby A baby covered in blood.
302 302 baby cheese.png Cheese Baby A baby made of cheese.
303 303 baby pizza.png Pizza Baby A baby made of pizza.
304 304 baby hotdog.png Hotdog Baby A baby that is also a hotdog.
305 305 baby hotdog.png Nature Baby A naked baby with a leaf.
306 306 baby borg.png Borg Baby A robotic baby.
307 307 baby corrupted.png Corrupted Baby A baby with seems to be covered by an alien life.
308 308 baby xmouth.png X Mouth Baby A gagged baby.
309 309 baby xeyes.png X Eyed Baby A comically dead baby.
310 310 baby stareyes.png Starry Eyed Baby A baby with starry eyes.
311 311 baby surgeon.png Surgeon Baby A baby ready for surgery.
312 312 baby sword.png Sword Baby A baby that's a sword.
313 313 baby monk.png Monk Baby A baby that's a monk.
314 314 baby disco.png Disco Baby A funky baby with an afro
315 315 baby puzzle.png Puzzle Baby A baby with a "Rubik's Cube" for a head
316 316 baby speaker.png Speaker Baby A baby that has a speaker for a head.
317 317 baby scary.png Scary Baby A baby that resembles Jeff the Killer.
318 318 baby fireball.png Fireball Baby A fireball with eyes. Possibly a reference to the fire enemy in the Donkey Kong and Mario games.
319 319 baby maw.png Maw Baby A baby that's just a mouth.
320 320 baby exploding.png Exploding Baby A baby that's a bomb.
321 321 baby cupcake.png Cupcake Baby A baby that's also a cupcake.
322 322 baby skinless.png Skinless Baby A baby without skin.
323 323 baby ballerina.png Ballerina Baby A baby wearing a tutu.
324 324 baby goblin.png Goblin Baby A baby that resembles a goblin.
325 325 baby coolgoblin.png Cool Goblin Baby A green baby with brown hair and cool shades.
326 326 baby geek.png Geek Baby A baby with black hair and nerdy glasses.
327 327 baby longbeard.png Long Beard Baby A baby with a long beard.
328 328 baby muttonchops.png Muttonchops Baby A baby with muttonchops.
329 329 baby spartan.png Spartan Baby A baby dressed as a Roman spartan.
330 330 baby tortoise.png Tortoise Baby A baby that looks like a tortoise.
331 331 baby slicer.png Slicer Baby A baby that resembles Shredder.
332 332 baby butterfly.png Butterfly Baby A baby with butterfly wings.
333 333 baby homeless.png Homeless Baby A baby that resembles a homeless person.
334 334 baby lumberjack.png Lumberjack Baby A baby that resembles a lumberjack.
335 335 baby cyberspace.png Cyberspace Baby A baby that resembles something from the Tron universe.
336 336 baby hero.png Hero Baby A baby that resembles Red from Gunstar Heroes.
337 337 baby boxers.png Boxers Baby A baby that resembles Arthur from Ghosts & Goblins (in his boxers).
338 338 baby winghelmet.png Wing Helmet Baby A baby that resembles Opa-Opa.
339 339 baby x.png X Baby A baby with an X for a head.
340 340 baby o.png O Baby A baby with an O for a head.
341 341 baby vomit.png Vomit Baby A baby with vomit coming from its mouth.
342 342 baby merman.png Merman Baby A baby that resembles Aquaman.
343 343 baby cyborg.png Cyborg Baby Might be a reference to a Cyborg from a novel/movie/game?
344 344 baby barbarian.png Barbarian Baby A baby that resembles the Barbarian from Diablo.
345 345 baby locust.png Locust Baby A baby that resembles a locust.
346 346 baby twotone.png Twotone Baby A completely white baby with a black outline.
347 347 baby 2600.png 2600 Baby A baby that resembles an Atari 2600 sprite.
348 348 baby fourtone.png Fourtone Baby A baby with a minimal colour sprite.
349 349 baby grayscale.png Grayscale Baby A baby colored with several shades of gray.
350 350 baby rabbit.png Rabbit Baby A baby that resembles Oswald the Lucky Rabbit.
351 351 baby mouse.png Mouse Baby A baby that resembles an old-style Mickey Mouse.
352 352 baby critter.png Critter Baby A critter that looks white and hairy. Might be a reference to the movie [Critters https://en.wikipedia.org/wiki/Critters_(film)].
353 353 baby bluerobot.png Blue Robot Baby A baby that resembles Mega Man.
354 354 baby pilot.png Pilot Baby A baby that resembles Jason from Blaster Master
355 355 baby redplumber.png Red Plumber Baby A baby that resembles Mario.
356 356 baby greenplumber.png Green Plumber Baby A baby that resembles Luigi.
357 357 baby yellowplumber.png Yellow Plumber Baby A baby that resembles Wario.
358 358 baby purpleplumber.png Purple Plumber Baby A baby that resembles Waluigi.
359 359 baby tanooki.png Tanooki Baby A baby that's wearing a Tanooki Suit.
360 360 baby mushroomman.png Mushroom Man Baby A baby that resembles Toad.
361 361 baby mushroomgirl.png Mushroom Girl Baby A baby that resembles Toadette.
362 362 baby cannonball.png Cannonball Baby A baby that resembles a Chain Chomp.
363 363 baby froggy.png Froggy Baby A baby that's wearing a Frog Suit.
364 364 baby turtledragon.png Turtle Dragon Baby A baby that resembles Bowser.
365 365 baby shellsuit.png Shell Suit Baby A baby wearing a Hammer Suit.
366 366 baby fiery.png Fiery Baby A baby wearing a Fire Suit.
367 367 baby meanmushroom.png Mean Mushroom Baby A baby that resembles a Goomba.
368 368 baby arcade.png Arcade Baby A baby that resembles Pac-Man.
369 369 baby scaredghost.png Scared Ghost Baby A blue ghost with a scared expression.
370 370 baby blueghost.png Blue Ghost Baby A baby that resembles Inky.
371 371 baby redghost.png Red Ghost Baby A baby that resembles Blinky.
372 372 baby pinkghost.png Pink Ghost Baby A baby that resembles Pinky.
373 373 baby orangeghost.png Orange Ghost Baby A baby that resembles Clyde.
374 374 baby pinkprincess.png Pink Princess Baby A baby that resembles Princess Peach.
375 375 baby yellowprincess.png Yellow Princess Baby A baby that resembles Princess Daisy.
376 376 baby dino.png Dino Baby A baby that resembles Yoshi.
377 377 baby elf.png Elf Baby A baby that resembles Link.
378 378 baby darkelf.png Dark Elf Baby A baby that resembles Dark Link
379 379 baby darkknight.png Dark Knight Baby A baby that resembles a Darknut
380 380 baby octopus.png Octopus Baby A baby that resembles an Octorok.
381 381 baby orangepig.png Orange Pig Baby A baby that resembles an orange Moblin.
382 382 baby bluepig.png Blue Pig Baby A baby that resembles a blue Moblin.
383 383 baby elfprincess.png Elf Princess Baby A baby that resembles Princess Zelda.
384 384 baby fishman.png Fishman Baby A baby that resembles a Zora.
385 385 baby fairyman.png Fairyman Baby A baby that resembles Tingle.
386 386 baby imp.png Imp Baby A baby that resembles Midna.
387 387 baby worm.png Worm Baby A baby that resembles Earthworm Jim.
388 388 baby bluewrestler.png Blue Wrestler Baby A baby that looks like the blue player in Smash TV.
389 389 baby redwrestler.png Red Wrestler Baby A baby that looks like the red player in Smash TV.
390 390 baby toast.png Toast Baby A baby that resembles Powdered Toast Man.
391 391 baby roboboy.png Roboboy Baby A baby that resembles Astro Boy.
392 392 baby liberty.png Liberty Baby A baby that resembles the Statue of Liberty.
393 393 baby dreamknight.png Dream Knight Baby A baby that resembles Meta Knight.
394 394 baby cowboy.png Cowboy Baby A baby that's wearing a cowboy outfit.
395 395 baby mermaid.png Mermaid Baby A baby that resembles Ariel.
396 396 baby plague.png Plague Baby A baby wearing a plague doctor outfit.
397 397 baby spacesoldier.png Space Soldier Baby A baby that resembles a Warhammer 40k Space Marine.
398 398 baby darkspacesoldier.png Dark Space Soldier Baby A baby that resembles a Warhammer 40k Chaos Space Marine.
399 399 baby gasmask.png Gas Mask Baby A baby that's wearing a gas mask.
400 400 baby tomboy.png Tomboy Baby A baby that resembles Sheik from the Legend of Zelda franchise.
401 401 baby corgi.png Corgi Baby A baby that looks like a corgi.
402 402 baby unicorn.png Unicorn Baby A baby that looks like a unicorn.
403 403 baby pixie.png Pixie Baby A baby that resembles Tinkerbell.
404 404 baby referee.png Referee Baby A baby wearing a referee outfit.
405 405 baby dealwithit.png Deal With It Baby A baby with a goatee and sunglasses.
406 406 baby astronaut.png Astronaut Baby A baby that's wearing an astronaut outfit.
407 407 baby blurred.png Blurred Baby A baby with a blur effect across its privates.
408 408 baby censored.png Censored Baby A baby with a censor bar across its privates.
409 409 baby coolghost.png Cool Ghost Baby A baby that resembles the character Shades (Sukezaemon) from Ufouria: The Saga.
410 410 baby gills.png Gills Baby A baby that resembles the character Gil (Jennifer) from Ufouria: The Saga.
411 411 baby bluehat.png Blue Hat Baby A baby that resembles the character Bop-Louie (Hebe) from Ufouria: The Saga.
412 412 baby catsuit.png Catsuit Baby A baby that's wearing a cat outfit. Also resembles the character Oh-Chan from Ufouria: The Saga (Japanese version).
413 413 baby pirate.png Pirate Baby A baby that's wearing a pirate outfit.
414 414 baby superrobo.png Super Robo Baby A baby that resembles Tekkaman the Space Knight.
415 415 baby lightmage.png Lightmage Baby A baby that resembles the white mage class from Final Fantasy.
416 416 baby puncher.png Puncher Baby A baby that resembles the warrior class from Final Fantasy.
417 417 baby holyknight.png Holy Knight Baby A baby that resembles the monk class from Final Fantasy.
418 418 baby shadowmage.png Shadowmage Baby A baby that resembles the black mage class from Final Fantasy.
419 419 baby firemage.png Firemage Baby A baby that resembles the red mage class from Final Fantasy.
420 420 baby priest.png Priest Baby A baby that's wearing a priest outfit.
421 421 baby zipper.png Zipper Baby A baby with a zipped mouth.
422 422 baby bag.png Bag Baby A baby with a bag over its head.
423 423 baby sailor.png Sailor Baby A baby that's wearing a sailor outfit.
424 424 baby rich.png Rich Baby A baby with a top hat and monocle.
425 425 baby toga.png Toga Baby A baby in an ancient Roman outfit.
426 426 baby knight.png Knight Baby A baby that resembles a Darknut from The Legend of Zelda.
427 427 baby blackknight.png Black Knight Baby A baby that resembles a black Darknut from The Legend of Zelda.

