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 30th, 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]

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
Shot Speed Stat Icon.png Shot Speed Blindfolded 1
Range Stat Icon.png Range Blindfolded 23.75
Speed Stat Icon.png Speed 1.0 0.85
Luck Stat Icon.png Luck 0 -2
Starting Item Icon.png Starting Pickups None x1 Bombs
Needs to be unlocked x1 Coins
Needs to be unlocked Store Key
Starting Item Icon.png Starting Item(s) Incubus,
Needs to be unlocked Cambion Conception,
Box of Friends
Triple shot,
Needs to be unlocked Wooden Nickel

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
Added in Afterbirth Box of Friends 357
Box of Friends
4 rooms
Double your friends Upon use, duplicates all of Isaac's familiars for the current room.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth D8 406
D8
4 rooms
Reroll stats Re-rolls Isaac's speed, range, tears, and damage.
Added in Afterbirth Diplopia 347
Diplopia
One time use
Double item vision Duplicates all pickups and item pedestals in the room.
Added in Afterbirth 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.
Added in Afterbirth 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).
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth Kidney Bean 421
Kidney Bean
2 rooms
Love toots! Upon use, Isaac farts, charming all nearby enemies.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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 (Added in Afterbirth † luck is increased by 2) and doubles the effects of trinkets.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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
Added in Afterbirth 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.
Added in Afterbirth Athame 408 Athame Call to the void Whenever Isaac takes damage, a black ring briefly appears around Isaac, dealing damage to all nearby enemies.
Added in Afterbirth 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.
Added in Afterbirth Binky 438 Binky Memories... Tears up, adds 1 soul heart, and decreases Isaac's size.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth Bursting Sack 377 Bursting Sack Spider love Spider enemies no longer target or deal contact damage to Isaac.
Added in Afterbirth Cambion Conception 412 Cambion Conception Feed them hate After taking damage a certain amount of times, a permanent demonic familiar spawns.
Added in Afterbirth Car Battery 356 Car Battery Double charge! Causes Isaac's activated item to activate twice on each use.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth Crack Jacks 354 Crack Jacks Don't swallow the prize! Adds one heart container and drops a random trinket.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth Explosivo 401 Explosivo Sticky bomb shot! Isaac's tears have a chance to stick to enemies and explode.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth Fruit Cake 418 Fruit Cake Rainbow effects! Isaac's tears gain a random effect that changes every shot.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth Immaculate Conception 413 Immaculate Conception Feed them love Upon picking up a certain amount of health, spawn a permanent angelic familiar.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth Lil' Loki 435 Lil' Loki 4-way buddy! A Loki familiar that follows Isaac and shoots 4 tears in a cross pattern.
Added in Afterbirth 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.
Added in Afterbirth Lusty Blood 411 Lusty Blood Their blood brings rage! Each time Isaac kills an enemy, Isaac's damage increases for the current room.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth Mom's Pearls 355 Mom's Pearls Range + luck up +1.25 Range Up. +0.5 Tear Height. +1 Luck Up.
Added in Afterbirth 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.
