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Collection Page (Afterbirth †)

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Collection Page
Removed in Afterbirth
Added in Afterbirth
Added in Afterbirth †
Afterbirth †

The table below is a recreation of what each page looks like when Afterbirth † is installed and all 547 items have been obtained.


(Click images to open the corresponding item page)

Page 1

The Sad OnionThe Sad OnionIncreases Tears by 0.7.The Inner EyeThe Inner EyeGrants triple shot but decreases tears.Spoon BenderSpoon BenderGrants Isaac homing tears.Cricket's HeadCricket's HeadIncreases damage by 0.5, and multiplies it by 1.5x.My ReflectionMy ReflectionGives Isaac's tears a boomerang effect, and increases range and shot speed.Number OneNumber One+1.5 tears, -17.62 rangeBlood of the MartyrBlood of the MartyrIncreases Damage by 1, and turns Isaac's tears into blood tears.Brother BobbyBrother BobbyFollows Isaac around shooting normal tears.SkatoleSkatoleAll types of fly except Boom Fly and Red Boom Fly become passive and slowly move towards Isaac. Does not prevent contact damage.Halo of FliesHalo of FliesSpawns two pretty fly familiars that block enemy shots and deal contact damage to enemies.1up!1up!Gives an extra life. Upon death, you will respawn in the previous room with full health and lose the 1up!.Magic MushroomMagic MushroomIncreases all stats and enlargens Isaac.The VirusThe VirusInflicts poison to enemies who make contact with Isaac. Speed down.Roid RageRoid RageIncreases speed by 0.6, range by 5.25, and tear height by 0.5.<3<3Grants Isaac one red heart container and fully restores Isaac's health.Raw LiverRaw LiverGrants 2 Heart Containers and completely restores health.Skeleton KeySkeleton KeySets your key count to the maximum of 99.A DollarA DollarGives Isaac 99 coins. Can be found multiple times in a single playthrough.Boom!Boom!Grants 10 bombs.TranscendenceTranscendenceGrants flight.
The CompassThe CompassReveals all special rooms (except secret rooms of any kind).LunchLunchAdds 1 heart container.DinnerDinnerAdds 1 heart container.DessertDessertGrants Isaac one full red heart container.BreakfastBreakfastGrants Isaac one full red heart container.Rotten MeatRotten MeatAdds one heart container.Wooden SpoonWooden SpoonIncreases speed by 0.3.The BeltThe BeltIncreases speed by 0.3.Mom's UnderwearMom's UnderwearIncreases range.Mom's HeelsMom's HeelsIncreases range.Mom's LipstickMom's LipstickIncreases range and shot height.Wire Coat HangerWire Coat HangerIncreases Tears by 0.7.The BibleThe BibleUpon 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.The Book of BelialThe Book of BelialUpon use increases damage by 2 for the current room and by a further +50% if the character also has the Blood of the Martyr.
Removed in Afterbirth Guarantees a Devil Room or Angel Room will be open after beating a boss while holding it, or Added in Afterbirth increases the chance by 12.5%.
The NecronomiconThe NecronomiconDamages all enemies in the room significantly.The PoopThe PoopSpawns a pile of poop where the character is standing and knocks nearby monsters back. May yield pickups like regular poop.Mr. BoomMr. BoomDrops a large bomb.Tammy's HeadTammy's HeadShoots 10 tears in a circle around Isaac, which retain the damage, shot speed, and special effects (such as poison) of Isaac's tears.Mom's BraMom's BraUpon use, petrifies all enemies in the current room for approximately 4 seconds.Kamikaze!Kamikaze!Creates 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.
Mom's PadMom's PadUpon use, inflicts fear to all enemies in the room for 5 seconds.Bob's Rotten HeadBob's Rotten HeadUpon use, Isaac holds a poison bomb which can be thrown towards any of the four cardinal points and explodes on impact.TeleportTeleportTeleports you to a random room on the level.Yum HeartYum HeartRestores 1 whole red heart.Lucky FootLucky Foot+1 Luck. Increases chance of winning Shell Game Beggar. (Independent of luck stat)Doctor's RemoteDoctor's RemoteSets a big red target on the ground (similar to the Epic Fetus item) which can be controlled with tear controls. After 6 seconds or by pressing space again, a huge explosive missile hits it, which damages all enemies caught in its blast radius.Cupid's ArrowCupid's ArrowGrants Isaac piercing tears that travel through enemies (but not obstacles) instead of breaking on impact with them.Shoop Da Whoop!Shoop Da Whoop!Fires a laser from Isaac's mouth.StevenStevenIncreases Damage by 1.PentagramPentagramIncreases damage and increases the chance for a Devil or Angel Room to appear.Dr. FetusDr. FetusTears are replaced by bombs that benefit from bomb-enhancing effects and slide for a fixed time after being fired.MagnetoMagnetoPulls pickups towards Isaac.Treasure MapTreasure MapReveals all rooms for every floor. However, it does not reveal icons or secret rooms.Mom's EyeMom's EyeAllows Isaac to fire tears from the back of his head.Lemon MishapLemon MishapCreates a small yellow pool of creep, which damages enemies that cross it.Distant AdmirationDistant AdmirationA red attack fly circles further out than the Halo of Flies / Pretty Flies, but closer than Forever Alone. Deals more damage than Forever Alone.Book of ShadowsBook of ShadowsUpon use, creates a protective shield nullifying all types of damage for 10 seconds.The LadderThe LadderAllows Isaac to walk across gaps one square across by automatically placing a ladder between the two walkable sections.Charm of the VampireCharm of the VampireHeals the character for half of a red heart for every 13 monsters killed.The BatteryThe BatteryActivated Items can be "overcharged" to allow for an additional use.
