The Binding of Isaac: Afterbirth †

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Issues: Incomplete list of fixed bugs and new bugs.

Afterbirth † is an expansion to The Binding of Isaac: Rebirth that was released on January 3rd, 2017 and costs $9.99.

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

Nicalis, the game's publisher, also created mod tools for easier creation of community mods with the release. They will occasionally release monthly or bi-monthly updates to Afterbirth † that incorporate certain high-quality and popular mods. These updates are known as Booster Packs.

Features[edit | edit source]

Additions[edit | edit source]

Mechanics[edit | edit source]

HUD[edit | edit source]

Found HUD
  • Found HUD is a HUD addition that gives numerical values to the player's current stats (e.g., damage, luck, speed, devil room chance). It can be enabled through the options menu.
  • It is based off of the Missing HUD mod for Rebirth and Afterbirth.

Victory Lap[edit | edit source]

  • A Victory Lap allows you to start a new run with almost all of your final items after completing the Dark Room. Multiple laps can be made as long as the Dark Room is cleared each time.
    • Completion Marks and most Achievements cannot be earned.
    • Isaac will take a full heart of damage on all floors after beginning a victory lap (unless he has The Wafer).
    • Some Items are lost upon starting a victory lap. Items lost this way are added back into their respective item pools and can be acquired again.
    • If the initial run was on normal difficulty, all victory laps will be on hard difficulty.
    • On the third and subsequent victory laps, the character will turn into The Lost. This version of The Lost does not get a Holy Mantle or D4. However, if the run was started as The Lost (or if the Holy Mantle was found) it is possible to keep the Holy Mantle from the previous run.
    • On the third and subsequent victory laps, Shops will no longer appear.
    • On the third and subsequent victory laps, Red Chests in the Dark Room will turn into Brown Chests and Golden Chests.
    • Killing any final boss aside from The Lamb will end the game, and the run will not be continued further.

Menus[edit | edit source]

Options[edit | edit source]

Charge bars
RERUN
  • RERUN is unlocked after completing the RERUN achievement.
  • After winning a run the Continue option in the main menu will be replaced by Rerun. Selecting it starts a new run using most of the previous won run's items. Isaac will take full heart damage on all floors.

Player[edit | edit source]

Characters[edit | edit source]

Character Apollyon App.png
Apollyon
Health Stat Icon.png Health HUD Red Heart.pngHUD Red Heart.png
Damage Stat Icon.png Damage 3.5 (*1.00)
Tears Stat Icon.png Tears +0
Shot Speed Stat Icon.png Shot Speed 1
Range Stat Icon.png Range 23.75
Speed Stat Icon.png Speed 1.0
Luck Stat Icon.png Luck 0
Starting Item Icon.png Starting Pickups None
Starting Item Icon.png Starting Item(s) Void

Transformations[edit | edit source]

Transformation Appearance Transformation effect Item Icon Item effect Recharge
Bookworm Bookworm Transformation.png
  • Roughly 50% of the time, Isaac shoots an extra tear, like 20/20.
Anarchist Cookbook Anarchist Cookbook Icon.png Spawns six troll bombs around the room. 3
Book of Revelations Book of Revelations Icon.png Adds 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). 6
Book of Secrets Book of Secrets Icon.png Upon use, gives the effect of Treasure Map, The Compass, or Blue Map for the duration of the current floor. 6
Book of Shadows Book of Shadows Icon.png Upon use, creates a protective shield nullifying all types of damage for 10 seconds. 3
How to Jump How to Jump Icon.png Gives Isaac the ability to jump (over gaps, spikes, etc.). 0
Monster Manual Monster Manual Icon.png Summons a random familiar for the current room. Can summon familiars not yet unlocked. 3
Satanic Bible Satanic Bible Icon.png Upon activation, Isaac gains a black heart. 6
Telepathy for Dummies Telepathy for Dummies Icon.png Upon activation, grants homing tears for the current room. 2
The Bible The Bible Icon.png 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. 6
The Book of Belial The Book of Belial Icon.png Upon use increases damage by 2 for the current room and by a further +50% if the character also has the Blood of the Martyr.
NoDLC Indicator.png Guarantees a Devil Room or Angel Room will be open after beating a boss while holding it.
DLC Indicator.png Increases the chance for a Devil or Angel Room to appear by 12.5%.
3
The Book of Sin The Book of Sin Icon.png Spawns a random pickup, pill, card, or trinket. 4
The Necronomicon The Necronomicon Icon.png Damages all enemies in the room significantly. 6
Spider Baby Spider Baby Transformation.png
  • Spawns a spider familiar that applies random status effects to enemies it comes in contact with.
Box of Spiders Box of Spiders Icon.png Summons 2-4 blue spiders. 2
Mutant Spider Mutant Spider Icon.png Grants quadruple shot but decreases tears.
Spider Baby Spider Baby Icon.png When hit, spawns up to 2 blue spiders.
Spider Bite Spider Bite Icon.png Adds a chance to shoot slowing tears, reducing speed of enemy movement and any projectile fired by them.
Spider Butt Spider Butt Icon.png Damages all enemies in the room and slows them and their projectiles down. 2
Spider Mod Spider Mod Icon.png 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.
Adult Adult Transformation.png
  • Grants a heart container.
  • Lowers the pitch of Isaac's voice.
3 Puberty pills
Stompy None
  • Taking damage has a chance to spawn rock waves.
Leo Leo Icon.png Allows you to crush rocks when you walk over them.
Magic Mushroom Magic Mushroom Icon.png Increases all stats and enlargens Isaac.
One Makes You Larger pills

Items[edit | edit source]

68 new items were added in the expansion: 19 activated items and 49 passive items.