Items[edit | edit source]

95 new items were added in the expansion: 19 activated items and 76 passive items.

Activated Collectibles[edit | edit source]

Name ID Icon Quote Description
Box of Friends 357
Box of Friends
4 rooms
Double your friends Upon use, duplicates all of Isaac's familiars for the current room.
D12 386
D12
3 rooms
Rerolls rocks Re-rolls all rocks in the current room into other random objects, such as bomb rocks, metal blocks, TNT, or poops.
D7 437
D7
3 rooms
Reroll rewards! Restarts the current room and brings back all enemies, allowing more rewards to be acquired by completing the room.
D8 406
D8
4 rooms
Reroll stats Re-rolls Isaac's speed, range, tears, and damage.
Diplopia 347
Diplopia
One time use
Double item vision Duplicates all pickups and item pedestals in the room.
Friendly Ball 382
Friendly Ball
3 rooms
Gotta fetch 'em all! Throwing 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.
Glass Cannon 352
Glass Cannon
4 seconds
Be gentle... When 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).
Glowing Hour Glass 422
Glowing Hour Glass
2 rooms
Turn back time When 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.
Jar of Flies 434
Jar of Flies
Unlimited
Gotta catch 'em all? Every 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.
Kidney Bean 421
Kidney Bean
2 rooms
Love toots! Upon use, Isaac farts, charming all nearby enemies.
Mega Bean 351
Mega Bean
3 rooms
Giga fart! When 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.
Mega Blast 441
Mega Blast
12 rooms
Laser breath Upon 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.
Mine Crafter 427
Mine Crafter
1 rooms
Booom! When 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.
Mom's Box 439
Mom's Box
4 rooms
What's inside? When used, Mom's Box will drop a random trinket on the ground. While held, increases luck by 1 and doubles the effects of trinkets.
Placebo 348
Placebo
4 rooms
Pill mimic When used, copies the effect of the pill Isaac is currently holding without consuming it. Does not copy the effects of cards or runes.
Tear Detonator 383
Tear Detonator
1 rooms
Remote tear detonation! When 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.
Teleport 2.0 419
Teleport 2.0
4 rooms
I-Teleport! When 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.
Ventricle Razor 396
Ventricle Razor
Unlimited
Short cutter Can be used to place an orange portal and a blue portal. Upon entering a portal, Isaac is teleported to the other portal.
Wooden Nickel 349
Wooden Nickel
1 rooms
Flip a coin When used, has a 50% chance to drop one random type of coin (penny, nickel, or dime).

Passive Collectibles[edit | edit source]

Name ID Icon Quote Description
8 Inch Nails 359 8 Inch Nails Stick it to 'em! +1.5 Damage Up. Replaces Isaac's tears with nails, which have increased knockback.
Athame 408 Athame Call to the void Whenever Isaac takes damage, a black ring briefly appears around Isaac, dealing damage to all nearby enemies.
Betrayal 391 Betrayal Turn your enemy Every 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 438 Binky Memories... Tears up, adds 1 soul heart, and decreases Isaac's size.
Black Powder 420 Black Powder Spin the black circle! Isaac 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 353 Bomber Boy Explosive blast! +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 385 Bumbo Bumbo want coin! Spawns 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 377 Bursting Sack Spider love Spider enemies no longer target or deal contact damage to Isaac.
Cambion Conception 412 Cambion Conception Feed them hate After taking damage a certain amount of times, a permanent demonic familiar spawns.
Car Battery 356 Car Battery Double charge! Causes Isaac's activated item to activate twice on each use.
Censer 387 Censer Peace be with you Gives Isaac a golden censer familiar which creates a huge aura of light that slows down any enemies and enemy shots inside it.
Chaos 402 Chaos !!! Chaos causes items to be chosen from random item pools. When picked up, drops between 1-6 random pickups on the floor.
Charged Baby 372 Charged Baby Bbbzzzzzt! A familiar that drops a Little Battery every 4 rooms. Has a small chance to freeze all enemies in the room when hit.
Circle of Protection 423 Circle of Protection Protect me from myself Surrounds Isaac with a large white halo around him that pulsates. With each pulse, the halo deals contact damage to enemies equal to Isaac's damage. Each pulse also converts any enemy shots touching the ring into friendly purple homing tears.
Continuum 369 Continuum Transcendent tears +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 354 Crack Jacks Don't swallow the prize! Adds one heart container and drops a random trinket.
Crown of Light 415 Crown of Light The untainted gain power Gives 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 371 Curse of the Tower You feel cursed... Causes Isaac to spawn 6 troll bombs on the floor every time he gets hit, similar to the Anarchist Cookbook mechanic.
Dead Eye 373 Dead Eye Accuracy brings power! Isaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.
Deep Pockets 416 Deep Pockets More stuff to carry! Allows Isaac to carry two cards or pills (or a combination of both) at the same time.
Eden's Blessing 381 Eden's Blessing Your future shines brighter +0.7 tears up. Grants a random item at the start of the next run.
Empty Vessel 409 Empty Vessel I reward an empty vessel While 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 368 Epiphora Intensifying tears Shooting 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 410 Evil Eye Eye shot! While 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 401 Explosivo Sticky bomb shot! Isaac's tears have a chance to stick to enemies and explode.
Farting Baby 404 Farting Baby It farts! A 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 361 Fate's Reward Your fate beside you A blue head familiar that will follow Isaac and fire tears copying his tear effects and damage.
Friend Zone 364 Friend Zone Friendly fly A 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 418 Fruit Cake Rainbow effects! Isaac's tears gain a random effect that changes every shot.
GB Bug 405 GB Bug Game breaking bug, right away! A 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 432 Glitter Bombs Prize bombs! Gives Isaac 5 bombs, and makes Isaac's bombs have a chance to drop random pickups or charm enemies when they explode.
God's Flesh 398 God's Flesh Shrink shot Tears 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 429 Head of the Keeper Penny tears! Isaac's tears become coins and now have a chance to drop pennies on the floor upon successfully hitting an enemy.
Holy Light 374 Holy Light Holy shot! Isaac 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 375 Host Hat Nice hat! A 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 413 Immaculate Conception Feed them love Upon picking up a certain amount of health, spawn a permanent angelic familiar.
Incubus 360 Incubus Dark friend A demonic familiar that follows Isaac and shoots tears identical to Isaac's in terms of damage, range, fire rate, and effects.
Key Bum 388 Key Bum He wants your keys! Spawns a portable key master that follows Isaac and collects keys, giving random chests in return.
Kidney Stone 440 Kidney Stone Matt's kidney stone Randomly 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 Gurdy 384 Lil Gurdy A gurd of your own! Gives 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 435 Lil' Loki 4-way buddy! A Loki familiar that follows Isaac and shoots 4 tears in a cross pattern.
Lost Fly 365 Lost Fly Lost protector A 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 411 Lusty Blood Their blood brings rage! Each time Isaac kills an enemy, Isaac's damage increases for the current room.
Marked 394 Marked Directed tears Isaac 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 399 Maw of the Void Consume thy enemy! +1.0 Damage Up. After continuously firing tears for 2.5 seconds, a red cross appears on Isaac's head that, upon releasing the fire button, creates a black ring that rapidly deals damage equal to Isaac's tear damage to any enemies in contact with it.
Milk! 436 Milk! Don't cry over it... A glass of milk follows Isaac and spills on the floor upon taking damage. After the milk spills, Isaac's tear delay is decreased by 2 for the rest of the room.
Mom's Pearls 355 Mom's Pearls Range + luck up +1.25 Range Up. +0.5 Tear Height. +1 Luck Up.
More Options 414 More Options There are even more options! Two items spawn in every Treasure Room. Only one can be taken; the other will disappear.
Mr. Dolly 370 Mr. Dolly Range + tears up Tears and Range up. Spawns 3 random types of hearts on the floor when picked up.
Multidimensional Baby 431 Multidimensional Baby ydduB Buddy Spawns 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 speed.
My Shadow 433 My Shadow Me! And my shaaaadow! Each 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 425 Night Light Scared of the dark? A cone of light shines in the direction Isaac is moving that slows enemies and enemy shots.
No. 2 378 No. 2 Uh oh... Continuously 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 430 Papa Fly Turret follower A blue fly familiar follows Isaac's movements on a 3 second delay. Papa Fly will fire tears at nearby enemies.
Pay to Play 380 Pay to Play Money talks This 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 428 PJs You feel cozy Grants four soul hearts and fully restores Isaac's red health.
Pupula Duplex 379 Pupula Duplex Wide shot Transforms 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 407 Purity Aura stat boost This 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 426 Obsessed Fan Follows my every move... A purple fly familiar that follows Isaac's movements on a 3 second delay and deals contact damage to enemies.
Restock 376 Restock Never ending stores! Causes shops to instantly restock their items when they are bought. Granted by default for every character in Greed Mode.
Rune Bag 389 Rune Bag Rune generator A bag that follows Isaac and drops a random rune every 3 rooms.
Sack Head 424 Sack Head More sacks! Greatly increases the chance to find sacks.
Scatter Bombs 366 Scatter Bombs We put bombs in your bombs! Adds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs.
Seraphim 390 Seraphim Sworn friend An 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 393 Serpent's Kiss The kiss of death Tears 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 367 Sticky Bombs Egg sack bombs! +5 bombs. Bombs stick to enemies and spawn 2-4 blue spiders if they kill an enemy.
Spear of Destiny 400 Spear of Destiny Your destiny In 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 403 Spider Mod Mod buddy! Displays 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 417 Succubus Damage booster Spawns 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 363 Sworn Protector Protective friend An orbital angel which does 7 contact damage per tick and blocks enemy shots. Upon blocking 10 shots in a room it drops an eternal heart.
Tech X 395 Tech X Laser ring tears Tears 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.
Toxic Shock 350 Toxic Shock Mass poison Upon 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 397 Tractor Beam Control your tears Isaac emits a beam from his face. Isaac's tears travel in the path of the beam.
The Wiz 358 The Wiz Double wiz shot! Tears 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.
Zodiac 392 Zodiac The heavens will change you Zodiac will give Isaac a random zodiac item effect that changes after every floor.