Steam SaleSteam SaleReduces all Shop prices by 50%, rounded down to 7 coins for an item, rounded up to 2-3 coins for a pickup.Anarchist CookbookAnarchist CookbookSpawns six troll bombs around the room.The HourglassThe HourglassUpon activation, enemies and their projectiles are slowed down for a short duration.Sister MaggySister MaggyA familiar that follows Isaac around shooting blood tears.TechnologyTechnologyReplaces tears with a piercing laser with unlimited range.Chocolate MilkChocolate MilkGrants charged tears that deal greater damage when fully charged.Growth HormonesGrowth HormonesIncreases damage by 1 and speed by 0.4.Mini MushMini MushIncreases Speed and Shot Height and decreases Isaac's size, but lowers Range.RosaryRosaryAdds 3 Soul Hearts and increases the chance for The Bible to appear in any item pool.Cube of MeatCube of MeatOrbiting familiar that blocks enemy shots and deals damage to enemies. If collected while already having one, makes the familiar evolve. Only drops from Horsemen. Similar to Ball of Bandages.A QuarterA QuarterAdds 25 to Isaac's coin count, capping at 99.PHDPHDConverts all bad pills into good pills, spawns one pill pickup and restores health. Identifies all pills upon pickup.X-Ray VisionX-Ray VisionReveals and opens all Secret Room and Super Secret Room entrances.My Little UnicornMy Little UnicornUpon use, grants invulnerability and increased speed for five seconds, removing the ability to shoot tears and replacing it with the ability to deal contact damage to enemies.Book of RevelationsBook of RevelationsAdds 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).The MarkThe MarkIncreases Damage and Speed, plus adds one Soul Heart.The PactThe PactIncreases damage by 0.5, tears by 0.7 and grants two soul hearts upon pickup.Dead CatDead CatSets the amount of red heart containers to 1, but gives Isaac 9 extra lives. After dying, Isaac is teleported to the last safe room. New heart containers can be obtained after picking up this item, but after each death, the number of heart containers is set to 1 again.Lord of the PitLord of the PitGrants flight and increases speed.The NailThe NailAdds 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.
We Need to Go Deeper!We Need to Go Deeper!Creates a trapdoor to go to the next floor. If used in The Womb, it will create a trapdoor to Sheol, even if the player hasn't unlocked it.Deck of CardsDeck of CardsGives Isaac a random Tarot Card.Monstro's ToothMonstro's ToothMonstro jumps onto a random enemy, doing area damage. Can damage/kill the player if summoned in an room without enemies.Loki's HornsLoki's HornsGives a random chance for projectiles to fire in all 4 cardinal directions.Little ChubbyLittle ChubbyA familiar that charges forward and deals touch damage to any enemies in its path.Spider BiteSpider BiteAdds a chance to shoot slowing tears, reducing speed of enemy movement and any projectile fired by them.The Small RockThe Small RockIncreases damage by 1, increases tears by 0.2, and decreases speed by 0.1.Spelunker HatSpelunker HatReveals type of adjacent rooms, including location for secret rooms and super secret rooms.Super BandageSuper BandageGrants one Heart Container and gives 2 Soul Hearts.The GamekidThe GamekidUpon use, turns the character into a into a Pac-Man-like creature for 5 seconds, granting invulnerability, inflicting fear on all enemies, and replenishing half a red heart container for every two enemies killed.Sack of PenniesSack of PenniesIsaac is followed by a small bag that drops a coin every 2 rooms.Robo-BabyRobo-BabyFollows Isaac around, shooting enemies with an eye laser similar to Technology.Little C.H.A.D.Little C.H.A.D.A familiar who will drop a half red heart every 2 rooms.The Book of SinThe Book of SinSpawns a random pickup, pill, card, or trinket.The RelicThe RelicIsaac is followed by a small blue cross that will drop a Soul Heart every 4 rooms.Little GishLittle GishSpawns a familiar that follows Isaac around and fires slowing tears, impeding enemies' speed.Little StevenLittle StevenSpawns a familiar that follows Isaac around and fires homing tears.The HaloThe HaloGrants one Heart Container, +0.3 Damage, +0.2 Tears, +0.25 Range, +0.3 Speed, and +0.5 Tear Height.Mom's Bottle of PillsMom's Bottle of PillsGives 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.The Common ColdThe Common ColdAdds a chance to shoot poison tears, dealing damage over time when inflicted.
The ParasiteThe ParasiteIsaac's tears split in two when they hit something.The D6The D6Allows Isaac to re-roll collectible items in the current room into other items, depending on the current room's Item Pool.Mr. MegaMr. MegaGives Isaac 5 bombs, and makes all dropped bombs larger, which have an increased blast radius and increased damage.The Pinking ShearsThe Pinking ShearsSeparates Isaac's head and body for the current room. Isaac's head, which now has flight, will be under the player's control, while his body will seek out enemies to attack by contact damage.The WaferThe WaferAll sources of damage that would cause more than one half heart of damage are reduced to one half heart instead.Money = PowerMoney = PowerIncreases damage by 0.04 for every coin Isaac has, up to +3.96 damage at 99 coins.Mom's ContactsMom's ContactsAdds a chance to shoot petrifying tears, which stop enemies in place and prevent them from moving or attacking. Range up.The BeanThe BeanIsaac releases bad gas, poisoning any enemy in close vicinity.Guardian AngelGuardian AngelSpawns an orbital familiar that blocks enemy projectiles, deals contact damage to enemies, and increases the speed of all orbital familiars.Demon BabyDemon BabyFollows Isaac and automatically fires at enemies in its reach.Mom's KnifeMom's KnifeIsaac'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.Ouija BoardOuija BoardGrants spectral tears that travel through obstacles (but not enemies) instead of breaking on impact with them.9 Volt9 VoltReduces the charge of any Activated Items by 1. Any 1 charge items instead have timed recharges.Dead BirdDead BirdSpawns a flying familiar for the current room that chases enemies whenever Isaac takes damage.BrimstoneBrimstoneTears 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.Blood BagBlood BagGrants one red heart container, restores 5 red hearts, and increases speed by 0.3.Odd MushroomOdd Mushroom+1.7 tears, +0.3 speed, reduces damage.Odd MushroomOdd MushroomGrants an empty heart container. Increases damage, range and shot height while reducing speed.Whore of BabylonWhore of BabylonIncreases damage and speed whenever Isaac has half a red heart or less (one red heart for Eve), ignoring any soul or black hearts.Monster ManualMonster ManualSummons a random familiar for the current room. Can summon familiars not yet unlocked.