Added in Afterbirth Mr. Dolly 370 Mr. Dolly Range + tears up Tears and Range up. Spawns 3 random types of hearts on the floor when picked up.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth PJs 428 PJs You feel cozy Grants four soul hearts and fully restores Isaac's red health.
Added in Afterbirth 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).}
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth Rune Bag 389 Rune Bag Rune generator A bag that follows Isaac and drops a random rune every 3 rooms.
Added in Afterbirth Sack Head 424 Sack Head More sacks! Greatly increases the chance to find sacks.
Added in Afterbirth Scatter Bombs 366 Scatter Bombs 'We put bombs in your bombs!' Adds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth Sworn Protector 363 Sworn Protector Protective friend An orbital angel which does 7 contact damage per tick and blocks enemy shots. When it blocks a shot, it has a very small chance to drop an eternal heart.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth 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
Added in Afterbirth Blasting Cap 73 Blasting Cap Pop! Pop! Exploding bombs have a chance to drop another bomb pickup.
Added in Afterbirth Black Feather 80 Black Feather With darkness comes power Increases Isaac's damage for possessing certain evil items.
Added in Afterbirth Blind Rage 81 Blind Rage Blind to damage Increases invincibility time after getting hit.
Added in Afterbirth Blister 77 Blister Bounce back! Increases knockback of tears.
Added in Afterbirth Brown Cap 90 Brown Cap Fartoom! Poop will explode after being destroyed.
Added in Afterbirth 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.
Added in Afterbirth Child Leash 89 Child Leash Keep your friends close... Causes familiars to stay closer to each other.
Added in Afterbirth 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.
Added in Afterbirth 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.
Added in Afterbirth Error 75 Error Effect not found? Gives a random trinket effect each room.
Added in Afterbirth Faded Polaroid 69 Faded Polaroid You feel faded Occasionally causes Isaac to blend into the ground, which briefly confuses all enemies in the room.
Added in Afterbirth Golden Horse Shoe 82 Golden Horse Shoe Feel lucky? +15% chance for a Treasure Room with two items to spawn.
Added in Afterbirth 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.
Added in Afterbirth Lazy Worm 66 Lazy Worm Pft Tear shot speed is greatly reduced.
Added in Afterbirth Lil Larva 86 Lil Larva The poop is moving... Spawns a blue fly from every pile of poop Isaac destroys.
Added in Afterbirth Louse 70 Louse Itchy, tasty... Occasionally spawns a Blue Spider.
Added in Afterbirth 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.
Added in Afterbirth NO! 88 NO! Never again! Removes all active items from every item pool.
Added in Afterbirth 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.
Added in Afterbirth Rainbow Worm 64 Rainbow Worm Bleep Bloop Blop Isaac's tears gain a worm effect that changes every 3 seconds.
Added in Afterbirth Rib of Greed 84 Rib of Greed Feels greedy Prevents Greed and Super Greed from appearing in Shops and Secret Rooms.
Added in Afterbirth 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.
Added in Afterbirth Second Hand 78 Second Hand Extended stat effect time! Increases the time that status effects stay on enemies.
Added in Afterbirth Shiny Rock 62 Shiny Rock It shines for its brothers Tinted rocks and rocks with Crawl Spaces will flash white every 10 seconds.
Added in Afterbirth Store Key 83 Store Key Stores are open Automatically opens all Shops.
Added in Afterbirth Stud Finder 74 Stud Finder The ground below feels hollow... Increases the chance to find a Crawl Space.
Added in Afterbirth Super Magnet 68 Super Magnet It Pulls Pulls enemies and pickups towards Isaac.
Added in Afterbirth Tape Worm 65 Tape Worm Floooooooooop! Doubles Isaac's range and halves his tear height.
Added in Afterbirth 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]