Trinkets[edit | edit source]

29 new trinkets were added in the expansion.

Name ID Icon Quote Description
Blasting Cap 73 Blasting Cap Pop! Pop! Exploding bombs have a chance to drop another bomb pickup.
Black Feather 80 Black Feather With darkness comes power Increases Isaac's damage for possessing certain evil items.
Blind Rage 81 Blind Rage Blind to damage Increases invincibility time after getting hit.
Blister 77 Blister Bounce back! Increases knockback of tears.
Brown Cap 90 Brown Cap Fartoom! Poop will explode after being destroyed.
Bob's Bladder 71 Bob's Bladder Creepy bombs Leaves a pool of green creep under all bombs Isaac places, which damages enemies that walk over it.
Child Leash 89 Child Leash Keep your friends close... Causes familiars to stay closer to each other.
Cracked Dice 67 Cracked Dice You feel cursed... kinda. Whenever Isaac gets hit, there is a chance that the effect of The D6, D8, D12, or D20 gets activated.
Endless Nameless 79 Endless Nameless I'm stuck in a loop... When Isaac uses a pill, card, or rune, there is a chance to spawn another one of the same type.
Error 75 Error Effect not found? Gives a random trinket effect each room.
Faded Polaroid 69 Faded Polaroid You feel faded Occasionally causes Isaac to blend into the ground, which briefly confuses all enemies in the room.
Golden Horse Shoe 82 Golden Horse Shoe Feel lucky? +15% chance for a Treasure Room with two items to spawn.
Karma 85 Karma Karma up Donating to a donation machine has a chance to heal Isaac for a full red heart or spawn a beggar. Increases the chance that donating to a Donation Machine will increase Isaac's luck.
Lazy Worm 66 Lazy Worm Pft Tear shot speed is greatly reduced.
Lil Larva 86 Lil Larva The poop is moving... Spawns a blue fly from every pile of poop Isaac destroys.
Louse 70 Louse Itchy, tasty... Occasionally spawns a Blue Spider.
Mom's Locket 87 Mom's Locket You feel her love Grants half a red heart each time a key is used. Converts half red heart pickups into full red hearts.
NO! 88 NO! Never again! Removes all active items from every item pool.
Poker Chip 76 Poker Chip It's double down time! Chests have a 50% chance of paying out with extra pickups and a 50% chance of paying out with nothing or enemies.
Rainbow Worm 64 Rainbow Worm Bleep Bloop Blop Isaac's tears gain a worm effect that changes every 3 seconds.
Rib of Greed 84 Rib of Greed Feels greedy Prevents Greed and Super Greed from appearing in Shops and Secret Rooms.
Safety Scissors 63 Safety Scissors Fuse Cutter Troll bombs turn into Bomb pickups before they explode. Mega troll bombs turn into 1+1 free bombs before they explode.
Second Hand 78 Second Hand Extended stat effect time! Increases the time that status effects stay on enemies.
Shiny Rock 62 Shiny Rock It shines for its brothers Tinted rocks and rocks with Crawl Spaces will flash white every 10 seconds.
Store Key 83 Store Key Stores are open Automatically opens all Shops.
Stud Finder 74 Stud Finder The ground below feels hollow... Increases the chance to find a Crawl Space.
Super Magnet 68 Super Magnet It Pulls Pulls enemies and pickups towards Isaac.
Tape Worm 65 Tape Worm Floooooooooop! Doubles Isaac's range and halves his tear height.
Watch Battery 72 Watch Battery Lil charge Increased chance of batteries spawning. Has a chance to add an extra charge to Isaac's activated item upon completing a room.

Pickups[edit | edit source]

Hearts[edit | edit source]

Heart Image Worth Additional Info Unlocked By
Gold Heart GoldHeart.PNG Gold Heart When a Gold Heart is lost, a few coins will be dropped around you. Gold Heart Complete challenge #21
Gold HeartGold Heart

Coins[edit | edit source]

Coin Image Worth Additional Info Unlocked By
Lucky Penny LuckyPennyAnim.gif 1

Increases luck by 1 when picked up.

Lucky Pennies Donate 1 coin to the Greed Machine
Lucky PenniesLucky Pennies
Sticky Nickel NickelAnim.gif 5

Will flip upside-down when Isaac tries to collect it. Afterwards, it will get stuck on the ground, unable to be picked up unless blasted off the ground with an explosion.

Sticky Nickels Complete the Boss Rush as Keeper
Sticky NickelsSticky Nickels

Bombs[edit | edit source]

Bomb Image Worth Additional Info Unlocked By
Gold Bomb Gold Bomb.png

Will not add to the player's bomb count, but when picked up, it will give the player unlimited bombs for the duration of the current floor, even if the current number of bombs is 0.

Gold Bomb Complete challenge #23
Gold BombGold Bomb

Pills[edit | edit source]

ID Pill Effect
28 Needs to be unlocked Percs!

Gives The Wafer 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.
effect while in the room. Unlocked by completing Challenge #24: PAY TO PLAY.

29 Needs to be unlocked Addicted!

Makes Isaac take a full heart of damage from all sources for the current room. Unlocked by completing Challenge #24: PAY TO PLAY.

30 Needs to be unlocked Re-Lax

For a short time, poop spawns wherever Isaac moves, like Explosive Diarrhea but with poop. A higher move speed means you can touch more tiles in the same time. A pun on laxatives. Unlocked by completing Challenge #25: Have a Heart.

31 Needs to be unlocked ???

Gives the Curse of the Maze effect for the remainder of the floor. The effect can stack with other curses. If no other curses are active for the floor, Curse of the Maze will appear under the level name when TAB is held. This effect cannot be negated by Black Candle Black Candle

Black Candle Icon.pngPrevents curses. Grants one black heart. Increases the chance for a Devil or angel room to appear.
. Unlocked by completing Challenge #25: Have a Heart.