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Dead Sea ScrollsDead Sea ScrollsTriggers the effect of a random activated item from a list of possible options (not every activated item is included).Bobby-BombBobby-BombGives Isaac 5 Bombs, and causes all dropped bombs to home towards the closest enemy.Razor BladeRazor BladeUpon use, deals one heart of damage to Isaac and grants +1.2 damage for the current room.Forget Me NowForget Me NowWhen activated, the level ends and is freshly regenerated with new rooms, monsters, and items. Disappears after use.Forever AloneForever AloneSpawns a blue attack fly that orbits a long distance from Isaac.Bucket of LardBucket of LardGrants two empty heart containers and heals Isaac by half a heart, but decreases speed by 0.2.A PonyA PonyPassively grants flight and increased speed. Upon use, Isaac charges in the direction the pony is facing, becoming invulnerable during the charge and damaging enemies.Bomb BagBomb BagIsaac is followed by a small bag that drops a Bomb, 1+1 Free, or a Troll Bomb every 3 rooms.A Lump of CoalA Lump of CoalThe more distance tears travel, the more damage they will do.Guppy's PawGuppy's PawRemoves one red heart container in exchange for gaining 3 Soul Hearts.Guppy's TailGuppy's TailIncreases chance of finding gold chests and normal chests, but reduces chance of finding pickups.IV BagIV BagUpon activation, Isaac loses a half-heart (one whole heart in The Womb onwards) for a random amount of coins, similar to the blood donation machine.Best FriendBest FriendDeploys a decoy Isaac that eventually explodes with an increased blast radius.Remote DetonatorRemote DetonatorBombs you place explode only when you use this item. Gives 5 bombs.StigmataStigmataIncreases damage, and adds 1 heart container.Mom's PurseMom's PurseAllows Isaac to hold 1 additional trinket.Bob's CurseBob's CurseGives 5 bombs and grants all bombs poison effect.Pageant BoyPageant BoySpawns several coins around Isaac.ScapularScapularOnce per room, when Isaac is reduced to his last half red Heart, the aura around his head temporarily vanishes and he is granted one Soul Heart.Speed BallSpeed BallIncreases speed by 0.3 and shot speed by 20%.
Bum FriendBum FriendA portable beggar who follows Isaac, picks up coins for himself, and occasionally drops a pickup after collecting a coin. Does not spawn collectibles.Guppy's HeadGuppy's HeadSpawns 2-4 blue flies to damage enemies.Prayer CardPrayer CardGrants an eternal heart per use.Notched AxeNotched AxeIsaac holds the axe above his head for as long as the spacebar button is held (or until he leaves the room). While holding the axe, Isaac can break any rock he touches, but cannot attack or pick up other items.InfestationInfestation1-3 blue flies randomly spawn every time Isaac gets hit.IpecacIpecacReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth.Tough LoveTough LoveAdds a chance to shoot a tooth instead of a tear, which deals greater damage than regular tears.The MulliganThe MulliganTears have a 1/6 chance of spawning allied blue flies when they hit an enemy.Technology 2Technology 2Decreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.Mutant SpiderMutant SpiderGrants quadruple shot but decreases tears.Chemical PeelChemical PeelTears fired from left eye do increased damage.The PeeperThe PeeperSpawns a familiar that floats slowly around the room on a zig-zag pattern similar to Boom Flies damaging enemies it passes through.HabitHabitWhen Isaac is hit, 1 point of an item's charge is filled.Bloody LustBloody LustIncreases damage as Isaac receives damage. Damage increase stays for the whole floor.Crystal BallCrystal BallReveals the map (except the Super Secret Room) and drops a random Tarot Card or soul heart.Spirit of the NightSpirit of the NightGrants spectral tears and flight.Crack the SkyCrack the SkySummons multiple beams of light in random locations around the room, dealing a large amount of damage to any enemy that touches them.AnkhAnkhUpon death, the player will respawn as ??? with 3 soul hearts.Celtic CrossCeltic CrossGrants a chance to trigger the Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 7 seconds.Ghost BabyGhost BabySpawns a familiar that follows Isaac around and fires spectral tears.
The CandleThe CandleThrows out a blue flame that can pass over gaps (but not through rocks). The flame damages anything in its path.Cat-O-Nine-TailsCat-O-Nine-TailsIncreases Shot Speed and damage.D20D20Rerolls all pickups in the current room.Harlequin BabyHarlequin BabySpawns a familiar that follows Isaac around and fires two tears at once in a V-pattern.Epic FetusEpic FetusIsaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.PolyphemusPolyphemusMakes Isaac shoot one huge tear. Also reduces Tears to minimum. Damage increased . If tear does more damage than an enemy's life, the tear continues to travel with the extra remaining damage.Daddy LonglegsDaddy LonglegsDaddy Long Legs' shadow follows Isaac and stomps on enemies.Spider ButtSpider ButtDamages all enemies in the room and slows them and their projectiles down.Sacrificial DaggerSacrificial DaggerDagger orbits Isaac, dealing very high damage.MitreMitreGrants a chance of converting any red hearts pickups into soul hearts instead.Rainbow BabyRainbow BabySpawns a familiar that follows Isaac around and fires tears with random effects.Dad's KeyDad's KeyOpens all doors in the current room when activated, including doors which require a key to open and entrances to secret rooms. Opens the big doors in the first room of both The Chest and the Dark Room.Stem CellsStem CellsAdds one filled heart container and increases Shot Speed.Portable SlotPortable SlotUpon activation, 1 coin will be consumed, and a random pickup may drop, similar to the slot machine.Holy WaterHoly WaterWhen Isaac receives damage, the bottle breaks and a puddle of blue creep forms, which damages non-flying enemies, similar to Lemon Mishap. The bottle is reformed upon entering a different room.FateFateGrants flight and one eternal heart.The Black BeanThe Black BeanWhen taking damage, Isaac farts, causing poison damage to all enemies in range.White PonyWhite PonyPassively grants flight and increased speed. Upon use, Isaac charges in the direction the pony is facing, becoming invulnerable during the charge and damaging enemies while also casting the effect of Crack the Sky.Sacred HeartSacred HeartIncreases damage and range while reducing shot speed and grants homing tears. Grants a Heart Container and replenishes all Red Hearts.ToothpicksToothpicks+0.7 tears, +16% shot speed.