Activated Collectibles[edit | edit source]

Name ID Icon Quote Description Recharge
Black Hole 512 Black Hole Icon.png Nothing can escape Throws a black hole on the ground which sucks in and damages enemies. 4
Brown Nugget 504 Brown Nugget Icon.png Friendly fly Spawns a stationary fly familiar that fires tears at nearby enemies. 7 seconds
Clicker 482 Clicker Icon.png Change Transforms Isaac into another random character. 6
Compost 480 Compost Icon.png Gain more friends! Spawns a blue spider or fly. Turns pickups in the room into blue spiders or flies. 2
Coupon 521 Coupon Icon.png Allow 6 weeks for delivery Upon use, makes a random item from a shop, devil deal, or black market free. 6
Crooked Penny 485 Crooked Penny Icon.png 50/50 Spawns a penny and has a 50% chance to double all items and pickups in the room. If the effect fails, the items and pickups disappear. 4
D1 476 D1 Icon.png What will it be? Duplicates a random pickup in the room. 4
D Infinity 489 D Infinity Icon.png Reroll forever Grants a random dice item that changes each use. 2
Dataminer 481 Dataminer Icon.png 109 Displaces enemy sprites for the current room and increases or decreases a random stat. 4
Delirious 510 Delirious Icon.png Unleash the power! Spawns a random charmed boss. 12
Dull Razor 486 Dull Razor Icon.png I feel numb... Hurts Isaac without depleting health, activating any items that trigger upon taking damage. 2
Eden's Soul 490 Eden's Soul Icon.png ... Spawns two item pedestals. 12, one time use
Mama Mega! 483 Mama Mega! Icon.png BOOOOOOOOOM! Damages all enemies and destroys all obstacles. The effect occurs every time a new room is entered for the rest of the floor. Opens doors to the floor's secret and super secret rooms. One time use
Metronome 488 Metronome Icon.png Waggles a finger Grants a random item effect for the current room. 2
Moving Box 523 Moving Box Icon.png Pack and unpack If the box is empty, picks up all items and pickups in a room and stores them. If the box is not empty, places all stored items and pickups in the current room. 4
Mr. ME! 527 Mr. ME! Icon.png Caaan Do! Summons a controllable ghost that can perform various tasks depending on what it targets. 4
Mystery Gift 515 Mystery Gift Icon.png Wrapped up nice for you! Upon use, spawns a random item from the current room's item pool, with a chance to spawn A Lump of Coal or The Poop instead. One time use
Plan C 475 Plan C Icon.png Use with caution Kills all enemies in the room, then kills Isaac three seconds later. One time use
Potato Peeler 487 Potato Peeler Icon.png A pound of flesh Removes a heart container, increases damage and range, and grants a Cube of Meat. 0
Pause 478 Pause Icon.png Stop! Freezes all enemies until a fire button is pressed. 2
Sharp Straw 507 Sharp Straw Icon.png More blood! Damages all enemies in the room. 8 seconds
Smelter 479 Smelter Icon.png Trinket melter! Consumes Isaac's currently held trinket and applies its effect permanently. 6
Sprinkler 516 Sprinkler Icon.png Sprinkles. Upon use, spawns a sprinkler that rotates and fires tears. 4
Telekinesis 522 Telekinesis Icon.png The power of mind! Upon use, for the next two seconds, any enemy shots that come near Isaac are held in place. After the charge is depleted, they are fired back as tears. 3 seconds
Void 477 Void Icon.png Consume Consumes all pedestal items in the room. Active items will have their effects added to Void, and passive items will grant stat upgrades. 6
Wait What? 484 Wait What Icon.png I can't believe it's not Butter Bean! Isaac farts, sending out rock waves. 10 seconds

Passive Collectibles[edit | edit source]