32 One makes you larger

Increases Isaac's size and decreases the pitch of his voice. This effect does not increase the size of Isaac's hitbox. Added in Afterbirth † These pills contribute to the Stompy transformation.

33 One makes you small

Decreases Isaac's size and increases the pitch of his voice. This effect decreases the size of Isaac's hitbox.

34 Infested!

Destroys all poop in the room and spawns a single Blue Spider under Isaac and on each destroyed poop.

35 Infested?

Spawns Blue Spiders equal to the number of enemies in the room. If there are no enemies in the room, spawns 1-3 Blue Spiders.

36 Power Pill!

Activates an effect similar to The Gamekid The Gamekid

The Gamekid Icon.png6 roomsUpon use, turns the character into a into a Pac-Man-like creature for 5 seconds, granting invulnerability, inflicting fear on all enemies, and replenishing half a red heart container for every two enemies killed.
.

37 Retro Vision

Briefly pixelates the screen 3 times over 30 seconds.

38 Friends Till The End!

Spawns three Blue Flies.

Cards[edit | edit source]

Name ID Icon Message Effect
? Card 48 Q Card Icon.png Double active When used, copies the effect of Isaac's currently held activated collectible item.
Get out of Jail Free Card 47 Get out of Jail Free Card Icon.png Open Sesame Upon use, opens all doors in the current room (including the golden door at The Chest / Dark Room), similar to Dad's Key.

Runes[edit | edit source]

Rune ID Icon Unlock method Message Effect
Blank Rune 40 Blank Rune Icon.png Blank Rune Complete challenge #30 (Removed in Afterbirth † The unlock is bugged and actually unlocks Kidney Stone)
Blank RuneBlank Rune
??? Grants a random rune effect. Has a 25% chance to spawn another Blank Rune upon use.

Consumables[edit | edit source]

Name ID Icon Message Effect
Dice Shard 49 Dice Shard Icon.png D6 + D20 Upon use, activates the effects of the D6 and the D20 at the same time.
Emergency Contact 50 Emergency Contact Icon.png Help from above When used, will cause two Mom's Hands to come down and grab two random enemies.

Chests[edit | edit source]

AngelChest.png Eternal chests
  • Eternal Chests are similar in appearance to Gold Chests, except they glow bright blue instead of gold, like a soul heart. They require one key to unlock, but can be reopened a random amount of times, each time requiring another key. They can be found in Angel rooms, in I AM ERROR Rooms and rarely in a normal room. Their loot is similar to Golden Chests, but there is a 25% chance they will drop nothing upon opening. If they contain nothing or an item, they will no longer be able to be reopened.
SpikeChest.png Spike chests
  • Spike Chests are purple colored chests with spikes protruding from them that will deal damage to Isaac upon opening unless he has the Holy Mantle active, which nullifies the damage, or if found in The Chest/Dark Room, where they are free to open. They can be rarely found upon completing a room or in greed mode shops. Their loot is similar to Brown Chests. Unlike other chests, they do not appear on the minimap.

Sacks[edit | edit source]

MysteryBag.png Mystery sack
  • Spawns 1-4 random pickups upon touching it. It will not drop any hearts, pills or chests, and they have an increased chance to drop batteries.

Entities[edit | edit source]

Monsters[edit | edit source]

Monster Description
Dart Fly
Dart Fly
Flies towards Isaac and attempts to mimic his movements. Deals contact damage.
Swarm Fly
Swarm Fly
Follows Isaac in large groups and deals contact damage.
Drowned Boom Fly
Drowned Boom Fly
Flies around the room diagonally, dealing touch damage. Upon death, explodes, and fires four blood shots in the cardinal directions. High chance to spawn a Drowned Charger upon death.
Corn
Corn
Quickly dashes in random directions, dealing contact damage.
Dank Squirt
Dank Squirt
Dashes towards the player and deals contact damage. Spawns 2 Clots upon death.
Roundy
Roundy
Pops out of the ground in random locations, creating a small rock wave. Fires an explosive Ipecac shot at Isaac if he is in sight.
Ulcer
Ulcer
Pops out of the ground in random locations and spawns a Dart Fly if Isaac is in sight. Fires a blood shot after spawning 6 Dart Flies.
Drowned Hive
Drowned Hive
Walks around the room, avoiding Isaac while spawning Drowned Chargers. Spawns a Drowned Charger upon death.
Dukie
Dukie
Flies around the room diagonally, occasionally spitting out a Dart Fly.
Flaming Gaper
Flaming Gaper
Walks towards Isaac, dealing contact damage. Usually turns into a Pacer or a Gusher upon death.
Cyclopia
Cyclopia
Walks towards Isaac, dealing contact damage and leaving behind a trail of damaging red creep. Occasionally shoots a blood shot towards Isaac.
Black Bony
Black Bony
Wanders around the room and throws three bones in a row at Isaac when he is in sight. Explodes upon death.
Dank Death's Head
Dank Death's Head
Moves diagonally around the room, dealing contact damage. Needs to be killed to complete the room.
Flesh Death's Head
Flesh Death's Head
Moves diagonally around the room, dealing contact damage. Explodes into 6 blood shots in all directions upon death. Can be killed, but also dies when the room is cleared.
Fat Bat
Fat Bat
Slowly flies towards Isaac. Shoots when Isaac aligns diagonally with it and will actively try to avoid Isaac's shots.
Red Ghost
Red Ghost
Disappears, then reappears near Isaac and fires a brimstone laser.
Flaming Fatty
Flaming Fatty
Slowly walks towards Isaac. Occasionally farts, which pushes Isaac and adjacent enemies away. Has a chance to leave behind a damaging flame upon death.
Conjoined Fatty
Conjoined Fatty
Slowly walks towards Isaac. Occasionally pauses to fart out a line of damaging green creep towards Isaac. Chance to turn into a regular Fatty upon death.
Blue Conjoined Fatty
Blue Conjoined Fatty
Slowly walks towards Isaac and occasionally farts out a homing Ipecac shot at Isaac.
Dank Globin
Dank Globin
Chases Isaac, dealing a full heart of contact damage. Upon taking enough damage, it collapses into a pile of goo, spawns a spider, and leaves a puddle of slowing black creep. Will regenerate after a short period of time if not killed quickly.
Black Globin
Black Globin
Chases Isaac, dealing a full heart of contact damage and spawning spiders whenever it takes damage. Spawns a spider, Black Globin's Head, and Black Globin's Body upon death.
Black Globin's Body
Black Globin's Body
Walks aimlessly around the room, occasionally spawning spiders.
Bone Knight
Bone Knight
Moves erratically around the room, charges toward Isaac when in line of sight, and leaves behind a trail of damaging red creep. Can only be damaged from behind.
Mega Clotty
Mega Clotty
Slowly moves around the room, occasionally hopping and firing 6 blood shots in all directions. Splits into two Clotties upon death.
Mom's Dead Hand
Mom's Dead Hand
Falls from the ceiling. If it lands on Isaac, it deals damage and teleports the player back to the spawn room of the floor. If it doesn't land on Isaac, it spawns several rock waves that travel outwards. Spawns several spiders upon death. Entering a room containing Mom's Dead Hand will warn the player with Mom's laugh.
Drowned Charger
Drowned Charger
Slowly moves around the room, charging at Isaac when he gets in its line of sight. Explodes into four blood shots in the ordinal directions upon death.
Scarred Para-Bite
Scarred Para-Bite
Moves towards Isaac, dealing contact damage and firing short-range blood shots. Can burrow underground and reappear elsewhere.
Scarred Guts
Scarred Guts
Attaches itself to a wall or obstacle and rolls around it, leaving a trail of damaging red creep.
Scarred Double Vis
Scarred Double Vis
Randomly wanders around the room. Pauses to charge and fire a Brimstone laser which fires from all four cardinal sides when Isaac gets in its line of sight.
Meatball
Meatball
Slides around the room, occasionally stopping to spew a fountain of short-range blood shots in all directions or to spit a line of damaging red creep. Spawns a Host upon death.
Imp
Imp
Slowly drifts towards Isaac, frequently firing 5 blood shots in quick succession towards Isaac. Tries to avoid Isaac's shots and occasionally teleports and reappears elsewhere.
Greed Gaper
Greed Gaper
Walks towards Isaac, dealing contact damage.
Blue Gaper
Blue Gaper
Walks towards Isaac, dealing contact damage.
Blue Boil
Blue Boil
Stationary enemy that decreases in size when hit, but regenerates to its full size until fully destroyed. Fires 1-3 blood shots towards Isaac when fully swollen.
Hush Fly
Hush Fly
Gathers with other Hush Flies and flies towards Isaac in certain patterns. Can also orbit Hush.

Bosses[edit | edit source]

Boss Rag Man.png
Boss Little Horn.png
Boss Dangle.png
Boss Turdlings.png
Rag Man Little Horn Dangle Turdlings
Boss The Frail.png
Boss The Stain.png
Boss The Forsaken.png
Boss Brownie.png
The Frail The Stain The Forsaken Brownie
Boss Hush.png
Boss Ultra Greed.png
Hush Ultra Greed

Beggars[edit | edit source]

Bomb bum.png Bomb bum

Bomb Bums are extremely rare, and ask for bombs. Each bomb donated has a chance to have him drop 1-2 bomb pickups or an item from the Bomb Bum Item Pool. After spawning a pedestal item, the Bomb Bum will disappear and can no longer be donated to.