Holy GrailHoly GrailGrants flight and one heart container.Dead DoveDead DoveGrants spectral tears and flight.Blood RightsBlood RightsDamages all enemies in the room, but deals a heart of damage to Isaac with each use.Guppy's Hair BallGuppy's Hair BallLoosely follows behind Isaac. Can be swung like a flail by rapidly spinning Isaac in a circle. Grows bigger by killing enemies.AbelAbelA familiar that mirrors the player's movements and shoots in the opposite direction.SMB Super FanSMB Super FanIncreases all stats.PyroPyroAdds 99 bombs.3 Dollar Bill3 Dollar BillGives 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.
Telepathy for DummiesTelepathy for DummiesUpon activation, grants homing tears for the current room.MEAT!MEAT!Adds a heart container and increases damage.Magic 8 BallMagic 8 BallIncreases Shot Speed, and drops a Tarot Card when picked up.Mom's Coin PurseMom's Coin PurseSpawns 4 random pills around Isaac.SqueezySqueezyIncreases tears by 0.4, and spawns 2 Soul Hearts pickups.Jesus JuiceJesus JuiceIncreases Damage and Range.BoxBoxSpawns 1 of each (non-collectible) item: 1 coin, 1 key, 1 bomb, 1 heart, 1 card, 1 pill, 1 trinket.Mom's KeyMom's KeySpawns 2 keys. Generates additional pickups from chests.Mom's EyeshadowMom's EyeshadowTears have a chance to charm enemies.Iron BarIron BarIncreases damage by 0.3 and adds a chance to shoot concussive tears, causing enemies to walk around randomly.Midas' TouchMidas' TouchEnemies that touch you are stunned and turn gold. Any enemy killed while in this state will drop a coin.Humbling BundleHumbling BundleGives one extra pickup (1+1 Free version) of Red Hearts, pennies, bombs, and keys. Does not work with blue, black, and half red hearts, nickels, and dimes.
Fanny PackFanny PackHas a chance to drop a random pickup when Isaac takes damage.Sharp PlugSharp PlugUsing an activated item while it's not charged will charge it and Sharp Plug does 2 full heart damage to Isaac.GuillotineGuillotineIsaac's head is removed from his body and floats around him. Increases Damage by 1 and grants -1 Tear Delay.Ball of BandagesBall of BandagesOrbiting familiar that deals damage to enemies. If collected while already having one, makes the familiar evolve. Only drops from Horsemen. Similar to Cube of Meat.Champion BeltChampion BeltIncreases damage, but also increases the chance of champion enemies appearing.Butt BombsButt BombsGives +5 bombs and makes all bombs Butt Bombs that fill the room with gas, damaging and confusing all enemies.Gnawed LeafGnawed LeafAfter standing still and not shooting for a short time, Isaac turns invincible until he moves or shoots.Spider BabySpider BabyWhen hit, spawns up to 2 blue spiders.Guppy's CollarGuppy's CollarGrants Isaac a permanent 50% chance to respawn with 1/2 of a red heart after death.Lost ContactLost ContactEvery tear has a small shield which will allow it to block one enemy projectile.AnemicAnemic+5 range. After Isaac is damaged, a trail of red creep will be left behind Isaac until he leaves the current room.Goat HeadGoat HeadA Devil Room / Angel Room Door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.Ceremonial RobesCeremonial RobesAdds 3 black hearts and increases Damage by 1.Mom's WigMom's WigAdds a chance to spawn blue spiders when firing tears. Restores 1 red heart.PlacentaPlacentaGrants a full heart container, and a chance to regenerate a half-heart of health every minute of gameplay.Old BandageOld BandageAdds one empty heart container. Whenever Isaac takes damage there's a chance that a Red Heart may drop.Sad BombsSad Bombs+5 Bombs. Upon exploding, bombs shoot 8 tears off in every direction, similar to Tammy's Head. The tears are affected by any tear modifiers Isaac has on his own tears.Rubber CementRubber CementTears bounce off walls, enemies, and environmental objects.Anti-GravityAnti-Gravity-2 Tear Delay. Tears float in position until firing ceases, after which they will fly off in the direction they were shot in.PyromaniacPyromaniacIsaac heals 1 heart instead of taking damage from an explosive source. Adds 5 bombs.
Cricket's BodyCricket's BodyGrants -1 Tear Delay and reduces Range. When tears hit an object or deplete their range, they spawn 4 smaller tears, whose Range and Damage scale with Isaac's.GimpyGimpyHas a chance of spawning a soul heart or black heart when taking damage. Enemies have a chance to drop a Half Red Heart after being killed.Black LotusBlack LotusGrants the player one red heart container, one soul heart, and one black heart.Piggy BankPiggy BankGives 3 pennies on pick-up. Every time Isaac is damaged, he will drop one additional penny.Mom's PerfumeMom's PerfumeAdds a chance to shoot fear tears and decreases tear delay by 1.Monstro's LungMonstro's LungIncreases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.AbaddonAbaddonIncreases damage and speed, removes all red heart containers, grants six black hearts, and adds a chance to shoot fear tears.Ball of TarBall of TarAdds a chance to shoot slowing tears and the character leaves a trail of slowing creep behind as he moves, impeding enemies' speed.Stop WatchStop WatchRemoved in Afterbirth Automatically inflicts slow to all enemies in every room.