Pickups & Chests[edit | edit source]

Name Icon Description
Gold Heart GoldHeart.PNG Gold Hearts are the rarest variation of a heart. They are unlocked by completing the challenge Added in AfterbirthXXXXXXXXL. They always appear as full hearts and, once picked up, drop money the next time Isaac loses a Heart. A Golden Heart appends to the end of the health bar, surrounding it in a golden glow.
Lucky Penny Coin.png A Lucky Penny increases luck by 1 when picked up. Unlocked by donating 1 coin to the Greed Machine. Bumbo and Bum Friend are unable to pick up Lucky Pennies; they instead hover over them attempting to pick them up. Humbling Bundle does not double lucky pennies.
Sticky Nickel Nickel.png A Nickel that 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. Unlocked by completing Boss Rush with Keeper. It won't reduce the spawn rate of regular Nickels: rather, Pennies have an additional chance to become Sticky Nickels.
Gold Bombs Gold Bomb.png Gold bombs will not add to the player's bomb count, but when picked up, they will give the player unlimited bombs for the duration of the current floor, similarly to Golden Keys. They are unlocked by completing the challenge Blue Bomber.
Angel Chests AngelChest.png Angel 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 and rarely in a normal room. Their loot is similar to Golden Chests, but they can also drop nothing upon opening. If they contain nothing or an item, they will no longer be able to be reopened.
Spike Chests SpikeChest.png 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, 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.
Mystery Sack MysteryBag.png The Mystery Sack will spawn 1-4 pickups upon touching it. Sack Head greatly increases the chances of finding sacks.