Environment[edit | edit source]

Chapters[edit | edit source]

Burning Basement.png Flooded Caves.png
Burning Basement Flooded Caves
Dank Depths.png Scarred Womb.png
Dank Depths Scarred Womb
Blue Womb.png
 ??? (Blue Womb)

Challenges[edit | edit source]

Name Conditions Goal Unlocked by Unlocks

Unknown display mode [XXXXXXXXL] Unknown display mode [SPEED!] Unknown display mode [Blue Bomber] Unknown display mode [PAY TO PLAY] Unknown display mode [Have a Heart] Unknown display mode [I RULE!] Unknown display mode [BRAINS!] Unknown display mode [PRIDE DAY!] Unknown display mode [Onan's Streak] Unknown display mode [The Guardian]

Changes[edit | edit source]

Player[edit | edit source]

Characters[edit | edit source]

Azazel
  • His mini-brimstone's range can be increased with range up items or pills.
The Lost

Items[edit | edit source]

Activated Collectibles[edit | edit source]

Bob's Rotten Head Bob's Rotten Head
Bob's Rotten Head Icon.png3 roomsUpon use, Isaac holds a poison bomb which can be thrown towards any of the four cardinal points and explodes on impact.
  • The head deals 3 times Isaac's tear damage as poison over time instead of either 6 or 8 points.
The Book of Belial The Book of Belial
The Book of Belial Icon.png3 roomsUpon use increases damage by 2 for the current room and by a further +50% if the character also has the Blood of the Martyr.
Removed in Afterbirth Guarantees a Devil Room or Angel Room will be open after beating a boss while holding it, or Added in Afterbirth increases the chance by 12.5%.
  • Increases the chance to open the Devil Room or Angel Room by 12.5% after killing a boss while holding it instead of guaranting it.
Book of Revelations Book of Revelations
Book of Revelations Icon.png6 roomsAdds 1 soul heart, increases the chance for a Devil or Angel Room to appear, and increases the chance for the next boss to be a Horseman (except on XL floors and floors with fixed bosses such as Mom).
  • Increases chance for a Devil/Angel Room Door to open by 17.5% instead of 35%.
Butter Bean Butter Bean
Butter Bean Icon.png3 secondsIsaac farts and pushes back nearby enemies.
  • Knocks back enemy shots.
Crack the Sky Crack the Sky
Crack the Sky Icon.png4 roomsSummons multiple beams of light in random locations around the room, dealing a large amount of damage to any enemy that touches them.
  • The beams have a high chance to directly target enemies.
D4 D4
D4 Icon.png6 roomsRerolls all of Isaac's items.
  • Previously held items are removed from the pause menu.
The D6 The D6
The D6 Icon.png6 roomsAllows Isaac to re-roll collectible items in the current room into other items, depending on the current room's Item Pool.
  • Reroll an item after defeating The Fallen no longer replace the Devil Room item he drops to a random item from the normal boss item pool.
D10 D10
D10 Icon.png1 roomsRerolls the enemies in a room. Only rerolls enemies that are still alive (does not spawn new enemies).
  • Fly enemies are only rerolled into other fly enemies.
  • Red flies can't be rerolled anymore (even though enemies can be rerolled into them).
Flush! Flush!
Flush! Icon.png6 roomsChanges all enemies in the room into poop. Does not work on all enemies (Knights and bosses are immune). Instantly kills Dingle, Dangle, and Brownie.
  • Floods the whole room with water.
  • Flushes all poop-related enemies and bosses away.
  • The ladders are covered in water but the walls are not when used inside a crawl space.
Guppy's Paw Guppy's Paw
Guppy's Paw Icon.pngUnlimitedRemoves one red heart container in exchange for gaining 3 Soul Hearts.
  • Can no longer be used without red heart containers.
Head of Krampus Head of Krampus
Head of Krampus Icon.png6 roomsFires a cross-patterned brimstone shot, just like The Fallen and Krampus shoot.
  • Has a 50% chance to rotate all beams around the player 90 degrees, similar to Krampus' second Brimstone attack.
The Jar The Jar
The Jar Icon.pngUnlimitedWhen at full health, up to 4 extra hearts can be stored in the jar.
  • Sprite changed.
Monstro's Tooth Monstro's Tooth
Monstro's Tooth Icon.png3 roomsMonstro jumps onto a random enemy, doing area damage. Can damage/kill the player if summoned in an room without enemies.
  • Has no effect if Monstro is in the room the item is used in.
The Poop The Poop
The Poop Icon.png1 roomsSpawns a pile of poop where the character is standing and knocks nearby monsters back. May yield pickups like regular poop.
  • Knocks back enemy shots.
Scissors Scissors
Scissors Icon.png6 roomsUpon use, turns Isaac's head into a stationary familiar for the current room which fires normal tears that deal 3.5 damage.
  • Its recharge time is 2 rooms instead of 6 rooms.
Undefined Undefined
Undefined Icon.png6 roomsTeleports Isaac to either the Secret Room, Super Secret Room, Treasure Room, or I AM ERROR.
  • Dark Room can no longer be cleared repeatedly.

Passive Collectibles[edit | edit source]

20/20 20/20
20 20 Icon.pngGrants double shot.
  • Sprite changed.
3 Dollar Bill 3 Dollar Bill
3 Dollar Bill Icon.pngGives Isaac a random tear effect every room.
Removed in Afterbirth The effect given changes upon entering a room.
Added in Afterbirth The effect changes every 3 seconds.
  • The type of randomized tear changes every 2–3 seconds. The item appears to select two tear effects at once, perhaps staggering the times at which each of those effects change.
  • If a run is quit, and then continued, 3 Dollar Bill will keep tear effects for the current room.
Abel Abel
Abel Icon.pngA familiar that mirrors the player's movements and shoots in the opposite direction.
  • Shoots tears towards Isaac regardless of which direction Isaac is shooting.
Ball of Bandages 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.
  • Blocks enemy shots.
Bob's Brain Bob's Brain
Bob's Brain Icon.pngSpawns a familiar that charges forward when shooting tears and explodes upon contact with an enemy, damaging and poisoning them. The familiar respawns after a few seconds.
  • Bob's Brain is fired directly from where it is located in the chain of familiars behind Isaac, making aiming it slightly more difficult.
  • Each copy takes up its own spot on the familiar line, but only the first one launches out. Respawning brains may end up stacking on top of each other.
Bomb Bag 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.
Box Box
Box Icon.pngSpawns 1 of each (non-collectible) item: 1 coin, 1 key, 1 bomb, 1 heart, 1 card, 1 pill, 1 trinket.
Butt Bombs 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
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.
  • Each tear deals Isaac's base damage.
The Common Cold The Common Cold
The Common Cold Icon.pngAdds a chance to shoot poison tears, dealing damage over time when inflicted.
  • The poison hits twice, dealing a total of double Isaac's damage.
Dr. Fetus Dr. Fetus
Dr. Fetus Icon.pngTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
  • Each bomb deals 5 times the character's normal tear damage instead of 3, plus a flat 30 damage. The flat 30 is not affected by damage multipliers.
Fire Mind 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.
  • Isaac gives a wide glow lighting up dark areas, such as those under the effects of the Curse of Darkness or the Dark One's attacks.
Isaac's Heart 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.
  • Brimstone shots damage the heart.
Leo Leo
Leo Icon.pngAllows you to crush rocks when you walk over them.
  • Nullifies effects of One Makes You Small pills, One Makes You Larger pills, and other items which decrease size, such as Caffeine Pill.
Lost Contact Lost Contact
Lost Contact Icon.pngEvery tear has a small shield which will allow it to block one enemy projectile.
  • Gives a shield to familiar's tears.
Lord of the Pit Lord of the Pit
Lord of the Pit Icon.pngGrants flight and increases speed.
  • Speed boost is applied immediately.
Mom's Contacts 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.
  • Range and tears height buffs are applied immediately.
Mom's Knife 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.
  • If picked up twice in the same run, two knives are fired at once.
Punching Bag Punching Bag
Punching Bag Icon.pngSpawns a Mulligan Familiar that will wander the room randomly. Enemies will attack the Mulligan if it's closer.
  • Dies after taking too much damage and then respawns after a long period of time. Exiting and continuing the run will cause it to reappear right away.
  • Dies instantly by enemies' beam-type attacks, such as Uriel's and Gabriel's beam. This also includes enemies' Technology lasers such as Eye and Camillo Jr..
  • Reappears instantly each time a familiar or orbital item is picked up.
Scorpio Scorpio
Scorpio Icon.pngGrants poison tears, which deal damage over time when inflicted.
  • The poison hits twice, dealing a total of double Isaac's damage.
Steam Sale 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.
  • Having multiple Steam Sales reduces all shop prices to 0 coins.
  • Causes the Deals with the Devil not to convert the heart type automatically.
Stop Watch Stop Watch
Stop Watch Icon.pngRemoved in Afterbirth Automatically inflicts slow to all enemies in every room.
Added in Afterbirth Upon taking damage, inflicts slow to all enemies for the current room.
  • The slow is only applied after the player is hit.
Strange Attractor Strange Attractor
Strange Attractor Icon.pngPickups, trinkets, and monsters are magnetically attracted to Isaac's tears.
  • Isaac's bombs are magnetically attracted to the player character's tears.
Tech.5 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.
The Virus The Virus
The Virus Icon.pngInflicts poison to enemies who make contact with Isaac. Speed down.
  • Each poison hit deals damage equal to Isaac's tear damage instead of 4 or 6 damage.
  • Enemies killed after they have been inflicted with this type of poison have a 20% chance to drop black hearts.