Added in Afterbirth Upon taking damage, inflicts slow to all enemies for the current room.
Tiny PlanetTiny PlanetRange up and makes shot tears revolve around Isaac until they drop.Infestation 2Infestation 2Spawns allied blue spiders from killed enemies.E ColiE ColiGives "Turdy Touch" Effect. Enemies that touch Isaac are changed into poop.Death's TouchDeath's TouchIncreases Damage by 1.5, reduces Tears by 0.3 and increases tear size. Grants piercing tears. Tears are replaced by Death's scythes, which is a cosmetic effect only.Key Piece 1Key Piece 1Combined with Key Piece 2, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.Key Piece 2Key Piece 2Combined with Key Piece 1, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.Experimental TreatmentExperimental TreatmentRandomly increases and decreases some of the character's stats.Contract From BelowContract From BelowDoubles the number of pickups and chests spawned after clearing a room or performing some other triggering action (such as using a blood donation machine), but reduces the chance for any pickups to spawn at all.InfamyInfamyChance to block projectiles coming from any direction.Trinity ShieldTrinity ShieldIsaac gains a shield that protects him from enemy shots.Tech.5Tech.5Grants a unlimited range piercing laser with random rate of fire that does not replace tears. The laser might occasionally fire with the effect of a random item or trinket, such as Hook Worm, Spoon Bender or Tiny Planet.

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20/2020/20Grants double shot.Blue MapBlue MapShows secret and super secret room locations on the map.BFFS!BFFS!Increases the size and damage of familiars.Hive MindHive MindIncreases the size of blue spiders and blue flies and doubles the amount of damage they deal.There's OptionsThere's OptionsThere will be 2 items available to choose from after defeating a boss. Choosing 1 item causes the other to disappear.Bogo BombsBogo BombsAll standard bomb pickups become 1+1 bomb pickups.Starter DeckStarter DeckIsaac can hold 2 cards at once and all pills are replaced by cards.Little BaggyLittle BaggyIsaac can hold 2 pills at once and all cards are replaced by pills.Magic ScabMagic ScabIncreases luck and HP by 1.Blood ClotBlood ClotIncreases damage by 1 and range by 5 for tears fired from the left eye.ScrewScrew+0.5 tears up, +0.2 shot speed up.Hot BombsHot BombsGrants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact.Fire MindFire MindGrants flaming tears that deal burning damage over time. Tears have a chance to explode on impact with an enemy, which creates a fire at the location of the explosion.Missing No.Missing No.Randomizes all passive items upon pickup and at the start of each succeeding floor.Dark MatterDark MatterIncreases Damage by 1 and adds a chance to shoot fear tears.Black CandleBlack CandlePrevents curses. Grants one black heart. Increases the chance for a Devil or angel room to appear.ProptosisProptosisTears start out massive with high damage, and then shrink down and become weaker over a short range.Missing Page 2Missing Page 2Gives 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.Smart FlySmart FlyAfter Isaac takes damage, this fly will deal continuous touch damage to whatever enemy caused the damage until it is dead. The fly will then systematically attack 1 enemy at a time until the room is cleared.Dry BabyDry BabySpawns a familiar that follows Isaac around and blocks enemy projectiles. Upon blocking a shot, it has a chance of triggering The Necronomicon effect.
Juicy SackJuicy SackA familiar that follows behind Isaac. It drips a trail of creep, which slows enemies, and spawns 1-2 blue spiders after each room.Robo-Baby 2.0Robo-Baby 2.0Fires lasers at any enemy in its line of sight and moves based on the direction Isaac is firing tears.Rotten BabyRotten BabyA familiar that spawns blue flies.Headless BabyHeadless BabyFamiliar that follows Isaac, leaving blood creep on the ground.LeechLeechSpawns a friendly familiar leech on the ground that hunts down enemies and heals you for half a heart each time it eats one.Mystery SackMystery SackSpawns a familiar that follows Isaac around and has a chance to drop a heart, coin, bomb, or key after clearing a room.BBFBBFSpawns a familiar that flies around the room in a manner similar to the Boom Fly and explodes on contact with an enemy. Respawns after ten seconds.Bob's BrainBob's BrainSpawns a familiar that charges forward when shooting tears and explodes upon contact with an enemy, damaging and poisoning them. The familiar respawns after a few seconds.Best BudBest BudWhen hit, summons a white attack fly similar to Distant Admiration for the current room.Lil BrimstoneLil BrimstoneA Familiar that shoots a thin Brimstone beam. Must charge like Brimstone before shooting.Isaac's HeartIsaac's HeartIsaac himself is now immune to all damage, and a heart familiar appears and follows Isaac. If the heart is hurt, Isaac is hurt.Lil HauntLil HauntA familiar that damages enemies by chasing them as well as inducing the fear effect.Dark BumDark BumSpawns 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.Big FanBig FanSpawns a large orbital familiar that blocks enemy projectiles and deals slight contact damage to enemies.Sissy LonglegsSissy LonglegsWanders about the room, occasionally spawning blue spiders.Punching BagPunching BagSpawns a Mulligan Familiar that will wander the room randomly. Enemies will attack the Mulligan if it's closer.How to JumpHow to JumpGives Isaac the ability to jump (over gaps, spikes, etc.).D100D100Upon use, rerolls all passive items on Isaac like the D4, every pedestal item in the room like The D6, and every pickup like the D20.D4D4Rerolls all of Isaac's items.D10D10Rerolls the enemies in a room. Only rerolls enemies that are still alive (does not spawn new enemies).