Name ID Icon Quote Description
7 Seals 526 7 Seals Icon.png Lil Harbingers! Grants a random Harbinger familiar that changes every 10 seconds.
Acid Baby 491 Acid Baby Icon.png Pills pills pills! Spawns a familiar that drops random pills every 2 rooms cleared. Upon using a pill, all enemies in the room are poisoned.
Adrenaline 493 Adrenaline Icon.png Panic - power Increases damage based on how many empty heart containers Isaac has.
Analog Stick 465 Analog Stick Icon.png 360 tears! Tears up. Allows Isaac to fire tears diagonally.
Angelic Prism 528 Angelic Prism Icon.png Eclipsed by the moon Grants a prism orbital with a large orbital radius. Tears that pass through the prism split into four multi-colored tears.
Angry Fly 511 Angry Fly Icon.png He's violent Spawns a fly familiar that orbits around a random enemy and deals 2 damage per tick to enemies it comes in contact with.
Apple! 443 Apple! Icon.png Trick or treat? Increases tears. Adds a chance to fire a high-damage razor blade.
Backstabber 506 Backstabber Icon.png Watch your back! Has a chance to fire tears that inflict bleeding on enemies, causing them to slowly take damage over time.
Belly Button 458 Belly Button Icon.png What's in there? Drops a random trinket. Grants an extra trinket slot.
Big Chubby 473 Big Chubby Icon.png Chub chub Spawns a familiar that slowly charges forward and damages enemies in its path.
Bloodshot Eye 509 Bloodshot Eye Icon.png Bloody friend Spawns an orbiting eye familiar that fires tears every 2 seconds.
Bozo 513 Bozo Icon.png Party time! Increases damage by a flat 0.1 and grants a soul heart. Enemies can randomly become briefly charmed or feared. Taking damage has a chance to spawn a rainbow poop.
Broken Modem 514 Broken Modem Icon.png LAG! Enemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals.
Buddy in a Box 518 Buddy in a Box Icon.png What could it be?! Grants a familiar with a random tear effect. The familiar is randomized at the start of each floor.
Camo Undies 497 Camo Undies Icon.png Camo kid Isaac becomes camouflaged at the beginning of each room. Enemies will not attack Isaac until he starts firing tears.
Compound Fracture 453 Compound Fracture Icon.png Bone tears! Increases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.
Cone Head 457 Cone Head Icon.png Hard headed! Grants a soul heart. Adds a chance to block enemy shots.
Contagion 466 Contagion Icon.png Outbreak! The first enemy killed in a room explodes and poisons nearby enemies. Poisoned enemies will also explode upon death.
Dad's Lost Coin 455 Dad's Lost Coin Icon.png I remember this... Increases range by 1.5. Drops a lucky penny. Other Effects Unknown
Dark Prince's Crown 442 Dark Prince's Crown Icon.png Loss is power Increases range, tears, and shot speed when at exactly one red heart.
Dead Tooth 446 Dead Tooth Icon.png Halitosis While firing, Isaac gains a green aura that poisons nearby enemies.
Depression 469 Depression Icon.png :( Spawns a cloud familiar that leaves a trail of tears that damages enemies. Has a chance to spawn damaging beams of light onto enemies that touch the cloud.
Dog Tooth 445 Dog Tooth Icon.png Bark at the moon! Increases damage and speed. Upon entering a room adjacent to a secret room, a howl sound effect will play.
Duality 498 Duality Icon.png You feel very balanced Whenever a Devil or Angel Room would spawn after defeating a boss, both rooms spawn. Only one can be entered.
Eucharist 499 Eucharist Icon.png Peace be with you An Angel Room door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.
Euthanasia 496 Euthanasia Icon.png Needle shot Adds a chance to fire needles. If a needle kills an enemy, it bursts into more needles.
Eye of Belial 462 Eye of Belial Icon.png Possessed tears! Grants piercing tears. After piercing one enemy, tears start homing and deal double damage.
Eye of Greed 450 Eye of Greed Icon.png Gold tears! Adds a chance to fire tears that temporarily stun enemies and turn them into gold. Any enemy killed while in this state will drop coins.
Fast Bombs 517 Fast Bombs Icon.png Faster bomb drops! Grants 7 bombs and allows bombs to be placed rapidly.
Finger! 467 Finger! Icon.png Watch where you point that! Spawns a finger familiar that points at enemies, dealing constant damage.
Ghost Pepper 495 Ghost Pepper Icon.png Flame tears Adds a chance to shoot a fire that damages enemies and remains in place until it deals enough damage or the room is left.
Glaucoma 460 Glaucoma Icon.png Blind tears! Adds a chance to shoot concussive tears, causing enemies to walk around randomly.
Glyph of Balance 464 Glyph of Balance Icon.png A gift from above Grants 2 soul hearts and modifies drops from Champion Monsters based on certain conditions.
Greed's Gullet 501 Greed's Gullet Icon.png Money = Health! Grants a heart container for every 25 coins Isaac has.
Hushy 470 Hushy Icon.png Lil hush! Spawns a Hush familiar that bounces around the room and deals contact damage. While firing tears, it stops moving.
Jacob's Ladder 494 Jacob's Ladder Icon.png Electric tears Tears fire sparks of electricity in random directions upon hitting an obstacle or enemy.
Jumper Cables 520 Jumper Cables Icon.png Bloody Recharge! Grants an active item charge every 15 enemies killed.
King Baby 472 King Baby Icon.png Lord of the dead! Spawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, it stops moving.
Large Zit 502 Large Zit Icon.png Creep shots Adds a chance to fire a creep shot that deals double damage and leaves a trail of slowing white creep.
Lead Pencil 444 Lead Pencil Icon.png He's a bleeder! After every 15 tears fired, Isaac will fire a high-damage cluster of tears.
Leprosy 525 Leprosy Icon.png You're tearing me apart! Upon taking damage, grants a body part as an orbital, which blocks enemy shots and deals 7 damage per tick to enemies it comes in contact with. The orbitals will be destroyed if they take enough damage from enemies or enemy shots.
Lil Delirium 519 Lil Delirium Icon.png He's delirious Grants a familiar that transforms into another random familiar every 10 seconds.
Lil Monstro 471 Lil Monstro Icon.png Ain't he cute? Spawns a familiar that fires clusters of tears. Must be charged before shooting.
Linger Bean 447 Linger Bean Icon.png Crying makes me toot Adds a chance to fire a gas cloud that damages nearby enemies.
Little Horn 503 Little Horn (Item) Icon.png Science! Adds a chance to fire a piercing tear that instantly kills any enemy that it touches.
Metal Plate 449 Metal Plate Icon.png It itches... Adds a chance to reflect enemy shots. Grants one soul heart.
Moldy Bread 456 Moldy Bread Icon.png Midnight snack! Grants a heart container.
Mom's Razor 508 Mom's Razor Icon.png 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.
Parasitoid 461 Parasitoid Icon.png Egg tears! Adds a chance to fire an egg sack which spawns slowing creep and spawns a blue fly or spider upon hitting an enemy.
Poke Go 505 Poke Go Icon.png Gotta catch em... Upon entering a room with enemies in it, has a chance to spawn a random charmed enemy that persists across rooms.
Polydactyly 454 Polydactyly Icon.png Hold me! Allows Isaac to carry two cards, pills, or any combination of both at the same time. Drops a random card or pill.
Pop! 529 Pop! Icon.png Eyeball tears! Replaces Isaac's tears with eyeballs that can bounce off of each other. The eyeballs are not limited by range, and will instead dissipate when they stop moving or when hitting an enemy or obstacle.
Sack of Sacks 500 Sack of Sacks Icon.png Gives Sacks! Spawns a sack familiar that has a chance to drop a sack upon clearing a room.
Shade 468 Shade Icon.png It follows Spawns a shadow familiar that follows Isaac's movements on a 1 second delay and deals contact damage to enemies.
Shard of Glass 448 Shard of Glass Icon.png Blood and guts! Upon taking damage, Isaac has a chance to drop a full red heart, gain 5 range, and leave a trail of damaging red creep for the current room.
Sinus Infection 459 Sinus Infection Icon.png Booger tears! Adds a chance to fire a booger which sticks to enemies and poisons them.
Sulfuric Acid 463 Sulfuric Acid Icon.png Acid tears! Increases damage. Adds a chance to fire acidic tears which can destroy obstacles.
Tarot Cloth 451 Tarot Cloth Icon.png I see the future Drops a random card or rune. Doubles the effects of cards and runes.
Technology Zero 524 Technology Zero Icon.png Static tears! Connects Isaac's tears with electricity that can damage enemies.
Varicose Veins 452 Varicose Veins Icon.png I'm leaking... Taking damage releases a ring of 10 high damage tears.
YO LISTEN! 492 YO LISTEN! Icon.png Yo listen! Increases luck. Spawns a fairy familiar that points out secret room entrances and tinted rocks.