Trinkets[edit | edit source]

Match Stick Match Stick
Match Stick Icon.pngIncreases the chance of Bombs dropping after clearing a room, and the chance of finding Bombs when opening a Chest.
  • Can replace the Tick.
Missing Poster Missing Poster
Missing Poster Icon.pngIf Isaac dies in a Sacrifice Room, a puzzle piece will appear on his last will (Added in Afterbirth and unlocks The Lost). Added in Afterbirth Revives Isaac as The Lost if unlocked. The Missing Poster then disappears.
  • No longer displays a particular puzzle piece on the last will screen if Isaac dies in a Sacrifice Room while holding it.
  • Dying in a Sacrifice Room while holding it unlock The Lost, regardless of current character.
    • If The Lost was already unlocked, Isaac will be revived as The Lost and Missing Poster will be consumed.
    • If the player's character is already The Lost, he will be revived in the previous room and Missing Poster will be consumed.
Mysterious Paper Mysterious Paper
Mysterious Paper Icon.pngHas a chance to replicate the effects of A Missing Page, The Polaroid, The Negative, or Missing Poster.
Tick Tick
Tick Icon.pngDrain 15% health of each enemy with more than 60 HP (ie. most bosses). Also restores one red heart of Isaac whenever he enters an uncleared boss room. The Tick cannot be swapped out for another trinket.

Interactions[edit | edit source]