Pills[edit | edit source]

Pill Effect
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.

Friends Till The End!

Spawns three Blue Flies.

Infested!

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

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.

One Makes You Small

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

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.

Needs to be unlocked Percs

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

Power Pill

Activates an effect similar to The Gamekid.

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.

Retro Vision

Briefly pixelates the screen 3 times over 30 seconds.

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. Unlocked by completing Challenge #25: Have a Heart.

Cards & Runes[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.
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.
Dice Shard 49 Dice Shard Icon.png D6 + D20 Upon use, activates the effects of the D6 and the D20 at the same time.
Rune ID Icon Unlock method Message Effect
Blank Rune 40 Blank Rune Icon.png Added in Afterbirth Blank Rune Complete challenge #30 (The unlock is bugged and actually unlocks Kidney Stone in Afterbirth. Fixed in Afterbirth Plus.)
Blank RuneBlank Rune
??? Grants a random rune effect. Has a 25% chance to spawn another Blank Rune upon use.

Transformations[edit | edit source]

Transformation Appearance Transformation effect Item Icon Item effect Recharge
Bob 100x100px
Bob's Rotten Head 42
Bob's Rotten Head
3 rooms
Reusable ranged bomb Upon use, Isaac holds a poison bomb which can be thrown towards any of the four cardinal points and explodes on impact.
Bob's Brain 273 Bob's Brain Explosive thoughts Spawns a familiar that charges forward when shooting tears, explodes upon contact with an enemy and poisons them. Respawns after few seconds.
Bob's Curse 140 Bob's Curse +5 poison bombs Gives 5 bombs and grants all bombs poison effect.
Ipecac 149 Ipecac Explosive shots Replaces tears with explosive and poisoning projectiles fired in an arc from the mouth.
Conjoined 100x100px
  • When attacking, the tumor faces shoot tears diagonally outwards, similar to the effect of The Wiz.
  • -0.3 damage.
  • Slightly decreases tears.
Brother Bobby 8 Brother Bobby Friends 'till the end Follows Isaac around shooting normal tears.
Harlequin Baby 167 Harlequin Baby Double shot buddy Spawns a familiar that follows Isaac around and fires two tears at once in a V-pattern.
Headless Baby 269 Headless Baby Bloody Friend Familiar that follows Isaac, leaving blood creep on the ground.
Little Steven 100 Little Steven Psychic friend Spawns a familiar that follows Isaac around and fires homing tears.
Mongo Baby 322 Mongo Baby Mongo Friend Summons a familiar that copies the tears of Isaac's other familiars.
Rotten Baby 268 Rotten Baby Infested friend A familiar that spawns blue flies.
Sister Maggy 67 Sister Maggy Friends 'till the end A familiar that follows Isaac around shooting blood tears.
Fun Guy 100x100px
Added in Afterbirth 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.
Mini Mush 71 Mini Mush Speed + range up Increases Speed and Shot Height and decreases Isaac's size, but lowers Range.
Magic Mushroom 12 Magic Mushroom All Stats Up! Increases all stats and enlargens Isaac.
Odd Mushroom 120 Odd Mushroom Fire rate up +1.7 tears, +0.3 speed, reduces damage.
Odd Mushroom 121 Odd Mushroom DMG up Grants an empty heart container. Increases damage, range and shot height while reducing speed.
1up! 11 1up! Extra life Gives an extra life. Upon death, you will respawn in the previous room with full health and lose the 1up!.
Blue Cap 342 Blue Cap HP + tears up + shot speed down Grants 1 heart container and increases tears, but decreases shot speed.
Leviathan 100x100px
The Nail 83
The Nail
6 rooms
Temporary demon form Adds 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.
The Mark 79 The Mark DMG up Increases Damage and Speed, plus adds one Soul Heart.
Missing Page 2 262 Missing Page 2 Evil up. Your enemies will pay! Gives 1 black heart. Upon taking damage that reduces Isaac's health to one heart or less, activates The Necronomicon effect, dealing 40 damage to all enemies in the room.
The Pact 80 The Pact DMG + Tears UP Increases damage by 0.5, tears by 0.7 and grants two soul hearts upon pickup.
Pentagram 51 Pentagram DMG up Increases damage and increases the chance for a Devil or Angel Room to appear.
Spirit of the Night 159 Spirit of the Night Scary Grants spectral tears and flight.
Added in Afterbirth 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.
Abaddon 230 Abaddon Evil + DMG up + fear shot Increases damage and speed, removes all red heart containers, grants six black hearts, and adds a chance to shoot fear tears.
Brimstone 118 Brimstone Blood laser barrage Tears 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.