Trinkets[edit | edit source]

29 new trinkets were added in the expansion.

Name ID Icon Quote Description
Bag Lunch 105 Bag Lunch Icon.png I wonder what it is Taking damage has a small chance to destroy the trinket and spawn Lunch.
Bat Wing 118 Bat Wing Icon.png They are growing... Upon killing an enemy, has a chance to grant flight for the rest of the room.
Black Tooth 95 Black Tooth Icon.png It looks dead Adds a chance to fire a black tooth that poisons enemies.
Bloody Crown 111 Bloody Crown Icon.png Drops with blood... Treasure Rooms appear in Chapter 4.
Butter! 122 Butter! Icon.png Can't hold it! Using an active item will drop it onto a pedestal on the ground.
Crow Heart 107 Crow Heart Icon.png Drain me Red heart damage will be taken before soul and black heart damage.
Cracked Crown 92 Cracked Crown Icon.png Boost stats Grants extra stat upgrades based on Isaac's passive items that increase stats. Also grants tears up and -1 tear delay.
Dim Bulb 101 Dim Bulb Icon.png I think it's broken Provides a boost to all stats when Isaac's active item is completely uncharged.
Door Stop 124 Door Stop Icon.png Hold the door! The last door Isaac went through stays open, allowing him to leave the room even if enemies are in it.
Duct Tape 109 Duct Tape Icon.png Stuck! Stops Isaac's familiars from moving.
Equality! 103 Equality! Icon.png = Turns pickups into their doubled versions while Isaac's numbers of coins, bombs and keys are equal.
Filigree Feather 123 Filigree Feather Icon.png Angelic Spoils! Angels drop items instead of key pieces when defeated.
Fish Tail 94 Fish Tail Icon.png It also stinks! Items and trinkets that generate blue flies or blue spiders will generate twice as many.
Fragmented Card 102 Fragmented Card Icon.png Double moon Makes two Secret Rooms spawn on each floor.
Hairpin 120 Hairpin Icon.png Poke that power outlet! Bosses charge you Fully recharges Isaac's active item upon entering a boss fight.
Locust of Conquest 117 Locust of Conquest Icon.png I bring conquest Upon entering a room with enemies, spawns 2-5 White Locusts which damage enemies.
Locust of Death 116 Locust of Death Icon.png I bring death Upon entering a room with enemies, spawns a Black Locust that does a very high amount of damage.
Locust of Famine 115 Locust of Famine Icon.png I bring famine Upon entering a room with enemies, spawns a Yellow Locust that damages and slows enemies.
Locust of Pestilence 114 Locust of Pestilence Icon.png I bring pestilence Upon entering a room with enemies, spawns a Green Locust which damages and poisons enemies.
Locust of War 113 Locust of War Icon.png I bring war Upon entering a room with enemies, spawns a Red Locust which detonates upon impact with enemies.
Lost Cork 106 Lost Cork Icon.png Uncorked Increases the radius of any creep produced by Isaac.
Meconium 91 Meconium Icon.png Eww Poop has a chance to turn into black poop.
Nose Goblin 98 Nose Goblin Icon.png Seems magic... Chance to fire a booger that sticks to enemies and deals damage over time.
Ouroboros Worm 96 Ouroboros Worm Icon.png Foop foop! Tears travel in a large spiral pattern and become spectral.
Pay to Win 112 Pay to Win Icon.png ... Restock boxes always spawn in Item Rooms.
Silver Dollar 110 Silver Dollar Icon.png Feels lucky... Shops appear in Chapter 4.
Stem Cell 119 Stem Cell Icon.png Regen! Heals for half a heart upon traveling to the next floor.
Super Ball 99 Super Ball Icon.png Boing! Makes tears have a chance to bounce off enemies and obstacles.
Tonsil 97 Tonsil Icon.png Sick... When hit, there is a small chance a removed tonsil familiar starts following Isaac, blocking enemy shots.
Used Diaper 93 Used Diaper Icon.png You stink Grants the Skatole effect in some rooms.
Vibrant Bulb 100 Vibrant Bulb Icon.png It needs power Provides a boost to all stats when Isaac's active item is fully charged.
Walnut 108 Walnut Icon.png That's a hard nut to crack! Taking damage has a small chance to destroy the trinket and spawn various pickups.
Wish Bone 104 Wish Bone Icon.png Make a wish Taking damage has a small chance to destroy the trinket and spawn a random item.
Wooden Cross 121 Wooden Cross Icon.png My faith protects me Grants a Holy Mantle shield upon entering a new floor, which protects against one hit of damage.