  • 20/20 20/20
    20 20 Icon.pngGrants double shot.
    + Brimstone 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.
    - Two brimstone shots are fired, without an increase in charge time.
  • 20/20 20/20
    20 20 Icon.pngGrants double shot.
    + Epic Fetus Epic Fetus
    Epic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
    - Makes two missiles drop one after the other.
  • 20/20 20/20
    20 20 Icon.pngGrants double shot.
    + The Inner Eye The Inner Eye
    The Inner Eye Icon.pngGrants triple shot but decreases tears.
    - 5 shots are fired with the normal decrease in fire rate instead of 3.
  • 20/20 20/20
    20 20 Icon.pngGrants double shot.
    + Mom's Knife 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.
    - Two knives are now thrown instead of one.
  • 20/20 20/20
    20 20 Icon.pngGrants double shot.
    + Mutant Spider Mutant Spider
    Mutant Spider Icon.pngGrants quadruple shot but decreases tears.
    - 6 shots are fired with the normal decrease in fire rate.
  • 20/20 20/20
    20 20 Icon.pngGrants double shot.
    + Technology Technology
    Technology Icon.pngReplaces tears with a piercing laser with unlimited range.
    - Two technology shots are fired simultaneously.
  • Azazel + Monstro's Lung Monstro's Lung
    Monstro's Lung Icon.pngIncreases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.
    - Gives several additional Brimstone beams around Azazel.
  • Azazel + My Reflection My Reflection
    My Reflection Icon.pngGives Isaac's tears a boomerang effect, and increases range and shot speed.
    - Greatly increases the Brimstone laser's range and makes the laser curve as Azazel moves around the room.
  • Azazel + Technology Technology
    Technology Icon.pngReplaces tears with a piercing laser with unlimited range.
    - Technology laser wraps around the Brimstone beam, dealing extra damage, but not increasing Brimstone range.
  • BBF 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.
    + Brimstone 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.
    - BBF will fire Brimstone beams in all directions upon exploding.
  • Brimstone 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.
    + Dr. Fetus Dr. Fetus
    Dr. Fetus Icon.pngTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
    - Isaac continuously fires bombs while charging the Brimstone beams.
  • Brimstone 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.
    + Epic Fetus Epic Fetus
    Epic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
    - Fires 10 Brimstone beams in all directions upon impact of a missile.
  • Brimstone 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.
    + Monstro's Lung Monstro's Lung
    Monstro's Lung Icon.pngIncreases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.
    - 3-5 additional Brimstone beams fire in random directions. One beam always fire straight forward as normal.
  • Brimstone 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.
    + My Reflection My Reflection
    My Reflection Icon.pngGives Isaac's tears a boomerang effect, and increases range and shot speed.
    - Makes the beam curve when moving.
  • Brimstone 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.
    + Mysterious Liquid Mysterious Liquid
    Mysterious Liquid Icon.pngTears leave a small, short lasting pool of creep on impact or when their range is depleted.
    - When Brimstone hits enemies or walls it leaves creep based on how long it hits.
  • Brimstone 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.
    + Proptosis Proptosis
    Proptosis Icon.pngTears start out massive with high damage, and then shrink down and become weaker over a short range.
    - Doubles damage but it rapidly decreases with distance, down to 0.1 from about 6 tiles away.
  • Brimstone 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.
    + Rubber Cement Rubber Cement
    Rubber Cement Icon.pngTears bounce off walls, enemies, and environmental objects.
    - Brimstone beam bounces off walls, creating a second beam that does half damage. Azazel's Brimstone will continue to full length after bouncing, but will deal half of damage.
  • Brimstone 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.
    + Sad Bombs 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.
    - Bombs explode into Brimstone beams in all directions.
  • Brimstone 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.
    + Tech.5 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.
    - Tech.5 fires at player's tear rate while Brimstone laser is charging.
  • Brimstone 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.
    + Technology Technology
    Technology Icon.pngReplaces tears with a piercing laser with unlimited range.
    - The Technology laser coils around the Brimstone beam, granting a 1.5x damage multiplier.
  • Brimstone 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.
    + Technology 2 Technology 2
    Technology 2 Icon.pngDecreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.
    - Laser fires while Brimstone is charging.
  • Brimstone 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.
    + Tough Love Tough Love
    Tough Love Icon.pngAdds a chance to shoot a tooth instead of a tear, which deals greater damage than regular tears.
    - Occasionally fires Brimstone beam with damage multiplier of Tough Love.
  • Broken Watch 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.
    + Stop Watch Stop Watch
    Stop Watch Icon.pngRemoved in Afterbirth Automatically inflicts slow to all enemies in every room.
    Added in Afterbirth Upon taking damage, inflicts slow to all enemies for the current room.
    - Both the slow effect and the rarer speed up can trigger at the start of a room. However, getting hit on a sped up room will trigger Stop Watch's slow down.
  • Cricket's Body Cricket's Body
    Cricket's Body Icon.pngGrants -1 Tear Delay 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.
    + Dr. Fetus Dr. Fetus
    Dr. Fetus Icon.pngTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
    - Bombs split outwards into 4 tiny bombs that are not affected by Isaac's bomb modifiers, which detonate almost immediately.
  • Death's Touch 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.
    + Fire Mind 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.
    - Scythes now properly explode.
  • Dr. Fetus Dr. Fetus
    Dr. Fetus Icon.pngTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
    + Hot Bombs Hot Bombs
    Hot Bombs Icon.pngGrants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact.
    - Bombs leave behind fire that damages enemies on contact after exploding.
  • Dr. Fetus Dr. Fetus
    Dr. Fetus Icon.pngTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
    + Mom's Knife 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.
    - Isaac continuously fires bombs while charging the knife.
  • Dr. Fetus Dr. Fetus
    Dr. Fetus Icon.pngTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
    + Monstro's Lung Monstro's Lung
    Monstro's Lung Icon.pngIncreases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.
    - Shoots 6 bombs which need to be fully charged before firing. The bombs detonate simultaneously.
  • Dr. Fetus Dr. Fetus
    Dr. Fetus Icon.pngTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
    + Mysterious Liquid Mysterious Liquid
    Mysterious Liquid Icon.pngTears leave a small, short lasting pool of creep on impact or when their range is depleted.
    - Exploding bombs leave behind a large pool of green creep.
  • Dr. Fetus Dr. Fetus
    Dr. Fetus Icon.pngTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
    + The Parasite The Parasite
    The Parasite Icon.pngIsaac's tears split in two when they hit something.
    - Bombs split into two bombs upon exploding.
  • Dr. Fetus Dr. Fetus
    Dr. Fetus Icon.pngTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
    + Poison tears - No damage increase from poison.
  • Dr. Fetus Dr. Fetus
    Dr. Fetus Icon.pngTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
    + Polyphemus 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.
    - Bombs become Mr. Mega bombs. After they explode, they leave behind a regular-sized bomb.
  • Dr. Fetus Dr. Fetus
    Dr. Fetus Icon.pngTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
    + Sad Bombs 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.
    - Fires tears as normally placed Sad Bombs would. If this synergy is combined with Ipecac, the tears from the bomb become explosive, which Isaac is not immune to. Tears fired from previous Dr. Fetus bombs can collide with other Dr. Fetus bombs (can be negated with spectral tears).
  • Dr. Fetus Dr. Fetus
    Dr. Fetus Icon.pngTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
    + Spoon Bender Spoon Bender
    Spoon Bender Icon.pngGrants Isaac homing tears.
    - Bombs are purple and act as if Isaac had Bobby-Bomb.
  • Dr. Fetus Dr. Fetus
    Dr. Fetus Icon.pngTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
    + Technology Technology
    Technology Icon.pngReplaces tears with a piercing laser with unlimited range.
    - Both bombs and lasers are fired.
  • Dr. Fetus Dr. Fetus
    Dr. Fetus Icon.pngTears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
    + Tough Love Tough Love
    Tough Love Icon.pngAdds a chance to shoot a tooth instead of a tear, which deals greater damage than regular tears.
    - Tears that would have fired a tooth shot instead become a bomb with the Mr. Mega, dealing more damage and shaking the screen.
  • Epic Fetus Epic Fetus
    Epic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
    + Hot Bombs Hot Bombs
    Hot Bombs Icon.pngGrants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact.
    - Creates a fire every time a shot lands.
  • Epic Fetus Epic Fetus
    Epic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
    + Ipecac Ipecac
    Ipecac Icon.pngReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth.
    + Sad Bombs 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.
    - Tear Blast tears explode and can damage Isaac.
  • Epic Fetus Epic Fetus
    Epic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
    + Mom's Knife 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.
    - Each explosion shoots 10 knives in a circle from the point of impact.
  • Epic Fetus Epic Fetus
    Epic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
    + Monstro's Lung Monstro's Lung
    Monstro's Lung Icon.pngIncreases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.
    - Adds 2 to 4 more crosshairs that orbit the main crosshair and fires a missile onto each crosshair.
  • Epic Fetus Epic Fetus
    Epic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
    + Mysterious Liquid Mysterious Liquid
    Mysterious Liquid Icon.pngTears leave a small, short lasting pool of creep on impact or when their range is depleted.
    - Exploding bombs leave behind a large pool of green creep.
  • Epic Fetus Epic Fetus
    Epic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
    + Sad Bombs 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.
    - Missiles fire a burst of tears where they land.
  • Epic Fetus Epic Fetus
    Epic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
    + Spoon Bender Spoon Bender
    Spoon Bender Icon.pngGrants Isaac homing tears.
    - Cursor slides towards enemies.
  • Epic Fetus Epic Fetus
    Epic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
    + Strange Attractor Strange Attractor
    Strange Attractor Icon.pngPickups, trinkets, and monsters are magnetically attracted to Isaac's tears.
    - Enemies get drawn towards the crosshair.
  • Epic Fetus Epic Fetus
    Epic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
    + Spoon Bender Spoon Bender
    Spoon Bender Icon.pngGrants Isaac homing tears.
    - Cursor slides towards enemies
  • Epic Fetus Epic Fetus
    Epic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
    + Technology Technology
    Technology Icon.pngReplaces tears with a piercing laser with unlimited range.
    - Explosion shoots Technology lasers in all directions. When firing/moving the cursor, Isaaac still shoot his Technology laser.
  • Epic Fetus Epic Fetus
    Epic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
    + Technology 2 Technology 2
    Technology 2 Icon.pngDecreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.
    - Both the Technology 2 laser, and the Epic Fetus missiles will be active.
  • Epic Fetus Epic Fetus
    Epic Fetus Icon.pngIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
    + Telepathy for Dummies Telepathy for Dummies
    Telepathy for Dummies Icon.png2 roomsUpon activation, grants homing tears for the current room.
    - Cursor slides towards enemies.
  • Fire Mind 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.
    + Mysterious Liquid Mysterious Liquid
    Mysterious Liquid Icon.pngTears leave a small, short lasting pool of creep on impact or when their range is depleted.
    - When the Fire Mind tear explodes, a much larger pool of creep is left behind.
  • Unknown display mode [Guppy] + - Ipecac shots now spawn blue flies on hit, both direct and indirect.
  • Holy Mantle Holy Mantle
    Holy Mantle Icon.pngAutomatically negates first taken damage in every room.
    + Stop Watch Stop Watch
    Stop Watch Icon.pngRemoved in Afterbirth Automatically inflicts slow to all enemies in every room.
    Added in Afterbirth Upon taking damage, inflicts slow to all enemies for the current room.
    - Blocking damage with Holy Mantle triggers the Stop Watch effect.
  • The Inner Eye The Inner Eye
    The Inner Eye Icon.pngGrants triple shot but decreases tears.
    + Mutant Spider Mutant Spider
    Mutant Spider Icon.pngGrants quadruple shot but decreases tears.
    - Shoots 7 tears instead of 3. No further decrease in fire rate.
  • Ipecac Ipecac
    Ipecac Icon.pngReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth.
    + Mysterious Liquid Mysterious Liquid
    Mysterious Liquid Icon.pngTears leave a small, short lasting pool of creep on impact or when their range is depleted.
    - Explosions leave behind a large pool of green creep.
  • The Ludovico Technique 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.
    + Mom's Knife 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.
    + Technology Technology
    Technology Icon.pngReplaces tears with a piercing laser with unlimited range.
    - Creates an uncontrollable laser ring centered on Isaac. The knife becomes stuck under Isaac and cannot be fired.
  • The Ludovico Technique 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.
    + Monstro's Lung Monstro's Lung
    Monstro's Lung Icon.pngIncreases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.
    - Tear becomes a cluster of variably sized tears spread over a small area. The tears move at the same speed when controlled but constantly move around each other.
  • The Ludovico Technique 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.
    + Mysterious Liquid Mysterious Liquid
    Mysterious Liquid Icon.pngTears leave a small, short lasting pool of creep on impact or when their range is depleted.
    - Pools the size of the tear constantly form on the ground dealing large amounts of damage to any non-flying enemy inside the tear.
  • A Lump of Coal A Lump of Coal
    A Lump of Coal Icon.pngThe more distance tears travel, the more damage they will do.
    + Brimstone 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.
    - Beam will gradually increase in size and damage the farther it travels, on a multiplier that is roughly +20% per tile of distance.
  • A Lump of Coal A Lump of Coal
    A Lump of Coal Icon.pngThe more distance tears travel, the more damage they will do.
    + Technology Technology
    Technology Icon.pngReplaces tears with a piercing laser with unlimited range.
    - Damage increases the further away the enemy is, on a multiplier that is roughly +20% per tile of distance.
  • A Lump of Coal A Lump of Coal
    A Lump of Coal Icon.pngThe more distance tears travel, the more damage they will do.
    + Technology Technology
    Technology Icon.pngReplaces tears with a piercing laser with unlimited range.
    + Tiny Planet Tiny Planet
    Tiny Planet Icon.pngRange up and makes shot tears revolve around Isaac until they drop.
    - The extra distance covered by the laser more than doubles damage right in front of Isaac, and it increases as normal further away.
  • A Lump of Coal A Lump of Coal
    A Lump of Coal Icon.pngThe more distance tears travel, the more damage they will do.
    + Technology 2 Technology 2
    Technology 2 Icon.pngDecreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.
    - Damage increases the further away the enemy is, on a multiplier that is roughly +20% per tile of distance.
  • Mom's Knife 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.
    + Monstro's Lung Monstro's Lung
    Monstro's Lung Icon.pngIncreases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.
    - Fires a cluster of 3-5 knives at maximum charge, each dealing 2x damage.
  • Mom's Knife 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.
    + Technology Technology
    Technology Icon.pngReplaces tears with a piercing laser with unlimited range.
    - Both the knife and the laser fire normally.
  • My Reflection My Reflection
    My Reflection Icon.pngGives Isaac's tears a boomerang effect, and increases range and shot speed.
    + Technology Technology
    Technology Icon.pngReplaces tears with a piercing laser with unlimited range.
    - Makes the beam curve when moving. Has the same effect on Azazel's mini-brimstone and doubles the range.
  • My Reflection My Reflection
    My Reflection Icon.pngGives Isaac's tears a boomerang effect, and increases range and shot speed.
    + Technology 2 Technology 2
    Technology 2 Icon.pngDecreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.
    - Laser is bent as Isaac moves, then gradually becomes straight as he stands still.
  • Mysterious Liquid Mysterious Liquid
    Mysterious Liquid Icon.pngTears leave a small, short lasting pool of creep on impact or when their range is depleted.
    + Technology Technology
    Technology Icon.pngReplaces tears with a piercing laser with unlimited range.
    - The laser spawns pools of liquid always when it hits obstacles and occasionally on enemies.
  • Proptosis Proptosis
    Proptosis Icon.pngTears start out massive with high damage, and then shrink down and become weaker over a short range.
    + Technology Technology
    Technology Icon.pngReplaces tears with a piercing laser with unlimited range.
    - The beam decreases in damage and width the farther it travels. Tears become virtually powerless across large rooms like the Boss Rush and the Hush fight.
  • Proptosis Proptosis
    Proptosis Icon.pngTears start out massive with high damage, and then shrink down and become weaker over a short range.
    + Technology 2 Technology 2
    Technology 2 Icon.pngDecreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.
    - The beam decreases in damage and width the farther it travels. Tears become virtually powerless across large rooms like the Boss Rush and the Hush fight.
  • Pisces Pisces
    Pisces Icon.png-1 Tear Delay, adds knock-back shots and increases tear size.
    + Technology 2 Technology 2
    Technology 2 Icon.pngDecreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.
    - Laser can knock back enemies well due to its high fire rate.
  • Rubber Cement Rubber Cement
    Rubber Cement Icon.pngTears bounce off walls, enemies, and environmental objects.
    + Technology Technology
    Technology Icon.pngReplaces tears with a piercing laser with unlimited range.
    - Laser bounces off of walls, creating a second beam that does half damage.
  • Rubber Cement Rubber Cement
    Rubber Cement Icon.pngTears bounce off walls, enemies, and environmental objects.
    + Technology 2 Technology 2
    Technology 2 Icon.pngDecreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.
    - Laser bounces off of walls, creating a second beam that does half damage.