Blank CardBlank CardHas the same effect as the card or rune currently held by Isaac.Book of SecretsBook of SecretsUpon use, gives the effect of Treasure Map, The Compass, or Blue Map for the duration of the current floor.Box of SpidersBox of SpidersSummons 2-4 blue spiders.Red CandleRed CandleThrows a persistent flame that deals high damage and diminishes as it damages enemies or blocks shots.The JarThe JarWhen at full health, up to 4 extra hearts can be stored in the jar.Flush!Flush!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.Satanic BibleSatanic BibleUpon activation, Isaac gains a black heart.Head of KrampusHead of KrampusFires a cross-patterned brimstone shot, just like The Fallen and Krampus shoot.Butter BeanButter BeanIsaac farts and pushes back nearby enemies.Magic FingersMagic FingersFor 1 coin, damages all enemies in the room.ConverterConverterWhen used, converts two soul hearts into a heart container.Pandora's BoxPandora's BoxUpon use, spawns certain pickups or items depending on the floor it is used on. Single-use.Unicorn StumpUnicorn StumpUpon use, grants invulnerability and increased speed for five seconds, but removes the ability to shoot tears.TaurusTaurusSpeed down; gains speed while in a room with enemies until gaining My Little Unicorn effect for a few seconds.AriesAries+0.25 Speed. Running into enemies while at a high speed will deal 18 points of damage. Does not prevent contact damage.CancerCancerAdds 3 soul hearts. Grants The Wafer effect for the current room upon taking damage.LeoLeoAllows you to crush rocks when you walk over them.VirgoVirgoGrants a chance to trigger the Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 10 seconds. Also converts "bad pills" into "good pills".LibraLibraGives 6 coins, 6 bombs, and 6 keys and balances out all attributes.ScorpioScorpioGrants poison tears, which deal damage over time when inflicted.
SagittariusSagittariusIncreases speed by +0.2 and grants piercing tears.CapricornCapricornAll stats up.AquariusAquariusA trail of blue creep is left behind Isaac, which damages enemies.PiscesPisces-1 Tear Delay, adds knock-back shots and increases tear size.Eve's MascaraEve's MascaraDoubles damage, halves tears stat, and greatly reduces shot speed.Judas' ShadowJudas' ShadowAdds an extra life; upon death, it respawns Isaac as Black Judas with only two black hearts.Maggy's BowMaggy's BowGives one heart container and doubles the healing provided by red hearts.Holy MantleHoly MantleAutomatically negates first taken damage in every room.Thunder ThighsThunder ThighsDestroys rocks upon contact with Isaac. Adds one heart container and lowers Speed.Strange AttractorStrange AttractorPickups, trinkets, and monsters are magnetically attracted to Isaac's tears.Cursed EyeCursed EyeGrants charged tears that can be fired in a tight burst of four. Getting hit while charging will teleport Isaac into another room.Mysterious LiquidMysterious LiquidTears leave a small, short lasting pool of creep on impact or when their range is depleted.GeminiGeminiSuture becomes attached to Isaac, and does touch damage to enemies within its attacking range.Cain's Other EyeCain's Other EyeSpawns a familiar that floats slowly around the room on a zig-zag pattern similar to The Peeper and shoots normal tears in the same direction as Isaac.???'s Only Friend???'s Only FriendSummons a big attack fly that can be controlled with the shooting direction-keys.Samson's ChainsSamson's ChainsPull a chain and ball behind you that will damage enemies on contact and is able to break stones.Mongo BabyMongo BabySummons a familiar that copies the tears of Isaac's other familiars.Isaac's TearsIsaac's TearsShoots 8 tears around Isaac, which retain the damage, shot speed, and special effects of his tears. Each tear shot by Isaac increases item charge by one.UndefinedUndefinedTeleports Isaac to either the Secret Room, Super Secret Room, Treasure Room, or I AM ERROR.ScissorsScissorsUpon use, turns Isaac's head into a stationary familiar for the current room which fires normal tears that deal 3.5 damage.
Breath of LifeBreath of LifeGrants a brief moment of invincibility when the charge bar hits zero. If spacebar is held for an additional second after hitting zero, Isaac will take damage.The PolaroidThe PolaroidIf the character has half a red heart or no red hearts after taking damage, it triggers the Book Of Shadows effect, creating a shield that nullifies all types of damage for 5 seconds. Also allows entrance into The Chest.The NegativeThe NegativeIf the character has half a red heart or no red hearts after taking damage, it triggers The Necronomicon effect, damaging all enemies in the room. Also allows entrance into the Dark Room.The Ludovico TechniqueThe Ludovico TechniqueInstead of firing tears, Isaac controls one floating tear that hover over obstacles. This tear deals constant damage when held in place over an enemy.Soy MilkSoy MilkTears shrink and do much less damage, but fire in very rapid succession.GodheadGodheadIncreases damage and range while reducing tears and shot speed. Grants homing tears and tears gain a damaging halo.Lazarus' RagsLazarus' RagsUpon dying, resurrect as Revived Lazarus with one heart container and Anemic item.The MindThe MindGrants the combined effects of the Blue Map, Treasure Map, and The Compass, revealing the floor layout and all special rooms, including Secret Rooms and Super Secret Rooms.The BodyThe BodyAdds 3 heart containers.The SoulThe SoulGrants two soul hearts. Isaac now repels enemy projectiles.Dead OnionDead OnionGrants piercing and spectral tears. Increases tear size (without increasing damage) while greatly reducing range and shot speed.Broken WatchBroken WatchChance upon entering a room to slow down or speed up every enemy and their attacks. The chance to slow enemies is quite higher than the chance to speed them up.The BoomerangThe BoomerangThrows 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.Safety PinSafety PinIncreases range and shot speed, while adding 1 Black Heart.Caffeine PillCaffeine PillIncreases speed and reduces character size. Also gives a random pill.Torn PhotoTorn PhotoTears + Shot speed up.Blue CapBlue CapGrants 1 heart container and increases tears, but decreases shot speed.Latch KeyLatch KeyIncreases Luck by 1, grants 1 Soul Heart and spawns 2 Keys.Match BookMatch BookGrants Isaac 1 Black Heart and 3 bombs. Can also give troll bombs.SynthoilSynthoilIncreases damage by 1, range by 5.25, and tear height by 0.5.