Oh Crap 100x100px
  • Whenever a pile of poop is destroyed, health is replenished by half a heart.
Flush! 291
Flush!
6 rooms
... Changes 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 36
The Poop
1 rooms
Plop! Spawns a pile of poop where the character is standing and knocks nearby monsters back. May yield pickups like regular poop.
E Coli 236 E Coli Turdy touch Gives "Turdy Touch" Effect. Enemies that touch Isaac are changed into poop.
Seraphim 100x100px
The Bible 33
The Bible
6 rooms
Temporary Flight Upon 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 185 Dead Dove Flight + spectral tears Grants spectral tears and flight.
Guardian Angel 112 Guardian Angel Extra protection Spawns an orbital familiar that blocks enemy projectiles, deals contact damage to enemies, and increases the speed of all orbital familiars.
Holy Grail 184 Holy Grail Flight + HP up Grants flight and one heart container.
Holy Mantle 313 Holy Mantle Holy shield Automatically negates first taken damage in every room.
Mitre 173 Mitre You Feel Blessed Grants a chance of converting any red hearts pickups into soul hearts instead.
Rosary 72 Rosary Faith up Adds 3 Soul Hearts and increases the chance for The Bible to appear in any item pool.
Added in Afterbirth Sworn Protector 363 Sworn Protector Protective friend An orbital angel which does 7 contact damage per tick and blocks enemy shots. When it blocks a shot, it has a very small chance to drop an eternal heart.
The Halo 101 The Halo All stats up Grants one Heart Container, +0.3 Damage, +0.2 Tears, +0.25 Range, +0.3 Speed, and +0.5 Tear Height.
Spun 100x100px
Added in Afterbirth † Adrenaline 493 Adrenaline Panic = power Increases damage based on how many empty heart containers Isaac has.
Added in Afterbirth † Euthanasia 496 Euthanasia Needle shot Adds a chance to fire needles. If a needle kills an enemy, it bursts into more needles.
Experimental Treatment 240 Experimental Treatment All stats up, then shuffled Randomly 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 70 Growth Hormones Speed + DMG up Increases damage by 1 and speed by 0.4.
Roid Rage 14 Roid Rage Speed and range up Increases speed by 0.6, range by 5.25, and tear height by 0.5.
Speed Ball 143 Speed Ball Speed + shot speed up Increases speed by 0.3 and shot speed by 20%.
Synthoil 345 Synthoil DMG up + range Increases damage by 1, range by 5.25, and tear height by 0.5.
The Virus 13 The Virus Poison touch Inflicts poison to enemies who make contact with Isaac. Speed down.
Yes, Mother? 100x100px
  • Isaac gains a stationary knife that trails directly behind him. It synergizes like Mom's Knife would.
Mom's Bottle of Pills 102
Mom's Bottle of Pills
6 rooms
Reusable pill generator Gives 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 39
Mom's Bra
3 rooms
Mass Fear Upon use, petrifies all enemies in the current room for approximately 4 seconds.
Mom's Pad 41
Mom's Pad
3 rooms
Gross... Upon use, inflicts fear to all enemies in the room for 5 seconds.
Mom's Wig 217 Mom's Wig You feel itchy... Adds a chance to spawn blue spiders when firing tears. Restores 1 red heart.
Mom's Eye 55 Mom's Eye Eye in the back of your head Allows Isaac to fire tears from the back of his head.
Mom's Purse 139 Mom's Purse More trinket room Allows Isaac to hold 1 additional trinket.
Mom's Contacts 110 Mom's Contacts Freeze effect Adds a chance to shoot petrifying tears, which stop enemies in place and prevent them from moving or attacking. Range up.
Mom's Knife 114 Mom's Knife Stab stab stab Isaac'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 Heels 30 Mom's Heels Range up Increases range.
Mom's Eyeshadow 200 Mom's Eyeshadow Charm tears Tears have a chance to charm enemies.
Mom's Perfume 228 Mom's Perfume Fear shot Adds a chance to shoot fear tears and decreases tear delay by 1.
Mom's Key 199 Mom's Key Less is now more +2 keys Spawns 2 keys. Generates additional pickups from chests.
Mom's Lipstick 31 Mom's Lipstick Range up Increases range and shot height.
Mom's Underwear 29 Mom's Underwear Range up Increases range.
Mom's Coin Purse 195 Mom's Coin Purse What's all this...? Spawns 4 random pills around Isaac.
Added in Afterbirth Mom's Pearls 355 Mom's Pearls Range + luck up +1.25 Range Up. +0.5 Tear Height. +1 Luck Up.
Added in Afterbirth † Mom's Razor 508 Mom's Razor It's sharp! Spawns an orbiting razor that damages enemies it touches and inflicts bleeding on enemies, causing them to slowly take damage over time.
Super Bum 100x100px
1
Bum Friend 144 Bum Friend He's greedy A 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 278 Dark Bum He wants to take your life Spawns 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.
Added in Afterbirth 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.
1: Image depicts the familiar. This transformation does not alter Isaac's appearance.