Pickups[edit | edit source]

Bombs[edit | edit source]

Troll bomb
  • Troll Bombs are now given a random amount of time before exploding. Before that they always exploded at a fixed time. This means that if two Troll Bombs spawn at the exact same time right next to each other, there's a high chance one Troll Bomb will blow up before the other, sending that Troll Bomb sliding outwards a bit before exploding.

Entities[edit | edit source]

Monsters[edit | edit source]

Bony
  • Only leaves behind bones when killed.

Environment[edit | edit source]

Rooms[edit | edit source]

Boss Room
  • Double Trouble boss rooms can now contain 2 bosses of different types. Additionally, they can appear as early as Chapter 1.
Arcade

Arcade 12.pngArcade 13.pngArcade 14.pngArcade 15.png

Angel Room
  • Possible rewards found in the room include:
  • Urns might spawn in the room.
  • Killing Key key master and shell game beggar no longer applies the 25% bonus.
  • Donating to a normal beggar until it pays out with an item on the current floor applies a 10% bonus instead of 25%.
  • Donating to a Devil beggar until it pays out with an item on the current floor applies a 10% bonus instead of 25%.
    • If this coin flip succeeds, a Devil Room will be generated regardless of the above coin flips.
  • "You feel blessed!" fortune in the Sacrifice Room of the current floor applies a bonus:
    • If the "You feel blessed!" fortune appeared on the 3rd sacrifice, the chance will be 15%.
    • If the "You feel blessed!" fortune appeared on the 5th sacrifice, the chance will be 50%.
    • If both "You feel blessed!" fortunes appeared, the chance will be 65%.
  • Angel Rooms that spawn after Isaac defeats Mom's Heart or It Lives will be normal Angel Rooms with items or pickups.
  • A troll bomb can sometimes appear behind the Angel Statue, blowing it up. If the Angel fights have been unlocked, this will begin the boss fight if the player is not careful or quick enough to move the bomb.
Bedroom
  • The clean bedroom occasionally has two clean beds instead of one.
  • The trapdoor in a dirty bedroom has a chance to lead to a Crawl Space.
  • Occasionally, one Rag Man will spawn inside the dirty bedroom.
Boss Rush

Boss Rush 2.pngBoss Rush 3.pngBoss Rush 4.pngBoss Rush 5.png

  • If a sack spawns for whatever reason, picking it up will start the Boss Rush. The player can still pick up one of the pedestal items.
Black Market
  • Black Market can no longer be accessed in The Chest and The Dark Room, and therefore cannot be used to collect more items.
Curse Room
Normal Challenge Room
  • The three waves appear in random orders rather than the original orders.
Sacrifice Room
  • The payouts only depend on the number of sacrifices made. The number of sacrifices is reset to 0 when the player goes to the next floor.
  • Rewards are reworked:
Number of sacrifices on Current Floor Possible Rewards
1st/2nd
  • 50% chance - Nothing
  • 50% chance - 1 Penny
3rd
  • 33% chance - Nothing
  • 67% chance - "You feel blessed!" (increased chance to receive an Angel Room over a Devil Room for the current floor; see Angel Room Generation Chance)
    • This does not increase the chance of receiving a Devil/Angel room after defeating a boss; it only increases the chance of getting an Angel Room over a Devil Room.
    • This can cause an Angel Room to spawn even if you have already taken a deal with the devil.
    • Note that this is less of a modifier than the "You feel blessed!" effect below.
4th
  • 50% chance - Nothing
  • 50% chance - 1 random chest
    • The type of chest is governed by the same mechanic as room drops. Thus, brown chests are more likely to spawn than any other kind of chest.
5th
  • 33% chance - 3 pennies
    • These coins do not have a chance to spawn as a nickel or a dime.
  • 67% chance - "You feel blessed!" (increased chance to receive an Angel Room over a Devil Room for the current floor; see Angel Room Generation Chance)
    • This does not increase the chance of receiving a Devil/Angel room after defeating a boss; it only increases the chance of getting an Angel Room over a Devil Room.
    • This can cause an Angel Room to spawn even if you have already taken a deal with the devil.
    • Note that this is more of a modifier than the "You feel blessed!" effect above.
6th
  • 33% chance - Teleport to the Devil/Angel Room.
    • If the Devil/Angel Room of the floor has not been entered yet, an Angel Room will be guaranteed to spawn (even if you have already taken a Devil Deal).
  • 67% chance - 1 random chest
    • The type of chest is governed by the same mechanic as room drops. Thus, brown chests are more likely to spawn than any other kind of chest.
7th
8th
9th
  • 100% chance - Uriel battle
10th
  • 50% chance - 7 soul hearts
  • 50% chance - 30 pennies
11th
12th and onwards
  • 50% chance - Nothing
  • 50% chance - Teleport directly to the Dark Room
  • Losing red hearts due to the spikes will reduce the chance for a Devil Room to appear.
  • The amount of luck that the player has does not affect the payout probabilities.
  • Angels are normally able to fly over spikes, but will take damage from sacrifice room spikes.
  • New layouts:

Sacrifice Room 2.pngSacrifice Room 3.pngSacrifice Room 4.pngSacrifice Room 5.png

Secret Room
Shop
  • There is a small chance when you bomb the Shopkeeper that they can turn into Greed and start attacking you.
Super Secret Room
Treasure Room
  • There's a rare chance that a treasure room might contains two items to choose from, only one of which can be taken.
  • Treasure rooms may also contain a restock box, allowing Isaac to re-roll offered items if he has coins or bombs.
  • New layouts:

Treasure Room 13.pngTreasure Room 14.pngTreasure Room 15.pngTreasure Room 16.pngTreasure Room 17.pngTreasure Room 18.pngTreasure Room 19.pngTreasure Room 20.pngTreasure Room 21.pngTreasure Room 22.pngTreasure Room 23.pngTreasure Room 26.pngTreasure Room 27.pngTreasure Room 28.pngTreasure Room 31.pngTreasure Room 32.pngTreasure Room 33.pngTreasure Room 34.pngTreasure Room 35.pngTreasure Room 36.pngTreasure Room 37.pngTreasure Room 38.pngTreasure Room 39.pngTreasure Room 24.pngTreasure Room 30.pngTreasure Room 25.pngTreasure Room 29.png

Other[edit | edit source]

  • When not having red hearts in Devil Room, the price of items switches to soul hearts.
  • Krampus has a new attack pattern.

Gallery[edit | edit source]

Trivia[edit | edit source]

  • Afterbirth is the placenta and fetal membranes discharged from the uterus after the birth of offspring, which might be why the title screen is bloody.


Broken Modem Icon.png Version History Broken Modem Icon.png

Removed in Afterbirth Rebirth v0.9, v1.0, v1.01, v1.02, v1.031, v1.032, v1.04, v1.041, v1.05, v1.05 Hotfix
Added in Afterbirth Afterbirth v1.06, v1.06 Hotfix, v1.06.0051, v1.06.0052, v1.06.0059, v1.06.0060, v1.06.0067, v1.06.0076, v1.06.0109
Added in Afterbirth † Afterbirth † v1.06.0180, v1.06.0181, v1.06.0182, v1.06.0183, v1.06.0185, v1.06.0187, v1.06.0188, v1.06.0190, v1.06.0192, v1.06.0192 (Re-release), v1.06.0193, v1.06.0211
Booster Pack #1 v1.06.J34, v1.06.J39
Booster Pack #2 v1.06.J75, v1.06.J85
Booster Pack #3 v1.06.J99, v1.06.J103, v1.06.J104
Booster Pack #4 v1.06.J113, v1.06.J114, v1.06.J119, V1.06.J127
Booster Pack #5 v1.06.J149, v1.06.J150, V1.06.J168


The Binding of Isaac: Rebirth The Binding of Isaac: Rebirth The Binding of Isaac: Rebirth
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 MainPageItems Small.png Items Item Pools 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