Pickups[edit | edit source]

Pickups & Chests[edit | edit source]

Name Icon Effects
Scared Hearts Red heart.png Identical to the standard Red Heart, but will run away as the player moves towards it.
Half Soul Hearts Half soul heart.png Half soul hearts are a variant of normal soul hearts that only add half a heart to the end of the normal bar. They are unlocked after getting the "Mr. Resetter!" achievement, which is granted after the player resets seven runs in quick succession.
Blended Hearts Red soul heart.png A heart variant which will fill up a full red Heart Container, but will act as a Soul Heart when no Containers are free.
Charged Keys Key.png Charged Keys grant a key and fully charge your currently held active item upon pickup. Can be differentiated from regular keys by having a pulsating white glow while on the ground. Unlocked after beating Challenge #33: Pokey Mans.
Mimics Mimic Chest.png Mimics appear similar to Brown Chests until Isaac moves near, at which point they sprout spikes that damage the player as a Spike Chest would. They can be distinguished from Brown Chests by their darker, purplish-brown coloring, a spot of blood on the lower-right corner, and the grayish spot on each side of the latch where the spikes will sprout from.

Pills[edit | edit source]

Pill Effect
Needs to be unlocked Feels like I'm walking on sunshine!

Temporarily makes Isaac invincible, similar to Unicorn Stump.
Unlocked by acquiring the Sin Collector achievement.

Needs to be unlocked Gulp!

Upon use, any trinkets that the player is holding are destroyed, and their effects are permanently applied to the player.
Unlocked by acquiring the Once More With Feeling! achievement.

Needs to be unlocked Horf!

Upon use, Isaac shoots an explosive tear with the Ipecac effect.
Unlocked by acquiring the Dedication achievement.

I'm Drowsy...

Upon use, slows all enemies for the duration of the room.

I'm Excited!!!

Upon use, increases the speed of all enemies for the duration of the room. The effect triggers again 30 seconds after use and 60 seconds after use.

Something's wrong...

Creates a pool of black creep beneath Isaac.

Needs to be unlocked Vurp!

Throws up the last pill you used.
Unlocked by acquiring the U Broke It! achievement. Will spawn itself if no other pills were taken beforehand.

X-Lax

Creates a pool of slippery brown creep underneath Isaac.

Cards & Runes[edit | edit source]

Name ID Icon Message Effect
Ace of Clubs 27 Ace of Clubs Icon.png Convert all Turns all pickups and chests in the room into bombs.
Ace of Diamonds 28 Ace of Diamonds Icon.png Convert all Turns all pickups and chests in the room into coins.
Ace of Hearts 30 Ace of Hearts Icon.png Convert all Turns all pickups and chests in the room into random heart pickups.
Ace of Spades 29 Ace of Spades (Card) Icon.png Convert all Turns all pickups and chests in the room into keys.
Ancient Recall 53 Ancient Recall Icon.png Draw 3 cards Spawns 3 random cards.
Era Walk 54 Era Walk Icon.png Savor the moment For the current room, enemies are slowed, Isaac's speed is increased, and his shot speed is decreased.
Holy Card 51 Holy Card Icon.png You feel protected Grants the Holy Mantle effect for the current room.
Huge Growth 52 Huge Growth Icon.png Become immense! Makes Isaac large for the current room, increasing his range and damage.
Rune ID Icon Unlock method Message Effect
Black Rune 41 Black Rune Icon.png Black Rune Defeat Ultra Greedier as Apollyon Void Deals 40 damage to all enemies in the room. Consumes all pickups in the room and turns them into blue flies and spiders. Consumes all pedestal items in the room and turns them into random stat upgrades.

NPCs[edit | edit source]

Monsters[edit | edit source]

Monster Description
Blister
Blister
Slowly hops towards Isaac, occasionally spawning black smoke balls. Spawns a Sack upon death.
Mushroom
Mushroom
Stationary enemy that occasionally pops up and fires four shots in the cardinal or diagonal directions. Takes less damage while its head is down.
Ministro
Ministro
Hops towards Isaac, occasionally spitting out a cluster of disorganized shots.
Nerve Ending 2
Nerve Ending 2
Static enemy which whips at Isaac if he gets too close.
Poison Mind
Poison Mind
Slowly crawls around the room diagonally, leaving a trail of green creep.
Portal
Portal
Continually spawns enemies from the current floor until it is killed.
Stoney
Stoney
Chases Isaac and blocks tears, but does not deal contact damage. Invulnerable; dies when the room is cleared.
The Thing
The Thing
Crawls along a wall and attempts to line up with Isaac, then spits a line of damaging red creep.

Bosses[edit | edit source]

Four new bosses were added to Afterbirth †. Additionally, Ultra Greed received a second form in Greed Mode's hard mode.

Boss Rag Mega.png
Boss Big Horn.png
Boss Sisters Vis.png
Boss Delirium.png
Boss Ultra Greedier.png
Rag Mega Big Horn Sisters Vis Delirium Ultra Greedier

Environment[edit | edit source]

Chapters[edit | edit source]

The Void.png
The Void

Obstacles[edit | edit source]

Super Special Rocks.png Super special rocks
  • Super special rocks are tinted rock variants which are much harder to spot, as they have a smaller mark and are not discolored. Super special rocks takes two bombs to blow up, and drop the contents of two tinted rocks.

Machines[edit | edit source]

Dressing Table.png Mom's Dressing Table

Challenges[edit | edit source]

Name Conditions Goal Unlocked by Unlocks
31. Backasswards
Isaac App.png
HUD Red Heart.pngHUD Red Heart.pngHUD Red Heart.png
Starts with:
8-10 random items
Item Pool Treasure Room.png: no
Item Pool Shop.png: yes
All Chapters progress in reverse order, losing 1 item and 1 red heart container each floor you ascend.
The Basement/The Cellar/Burning Basement I Backasswards Defeat ??? or The Lamb for the 1st time Laz Bleeds More! Laz Bleeds More!
32. Aprils Fool
Isaac App.png
HUD Red Heart.pngHUD Red Heart.pngHUD Red Heart.png
Item Pool Treasure Room.png: yes
Item Pool Shop.png: yes
The minimap displays the floor's layout accurately, but displays Isaac's position inaccurately.