NPCs[edit | edit source]

Monsters[edit | edit source]

Many new monsters were added in the expansion. Additionally, several new champion types were added.

Monster Description
Dart Fly
Dart Fly
Added in Afterbirth
Flies towards Isaac and attempts to mimic his movements. Deals contact damage.
Swarm Fly
Swarm Fly
Added in Afterbirth
Follows Isaac in large groups and deals contact damage.
Drowned Boom Fly
Drowned Boom Fly
Added in Afterbirth
Flies around the room diagonally, dealing touch damage. Upon death, explodes, fires four blood shots in the cardinal directions, and spawns a Drowned Charger.
Corn
Corn
Added in Afterbirth
Quickly dashes in random directions, dealing contact damage.
Dank Squirt
Dank Squirt
Added in Afterbirth
Dashes towards the player and deals contact damage. Spawns 2 Clots upon death.
Roundy
Roundy
Added in Afterbirth
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
Added in Afterbirth
Pops out of the ground in random locations and spits a blood shot at Isaac or spawns a Dart Fly if Isaac is in sight.
Drowned Hive
Drowned Hive
Added in Afterbirth
Walks around the room, avoiding Isaac while spawning Drowned Chargers. Spawns a Drowned Charger upon death.
Dukie
Dukie
Added in Afterbirth
Flies around the room diagonally, occasionally spitting out a Dart Fly.
Flaming Gaper
Flaming Gaper
Added in Afterbirth
Walks towards Isaac, dealing contact damage. Usually turns into a Pacer or a Gusher upon death.
Cyclopia
Cyclopia
Added in Afterbirth
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
Added in Afterbirth
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
Added in Afterbirth
Moves diagonally around the room, dealing contact damage. Needs to be killed to complete the room.
Flesh Death's Head
Flesh Death's Head
Added in Afterbirth
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
Added in Afterbirth
Slowly flies towards Isaac. Shoots when Isaac aligns diagonally with it and will actively try to avoid Isaac's shots.
Red Ghost
Red Ghost
Added in Afterbirth
Disappears, then reappears near Isaac and fires a brimstone laser.
Flaming Fatty
Flaming Fatty
Added in Afterbirth
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
Added in Afterbirth
Slowly walks towards Isaac. Occasionally spits a line of damaging green creep towards Isaac. Turns into a regular Fatty upon death.
Blue Conjoined Fatty
Blue Conjoined Fatty
Added in Afterbirth
Slowly walks towards Isaac and occasionally spits a homing Ipecac shot at Isaac.
Dank Globin
Dank Globin
Added in Afterbirth
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
Added in Afterbirth
Chases Isaac, dealing a full heart of contact damage and spawning spiders. Upon taking enough damage, it separates into a head and body. The head slides towards Isaac, leaving a trail of damaging red creep. The body wanders around aimlessly, occasionally spawning spiders.
Black Globin's Body
Black Globin's Body
Added in Afterbirth
Walks aimlessly around the room, occasionally spawning spiders.
Bone Knight
Bone Knight
Added in Afterbirth
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
Added in Afterbirth
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
Added in Afterbirth
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
Added in Afterbirth
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
Added in Afterbirth
Moves towards Isaac, dealing contact damage and firing short-range blood shots. Can burrow underground and reappear elsewhere.
Scarred Guts
Scarred Guts
Added in Afterbirth
Attaches itself to a wall or obstacle and rolls around it, leaving a trail of damaging red creep.
Scarred Double Vis
Scarred Double Vis
Added in Afterbirth
Charges and fires a Brimstone laser which fires from all four sides when Isaac gets in its line of sight.
Meatball
Meatball
Added in Afterbirth
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
Added in Afterbirth
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
Added in Afterbirth
Walks towards Isaac, dealing contact damage.
Blue Gaper
Blue Gaper
Added in Afterbirth
Walks towards Isaac, dealing contact damage. Has triple the health of a normal Gaper.
Blue Boil
Blue Boil
Added in Afterbirth
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
Added in Afterbirth
Gathers with other Hush Flies and flies towards Isaac in certain patterns. Can also orbit Hush.

Bosses[edit | edit source]

Several new bosses were added in the expansion. Additionally, many bosses received new champion variants.

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
21. XXXXXXXXL
Isaac App.png
HUD Red Heart.pngHUD Red Heart.pngHUD Red Heart.png
Item Pool Treasure Room.png: yes
Item Pool Shop.png: yes
Every floor is the size of an XL Womb floor, but does not combine the floors of each chapter.
Boss Mom's Heart.png / Boss It Lives.png Added in Afterbirth XXXXXXXXL Defeat Mom for the 1st time
XXXXXXXXLXXXXXXXXL
Gold Heart
22. SPEED!
Isaac App.png
HUD Red Heart.pngHUD Red Heart.pngHUD Red Heart.png
Item Pool Treasure Room.png: yes
Item Pool Shop.png: yes
Everything is sped up like the Broken Watch effect.
Boss Mom's Heart.png / Boss It Lives.png
within 16 minutes, otherwise under
constant periodic damage every 10 seconds.
Added in Afterbirth SPEED! Defeat Mom for the 1st time
SPEED!SPEED!
Get out of Jail Free Card
23. Blue Bomber
???
HUD Soul Heart.pngHUD Soul Heart.pngHUD Soul Heart.png
Blindfolded App.png Blindfolded
Starts with:
Brother Bobby Brother Bobby
Brother Bobby Icon.pngFollows Isaac around shooting normal tears.