A SnackA SnackGrants one full red heart container.DiplopiaDiplopiaDuplicates all pickups and item pedestals in the room.PlaceboPlaceboWhen used, copies the effect of the pill Isaac is currently holding without consuming it. Does not copy the effects of cards or runes.Wooden NickelWooden NickelWhen used, has a 50% chance to drop one random type of coin (penny, nickel, or dime).Toxic ShockToxic ShockUpon 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.Mega BeanMega BeanWhen 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.Glass CannonGlass CannonWhen 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).Bomber BoyBomber Boy+5 bombs. Isaac's bombs will now explode in a large cross-shaped pattern (roughly 5 bombs explosions wide). This also affects troll bombs.Crack JacksCrack JacksAdds one heart container and drops a random trinket.Mom's PearlsMom's Pearls+1.25 Range Up. +0.5 Tear Height. +1 Luck Up.Car BatteryCar BatteryCauses Isaac's activated item to activate twice on each use.Box of FriendsBox of FriendsUpon use, duplicates all of Isaac's familiars for the current room.The WizThe WizTears 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.8 Inch Nails8 Inch Nails+1.5 Damage Up. Replaces Isaac's tears with nails, which have increased knockback.IncubusIncubusA demonic familiar that follows Isaac and shoots tears identical to Isaac's in terms of damage, range, fire rate, and effects.Fate's RewardFate's RewardA blue head familiar that will follow Isaac and fire tears copying his tear effects and damage.Lil ChestLil ChestSpawns a chest familiar that follows Isaac and drops a random pickup every few rooms.Sworn ProtectorSworn ProtectorAn orbital angel which does 7 contact damage per tick and blocks enemy shots. Upon blocking 10 shots in a room it drops an eternal heart.Friend ZoneFriend ZoneA 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.Lost FlyLost FlyA 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.

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Scatter BombsScatter BombsAdds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs.Sticky BombsSticky Bombs+5 bombs. Bombs stick to enemies and spawn 2-4 blue spiders if they kill an enemy.EpiphoraEpiphoraShooting 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.ContinuumContinuum+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.Mr. DollyMr. DollyTears and Range up. Spawns 3 random types of hearts on the floor when picked up.Curse of the TowerCurse of the TowerCauses Isaac to spawn 6 troll bombs on the floor every time he gets hit, similar to the Anarchist Cookbook mechanic.Charged BabyCharged BabyA familiar that drops a Little Battery every 4 rooms. Has a small chance to freeze all enemies in the room when hit.Dead EyeDead EyeIsaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.Holy LightHoly LightIsaac has a random chance to fire a Holy tear, which, when it hits an enemy, will spawn a Crack the Sky-style light beam on the same enemy, dealing damage.Host HatHost HatA 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.RestockRestockCauses shops to instantly restock their items when they are bought. Granted by default for every character in Greed Mode.Bursting SackBursting SackSpider enemies no longer target or deal contact damage to Isaac.No. 2No. 2Continuously 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.Pupula DuplexPupula DuplexTransforms 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).Pay to PlayPay to PlayThis 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.Eden's BlessingEden's Blessing+0.7 tears up. Grants a random item at the start of the next run.Friendly BallFriendly BallThrowing the ball at an enemy instantly kills it and captures it. The captured enemy can later be released and will be friendly, fighting for Isaac and persisting between rooms.Tear DetonatorTear DetonatorWhen 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.Lil GurdyLil GurdyGives 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.BumboBumboSpawns 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.
D12D12Re-rolls all rocks in the current room into other random objects, such as bomb rocks, metal blocks, TNT, or poops.CenserCenserGives Isaac a golden censer familiar which creates a huge aura of light that slows down any enemies and enemy shots inside it.Key BumKey BumSpawns a portable key master that follows Isaac and collects keys, giving random chests in return.Rune BagRune BagA bag that follows Isaac and drops a random rune every 3 rooms.SeraphimSeraphimAn angel familiar which follows Isaac and fires homing tears which deal 10 damage at -25% shot speed and a reduced fire rate.BetrayalBetrayalEvery time Isaac takes damage, a charm effect is applied to every enemy in the room, causing them to attack each other rather than Isaac.ZodiacZodiacZodiac will give Isaac a random zodiac item effect that changes after every floor.Serpent's KissSerpent's KissTears 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.MarkedMarkedIsaac 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.Tech XTech XTears 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.Ventricle RazorVentricle RazorCan be used to place an orange portal and a blue portal. Upon entering a portal, Isaac is teleported to the other portal.Tractor BeamTractor BeamIsaac emits a beam from his face. Isaac's tears travel in the path of the beam.God's FleshGod's FleshTears 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.Maw of the VoidMaw of the Void+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.Spear of DestinySpear of DestinyIn 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.ExplosivoExplosivoIsaac's tears have a chance to stick to enemies and explode.ChaosChaosChaos causes items to be chosen from random item pools. When picked up, drops between 1-6 random pickups on the floor.Spider ModSpider ModDisplays 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.Farting BabyFarting BabyA 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.GB BugGB BugA 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.
D8D8Re-rolls Isaac's speed, range, tears, and damage.PurityPurityThis 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.AthameAthameWhenever Isaac takes damage, a black ring briefly appears around Isaac, dealing damage to all nearby enemies.Empty VesselEmpty VesselWhile 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.Evil EyeEvil EyeWhile 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.Lusty BloodLusty BloodEach time Isaac kills an enemy, Isaac's damage increases for the current room.Cambion ConceptionCambion ConceptionAfter taking damage a certain amount of times, a permanent demonic familiar spawns.Immaculate ConceptionImmaculate ConceptionUpon picking up a certain amount of health, spawn a permanent angelic familiar.More OptionsMore OptionsTwo items spawn in every Treasure Room. Only one can be taken; the other will disappear.Crown of LightCrown of LightGives 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.Deep PocketsDeep PocketsAllows Isaac to carry two cards or pills (or a combination of both) at the same time.SuccubusSuccubusSpawns 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.Fruit CakeFruit CakeIsaac's tears gain a random effect that changes every shot.Teleport 2.0Teleport 2.0When 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.Black PowderBlack PowderIsaac 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.Kidney BeanKidney BeanUpon use, Isaac farts, charming all nearby enemies.Glowing Hour GlassGlowing Hour GlassWhen 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.Circle of ProtectionCircle of ProtectionSurrounds 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.Sack HeadSack HeadGreatly increases the chance to find sacks.Night LightNight LightA cone of light shines in the direction Isaac is moving that slows enemies and enemy shots.