Pedestal items and pickups are not what they appear to be. Active item, pill, card, and rune effects are randomized upon each use, making them very unreliable or deadly (for example Suicide King). Items with no charge time (i.e. How To Jump, IV Bag, etc) can be used repeatedly for random effects. Trinkets function normally. Every boss is The Bloat. Isaac's health is not what it appears to be. Key and bomb numbers are accurate.

Boss Mom's Heart.png / Boss It Lives.png Aprils fool Defeat Mom for the 1st time Maggy Now Holds a Pill! Maggy Now Holds a Pill!
33. Pokey Mans
Isaac App.png
HUD Red Heart.pngHUD Red Heart.pngHUD Red Heart.png
Starts with:
Friendly Ball Friendly Ball
Mom's Eyeshadow Mom's Eyeshadow
Item Pool Treasure Room.png: no
Item Pool Shop.png: yes
Each use of Friendly Ball causes a random monster to be spawned. Friendly Ball instantly charges once the spawned monster is killed.
Isaac Pokey Mans Defeat Mom's Heart 11 times Charged Key Charged Key
34. Ultra Hard
Isaac App.png
HUD Red Heart.pngHUD Red Heart.pngHUD Red Heart.png
Starts with:
Key Piece 1 Key Piece 1
Key Piece 2 Key Piece 2
Curse of the Labyrinth
Curse of the Blind
Curse of the Lost
Curse of the Maze
Item Pool Treasure Room.png: yes
Item Pool Shop.png: yes
All enemies spawn as champions if possible. Boss fights will be double trouble if possible. No heart pickups drop.
Boss Mega Satan.png Ultra Hard Defeat ??? or The Lamb for the first time Samson Feels Healthy! Samson Feels Healthy!
35. Pong
Isaac App.png
HUD Red Heart.pngHUD Red Heart.pngHUD Red Heart.png
Starts with:
Cupid's Arrow Cupid's Arrow
Rubber Cement Rubber Cement
Item Pool Treasure Room.png: no
Item Pool Shop.png: yes
Damage fixed at 100, tear delay fixed at 150.
??? PONG Defeat Isaac 5 times Greed's Gullet Greed's Gullet

Achievements[edit | edit source]

Name Image Description Unlock In Game Secret Number
Backasswards
Backasswards
Unlocked a new challenge. Defeat ??? or The Lamb for the 1st time 277
Aprils fool
Aprils fool
Unlocked a new challenge. Defeat Mom for the 1st time 278
Pokey Mans
Pokey Mans
Unlocked a new challenge. Defeat Mom's Heart 11 times 279
Ultra Hard
Ultra Hard
Unlocked a new challenge. Defeat ??? or The Lamb for the first time 280
PONG
PONG
Unlocked a new challenge. Defeat Isaac 5 times 281
D Infinity
D Infinity
Unlocked a new item. Defeat Delirium as Isaac 282
Eucharist
Eucharist
Unlocked a new item. Defeat Delirium as Magdalene 283
Silver Dollar
Silver Dollar
Unlocked a new item. Defeat Delirium as Cain 284
Shade
Shade
Unlocked a new item. Defeat Delirium as Judas 285
King Baby
King Baby
Unlocked a new item. Defeat Delirium as ??? 286
Bloody Crown
Bloody Crown
Unlocked a new item. Defeat Delirium as Samson 287
Dull Razor
Dull Razor
Unlocked a new item. Defeat Delirium as Eve 288
Eden's Soul
Eden's Soul
Unlocked a new item. Defeat Delirium as Eden 289
Dark Prince's Crown
Dark Prince's Crown
Unlocked a new item. Defeat Delirium as Azazel 290
Compound Fracture
Compound Fracture
Unlocked a new item. Defeat Delirium as Lazarus 291
Euthanasia
Euthanasia
Unlocked a new item. Defeat Delirium as Lilith 292
Holy Card
Holy Card
Unlocked a new item. Defeat Delirium as The Lost 293
Crooked Penny
Crooked Penny
Unlocked a new item. Defeat Delirium as Keeper 294
Void
Void
Unlocked a new item. Defeat Delirium as Apollyon 295
D1
D1
Unlocked a new item. Defeat Ultra Greedier as Isaac 296
Glyph of Balance
Glyph of Balance
Unlocked a new item. Defeat Ultra Greedier as Magdalene 297
Sack of Sacks
Sack of Sacks
Unlocked a new item. Defeat Ultra Greedier as Cain 298
Eye of Belial
Eye of Belial
Unlocked a new item. Defeat Ultra Greedier as Judas 299
Meconium
Meconium
Unlocked a new item. Defeat Ultra Greedier as ??? 300
Stem Cell
Stem Cell
Unlocked a new item. Defeat Ultra Greedier as Samson 301
Crow Heart
Crow Heart
Unlocked a new item. Defeat Ultra Greedier as Eve 302
Metronome
Metronome
Unlocked a new item. Defeat Ultra Greedier as Eden 303
Bat Wing
Bat Wing
Unlocked a new item. Defeat Ultra Greedier as Azazel 304
Plan C
Plan C
Unlocked a new item. Defeat Ultra Greedier as Lazarus 305
Duality
Duality
Unlocked a new item. Defeat Ultra Greedier as Lilith 306
Dad's Lost Coin
Dad's Lost Coin
Unlocked a new item. Defeat Ultra Greedier as The Lost 307
Eye of Greed
Eye of Greed
Unlocked a new item. Defeat Ultra Greedier as Keeper 308
Black Rune
Black Rune
Unlocked a new item. Defeat Ultra Greedier as Apollyon 309
Locust of Pestilence
Locust of Pestilence
Unlocked a new item. Defeat Satan as Apollyon 311
Locust of Famine
Locust of Famine
Unlocked a new item. Defeat ??? as Apollyon 312
Locust of Death
Locust of Death
Unlocked a new item. Defeat The Lamb as Apollyon 313
Locust of Conquest
Locust of Conquest
Unlocked a new item. Complete the Boss Rush as Apollyon 314
Hushy
Hushy
Unlocked a new item. Defeat Hush as Apollyon 315
Brown Nugget
Brown Nugget
Unlocked a new item. Defeat Ultra Greed as Apollyon 316
Mort Baby
Mort Baby
Unlocked a new co-player baby. Defeat Mega Satan as Apollyon 317
Smelter
Smelter
Unlocked a new item. Defeat Mom's Heart or It Lives! as Apollyon 318
Apollyon Baby
Apollyon Baby
Unlocked a new co-player baby. Earn all Hard Mode Completion Marks as Apollyon 319
New Area
New Area
Unlocked a new area. Defeat Hush for the 1st time 320
Once More with Feeling!
Once More with Feeling!
Unlocked a new item. Complete a Victory Lap, defeating The Lamb 321
Hat trick!
Hat trick!
Unlocked a new item. Get a 3-win streak 322
5 Nights at Mom's
5 Nights at Mom's
Unlocked super special rocks. Get a 5-win streak, using a different character for each win. 323
Sin collector
Sin collector
Unlocked a new item. Collect every entry in the Bestiary (Bugged v190 - Mobs that don't exist in the bestiary are being counted. This allows Sin Collector to be unlocked without a complete bestiary) 324
Dedication
Dedication
Unlocked a new item. Participate in 31 dailies (they don't have to be consecutive; it will still count if you die in the first room) 325
ZIP!
ZIP!
Unlocked a new item. Defeat The Lamb in under 20 minutes 326
It's the Key
It's the Key
Unlocked a new item. Defeat The Lamb without taking hearts, coins, and bombs 327
Mr. Resetter!
Mr. Resetter!
Unlocked a new item. Reset 7 times in a row 328
Living on the edge
Living on the edge
Unlocked a new item. Beat a floor after Basement I, start-to-finish, with only half a heart of health (can use The Lost) 329
U Broke It!
U Broke It!
Unlocked a new item. Obtain 50 items on a run (e.g., via two Steam Sales and Restock - Duplicate passives/familiars count towards the total, e.g., multiple Breakfasts) 330
Laz Bleeds More!
Laz Bleeds More!
Unlocked a new starting item. Beat challenge #31 331
Maggy Now Holds a Pill!
Maggy Now Holds a Pill!
Unlocked a new starting item. Beat challenge #32 332
Charged Key
Charged Key
Unlocked a new item. Beat challenge #33 333
Samson Feels Healthy!
Samson Feels Healthy!
Unlocked a new starting item. Beat challenge #34 334
Greed's Gullet
Greed's Gullet
Unlocked a new item. Beat challenge #35 335
The Marathon
The Marathon
Unlocked a new item. Get a 5-win streak in Daily Challenges 336
RERUN
RERUN
Unlocked the power of RERUN. Complete 3 Victory Laps and start a 4th 337
Delirious
Delirious
Unlocked a new item. (Also unlocks Lil Delirium) Defeat Delirium for the first time as any character 338
1000000%
1000000%
Just Stop! 339