Kamikaze! Kamikaze!
Kamikaze! Icon.pngUnlimitedCreates an explosion in the same area as Isaac, dealing half a heart of damage to him and also damaging all enemies caught in the blast radius.

Pyromaniac Pyromaniac
Pyromaniac Icon.pngIsaac heals 1 heart instead of taking damage from an explosive source. Adds 5 bombs.

Mr. Mega Mr. Mega
Mr. Mega Icon.pngGives Isaac 5 bombs, and makes all dropped bombs larger, which have an increased blast radius and increased damage.

Item Pool Treasure Room.png: no
Item Pool Shop.png: yes
Boss Satan.png Added in Afterbirth Blue Bomber Destroy 10 tinted rocks and defeat Mom's Heart 11 times
Blue BomberBlue Bomber
Gold Bomb
24. PAY TO PLAY
Isaac App.png
HUD Red Heart.pngHUD Red Heart.pngHUD Red Heart.png
Starts with:
Money = Power Money = Power
Money = Power Icon.pngIncreases damage by 0.04 for every coin Isaac has, up to +3.96 damage at 99 coins.

Sack of Pennies Sack of Pennies
Sack of Pennies Icon.pngIsaac is followed by a small bag that drops a coin every 2 rooms.

50 coins
Item Pool Treasure Room.png: no
Item Pool Shop.png: yes
Every door costs 1 cent to enter. Isaac drops money when hit. Isaac dies if you run out of money.
Isaac Added in Afterbirth PAY TO PLAY Defeat Isaac as Cain
PAY TO PLAYPAY TO PLAY
2 new pills
25. Have a Heart
Isaac App.png
Red HeartEmpty Red HeartEmpty Red HeartEmpty Red HeartEmpty Red HeartEmpty Red Heart
Empty Red HeartEmpty Red HeartEmpty Red HeartEmpty Red HeartEmpty Red HeartEmpty Red Heart
Starts with:
Charm of the Vampire Charm of the Vampire
Charm of the Vampire Icon.pngHeals the character for half of a red heart for every 13 monsters killed.

Item Pool Treasure Room.png: yes
Item Pool Shop.png: yes
Pennies drop instead of red hearts. Many items that restore red hearts have no effect.
Boss Mom's Heart.png / Boss It Lives.png Added in Afterbirth Have a Heart Defeat Mom for the 1st time
Have a HeartHave a Heart
2 new pills 2
26. I RULE!
Isaac App.png
HUD Red Heart.pngHUD Red Heart.pngHUD Red Heart.png
Starts with:
The Boomerang The Boomerang
The Boomerang Icon.png4 secondsThrows a short-range boomerang which does a bit of damage and has a high chance to stun the enemy for 2 seconds. Can also be used to grab pickups.

Key Piece 1 Key Piece 1
Key Piece 1 Icon.pngCombined with Key Piece 2, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.

Key Piece 2 Key Piece 2
Key Piece 2 Icon.pngCombined with Key Piece 1, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.

The Ladder The Ladder
The Ladder Icon.pngAllows Isaac to walk across gaps one square across by automatically placing a ladder between the two walkable sections.

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.

Trinity Shield Trinity Shield
Trinity Shield Icon.pngIsaac gains a shield that protects him from enemy shots.

Item Pool Treasure Room.png: no
Item Pool Shop.png: yes
Boss Mega Satan.png Added in Afterbirth I RULE! Defeat ??? or The Lamb for the 1st time, and defeat Satan as Isaac
I RULE!I RULE!
Poker Chip
27. BRAINS!
???
HUD Soul Heart.pngHUD Soul Heart.pngHUD Soul Heart.png
Blindfolded App.png Blindfolded
Starts with:
3 Bob's Brain Bob's Brain
Bob's Brain Icon.pngSpawns a familiar that charges forward when shooting tears, explodes upon contact with an enemy and poisons them. Respawns after few seconds.

Thunder Thighs Thunder Thighs
Thunder Thighs Icon.pngDestroys rocks upon contact with Isaac. Adds one heart container and lowers Speed.

Item Pool Treasure Room.png: no
Item Pool Shop.png: yes
??? Added in Afterbirth BRAINS! Defeat Isaac 5 times
BRAINS!BRAINS!
Stud Finder
28. PRIDE DAY!
Isaac App.png
HUD Red Heart.pngHUD Red Heart.pngHUD Red Heart.png
Starts with:
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.

Rainbow Baby Rainbow Baby
Rainbow Baby Icon.pngSpawns a familiar that follows Isaac around and fires tears with random effects.

Added in Afterbirth Rainbow Worm Rainbow Worm
Rainbow Worm Icon.pngIsaac's tears gain a worm effect that changes every 3 seconds.

Item Pool Treasure Room.png: no
Item Pool Shop.png: yes
Cannot drop or replace Rainbow Worm.
Boss Mom's Heart.png / Boss It Lives.png Added in Afterbirth PRIDE DAY! Defeat Mom for the 1st time
PRIDE DAY!PRIDE DAY!
D8
29. Onan's Streak
Judas App.png
HUD Red Heart.png
Starts with:
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.
Added in Afterbirth Increases the chance for a Devil or Angel Room to appear by 12.5%.

Chocolate Milk Chocolate Milk
Chocolate Milk Icon.pngGrants charged tears that deal greater damage when fully charged.

Item Pool Treasure Room.png: yes
Item Pool Shop.png: yes
Missing a shot deals damage to Judas.
Isaac Added in Afterbirth Onan's Streak Defeat Mom for the 1st time
Onan's StreakOnan's Streak
Kidney Stone
30. The Guardian
Isaac App.png
HUD Red Heart.pngHUD Red Heart.pngHUD Red Heart.png
Blindfolded App.png Blindfolded
Starts with:
Holy Grail Holy Grail
Holy Grail Icon.pngGrants flight and one heart container.

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.

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.

Spear of Destiny Spear of Destiny
Spear of Destiny Icon.pngIn addition to tears, Isaac now holds a spear in front of him which deals damage equal to 2 times his tear damage, and occasionally inflicts fear. The spear cannot be thrown, but deals damage while it is in contact with an enemy.

Item Pool Treasure Room.png: no
Item Pool Shop.png: yes
Isaac's Heart will follow the Punching Bag instead of Isaac.
Boss Mom's Heart.png / Boss It Lives.png Added in Afterbirth The Guardian Defeat Mom for the 1st time
The GuardianThe Guardian
Blank Rune

Changes[edit | edit source]

Items[edit | edit source]

Activated Collectibles[edit | edit source]

Book of Revelations

Increases chance for a Devil/Angel Room Door to open by 17.5%.

Passive Collectibles[edit | edit source]

20/20
3 Dollar Bill
  • 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 shoots tears towards Isaac regardless of which direction Isaac is shooting.
Ball of Bandages
  • Ball of Bandages blocks enemy shots.
Bob's Brain
  • Bob's Brain is fired directly from where it is located in the chain of familiars behind Isaac, making aiming it slightly more difficult.
Bomb Bag
Box
  • Can drop a Gold Bomb.

Interactions[edit | edit source]


Pickups[edit | edit source]

Bombs[edit | edit source]

Troll Bombs
  • 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.

NPCs[edit | edit source]

Monsters[edit | edit source]

Bony
  • They only leave 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.
  • Hush is always fought in a 2x2 room and Ultra Greed is fought in a double-sized one (2x1).
Arcade
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.
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]

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
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