Changes[edit | edit source]

Player[edit | edit source]

Characters[edit | edit source]

Magdalene
  • If the Aprils Fool challenge is completed, she will also start with a Speed Up pill.
Samson
  • If the Ultra Hard challenge is completed, he will also start with Child's Heart.
Lazarus
Lazarus Risen
  • If the Backasswards challenge is completed, the Anemic effect is permanent and no longer requires him to take damage.
Eden
  • Holding R to reset will consume an Eden Token and start a new run.
  • Added 30 new Eden hairstyles.

Items[edit | edit source]

Activated Collectibles[edit | edit source]

Butter Bean Butter Bean
  • If Isaac swaps Butter Bean for a different active item, then picks up Butter Bean again, it has a small chance to transform into Wait What?.
D4 D4
  • Re-rolls each of Isaac's passive items into a random item from the specific item pool where it was acquired.
Diplopia Diplopia
  • No longer spawns extra items for empty item pedestals.
Glowing Hour Glass Glowing Hour Glass
Jar of Flies Jar of Flies
  • The item's sprite fills up with more flies depending on how many flies it contains.
Undefined Undefined
  • The Void is reset on exiting the I AM ERROR room, and can be cleared repeatedly as long as the player is able to gather enough charges to successfully warp to it.

Passive Collectibles[edit | edit source]

The Battery The Battery
  • Self-recharging active items can charge the yellow meter, allowing Isaac to use them twice immediately.
Blue Map Blue Map
Cambion Conception Cambion Conception
  • The effect of Dull Razor counts towards the Cambion Conception payout allowing familiars to be spawned without taking real damage.
Dead Cat Dead Cat
  • This item counts as 9 items, so if the player is game on trying for an early portal to The Void after beating Mom, this will significantly boost the progress closer to 20 items.
Epiphora Epiphora
  • Being hit, changing rooms, and using items no longer reset the Epiphora bonus.
    • During the delay when transitioning between rooms, picking up an item, or using an active item, it's possible to change firing direction without resetting the bonus.
Fruit Cake Fruit Cake
Hive Mind Hive Mind
  • The effect also applies to locusts.
Lil Brimstone Lil Brimstone
  • Got renamed from "Lil' Brimstone" to "Lil Brimstone".
Lil Haunt Lil Haunt
  • Got renamed from "Lil' Haunt" to "Lil Haunt".
PHD PHD
  • Converts:
    • ??? into Telepills
    • Addicted into Percs!
    • Paralysis into Pheromones
    • Retro Vision into I can see forever!
    • R U A Wizard? into Power Pill!
    • X-Lax into Something's wrong...
Purity Purity
  • Better visualisation of Purity's glow.
DLC Indicator.png Restock Restock
  • Purchasing an item that is on sale will replace it with another that is on sale.
Rubber Cement Rubber Cement
  • Tears bounce off bombs.
The Small Rock The Small Rock
  • The speed and tears changes will take effect immediately. Without Afterbirth+, they didn't immediately change until Isaac's speed or tears stats are updated the next time.
Steam Sale Steam Sale
  • Items have a chance to be discounted further by random sales; for example, a discounted item originally costing 5 coins will then cost 2 coins instead of 3.

Trinkets[edit | edit source]

Safety Scissors Safety Scissors
Tick Tick

Interactions[edit | edit source]


Pickups[edit | edit source]

Pills[edit | edit source]

  • The Friends till the End! pill now has narration.

Cards and Runes[edit | edit source]

Chaos Card Chaos Card
? Card ? Card
  • Its card ID is 48 instead of 43.

Chests =[edit | edit source]

Golden chest
Spike chest

NPCs[edit | edit source]

Monsters[edit | edit source]

Dank Squirt
  • Dank Squirts can be spawned if Delirium turns into Brownie at low health and dies. Killing them will count as killing Delirium.
Drowned Hive / Hive
Super Pooter
  • Got renamed from "Fat Fly" to "Super Pooter".
Nest
Oob

Mini-Bosses[edit | edit source]

Greed
Super Greed

Bosses[edit | edit source]

Brownie
The Duke of Flies
  • The Large Attack Flies will now orbit around him when coughed up instead of homing in on Isaac.
Hush
  • Due to the way entity stacking works ??? may rarely appear instead and once defeated will skip "phase 2" entirely and will give a completion mark as if Hush was defeated.
Krampus
  • Can shoot Brimstone lasers in all 4 diagonal directions.
Little Horn
  • Has new champion versions:
    • Orange: Spits out an orange Troll Bomb instead of a black ball. The bomb deals contact damage and leaves a patch of fire similar to Hot Bombs.
    • Black: Does not attack with Pits or troll bombs, but fires smoke balls more frequently.
Mega Satan
  • If The Void is unlocked, there is a 50% chance that the game will not immediately end, and Mega Satan will instead drop an ending chest along with a portal. Entering the chest ends the game and plays the cutscene, while entering the portal will take Isaac to The Void.
Rag Man
  • Has new champion versions:
    • Black: Spawns 2 spiders instead of a Ragling. Uses his resurrect frequently. This won't resurrect anything since the spiders don't leave corpses, but still heals him. Sprays tears during his resurrect, similar to Monstro's spit.
    • Red: No longer fires tears. Can have up to 4 Raglings at one time. Can revive 2 Raglings at once.
Triachnid
  • Now has a death animation.
Ultra Greed

Environment[edit | edit source]

Chapters[edit | edit source]

???
  • Additionally, an exit will spawn in the corner of the room, containing a Portal leading to The Void.
Cathedral
  • Some rooms contain Angel Statues that can be bombed to summon the Angels and acquire key pieces.

Rooms[edit | edit source]

Treasure Room
  • There is a chance that 2-3 Greed Gapers may appear in the room.
  • Treasure rooms can rarely contain two items that can both be taken or poop, trinket and a couple of pickups instead of an item.
  • New layouts:

Treasure 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.png

Shop
  • There is a 20% chance for donation machine to be replaced by restock box.
  • There is a small chance for the shop to be replaced by one of its two rare variants:

Shop 7.pngShop 6.png (the two pennies are lucky pennies)

Curse Room
  • Can contain a Devil statue and a random item, surrounded by spikes.
Sacrifice Room
  • New layout:

Sacrifice Room 10.png

Secret Room
Devil Room
Angel Room
  • Can contain 5 soul hearts.
  • Two angel statues can appear in the same room, allowing Isaac to fight both Uriel and Gabriel. It is possible to get both Key Pieces if Isaac awakes and fights each of them one by one; however, fighting both at once will only spawn one Key Piece corresponding to the last defeated angel.
Dice Room
  • The 1 pip room re-rolls each of Isaac's passive items into a random item from the specific item pool where it was acquired.
  • The 4 pips room rerolls item pedestals located in the shop and the library.
  • Have a small icon in the corner of the room that denotes what the effect of the room is.
I AM ERROR
Boss Rush
  • There is a small chance that there will be 8 items to choose from.
  • Using the Black Rune will start the Boss Rush.
  • New layout:

Boss Rush 6.png

Crawl Space
  • New layouts (rares):

ItemDungeon 10.pngItemDungeon 11.png

Black Market
  • Players can no longer access the Black Market through the wall glitch. However, it is still possible to access the Black Market using the glitch via special circumstances including having Ipecac and The Inner Eye.

Obstacles[edit | edit source]

Mushrooms
Skulls

Machines[edit | edit source]

Greed machine

Challenges[edit | edit source]

  • Killing Delirium will count as completing challenges.
I RULE!

Bugs[edit | edit source]

Fixed bugs[edit | edit source]

New bugs[edit | edit source]

Bug Bug! If an angel statue is broken inside the devil room the door will incorrectly be shown to be open, but can't be escaped from
Bug Bug! Sometimes, Scolex's sprite will be replaced with that of a second form Frail, who has an upside-down tail. This is purely a visual bug and the Frail will have all of Scolex's attacks and AI, though the tail's hitbox will be slightly misplaced. This appears to only happen to black champion Scolex, and has been seen in both Hard and Greedier Mode.
Bug Bug! When Scolex is slowed, some of his body parts may detach or won't even show up - they will only be visible while entering the ground (especially the tail).

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

NoDLC Indicator.png Rebirth v0.9, v1.0, v1.01, v1.02, v1.031, v1.032, v1.04, v1.041, v1.05, v1.05 Hotfix
DLC Indicator.png 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
Afterbirth† Indicator.png 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

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

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