Obsessed FanObsessed FanA purple fly familiar that follows Isaac's movements on a 3 second delay and deals contact damage to enemies.Mine CrafterMine CrafterWhen 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.PJsPJsGrants four soul hearts and fully restores Isaac's red health.Head of the KeeperHead of the KeeperIsaac's tears become coins and now have a chance to drop pennies on the floor upon successfully hitting an enemy.Papa FlyPapa FlyA blue fly familiar follows Isaac's movements on a 3 second delay. Papa Fly will fire tears at nearby enemies.Multidimensional BabyMultidimensional BabySpawns 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.Glitter BombsGlitter BombsGives Isaac 5 bombs, and makes Isaac's bombs have a chance to drop random pickups or charm enemies when they explode.My ShadowMy ShadowEach time Isaac takes damage, inflicts fear on all enemies in the room and spawns a black friendly Charger that will attack enemies. The Charger will be killed if it is damaged too much.Jar of FliesJar of FliesEvery 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.Lil' LokiLil' LokiA Loki familiar that follows Isaac and shoots 4 tears in a cross pattern.Milk!Milk!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.D7D7Restarts the current room and brings back all enemies, allowing more rewards to be acquired by completing the room.BinkyBinkyTears up, adds 1 soul heart, and decreases Isaac's size.Mom's BoxMom's BoxWhen used, Mom's Box will drop a random trinket on the ground. While held, increases luck by 1 and doubles the effects of trinkets.Kidney StoneKidney StoneRandomly 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.Mega BlastMega BlastUpon 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.Dark Prince's CrownDark Prince's CrownIncreases range, tears, and shot speed when at exactly one red heart.Apple!Apple!Increases tears. Adds a chance to fire a high-damage razor blade.Lead PencilLead PencilAfter every 15 tears fired, Isaac will fire a high-damage cluster of tears.Dog ToothDog ToothIncreases damage and speed. Upon entering a room adjacent to a secret room, a howl sound effect will play.
Dead ToothDead ToothWhile firing, Isaac gains a green aura that poisons nearby enemies.Linger BeanLinger BeanAdds a chance to fire a gas cloud that damages nearby enemies.Shard of GlassShard of GlassUpon 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.Metal PlateMetal PlateAdds a chance to reflect enemy shots. Grants one soul heart.Eye of GreedEye of GreedAdds a chance to fire tears that temporarily stun enemies and turn them into gold. Any enemy killed while in this state will drop coins.Tarot ClothTarot ClothDrops a random card or rune. Doubles the effects of cards and runes.Varicose VeinsVaricose VeinsTaking damage releases a ring of 10 high damage tears.Compound FractureCompound FractureIncreases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.PolydactylyPolydactylyAllows Isaac to carry two cards, pills, or any combination of both at the same time. Drops a random card or pill.Dad's Lost CoinDad's Lost CoinIncreases range by 1.5. Drops a lucky penny.Moldy BreadMoldy BreadGrants one full red heart container.Cone HeadCone HeadGrants a soul heart. Adds a chance to block enemy shots.Belly ButtonBelly ButtonDrops a random trinket. Grants a second trinket slot.Sinus InfectionSinus InfectionAdds a chance to fire a booger which sticks to enemies and poisons them.GlaucomaGlaucomaAdds a chance to shoot concussive tears, causing enemies to walk around randomly.ParasitoidParasitoidAdds a chance to fire an egg sack which spawns slowing creep and spawns a blue fly or spider upon hitting an enemy.Eye of BelialEye of BelialGrants piercing tears. After piercing one enemy, tears start homing and deal double damage.Sulfuric AcidSulfuric AcidIncreases damage. Adds a chance to fire acidic tears which can destroy obstacles.Glyph of BalanceGlyph of BalanceGrants 2 soul hearts and modifies drops from Champion Monsters based on certain conditions.Analog StickAnalog Stick+0.3 tears up. Allows Isaac to fire tears diagonally.
ContagionContagionThe first enemy killed in a room explodes and poisons nearby enemies. Poisoned enemies will also explode upon death.Finger!Finger!Spawns a finger familiar that points at enemies, dealing constant damage.ShadeShadeSpawns a shadow familiar that follows Isaac's movements on a 1 second delay and deals contact damage to enemies.DepressionDepressionSpawns 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.HushyHushySpawns a Hush familiar that bounces around the room and deals contact damage. While firing tears, it stops moving.Lil MonstroLil MonstroSpawns a familiar that fires clusters of tears. Must be charged before shooting.King BabyKing BabySpawns a familiar that follows Isaac and makes other familiars follow it. While firing tears, it stops moving.Big ChubbyBig ChubbySpawns a familiar that slowly charges forward and damages enemies in its path.TonsilTonsilGrants a familiar that can block enemy shots.Plan CPlan CKills all enemies in the room, then kills Isaac three seconds later.D1D1Duplicates a random pickup in the room.VoidVoidConsumes all pedestal items in the room. Active items will have their effects added to Void, and passive items will grant stat upgrades.PausePauseFreezes all enemies until a fire button is pressed.SmelterSmelterConsumes Isaac's currently held trinket and applies its effect permanently.CompostCompostSpawns a blue spider or fly. Turns pickups in the room into blue spiders or flies.DataminerDataminerDisplaces enemy sprites for the current room, randomly increases one stat and decreases another.ClickerClickerTransforms Isaac into another random character.Mama Mega!Mama Mega!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.Wait What?Wait What?Isaac farts, sending out rock waves.Crooked PennyCrooked PennySpawns 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.

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Dull RazorDull RazorHurts Isaac without depleting health, activating any items that trigger upon taking damage.Potato PeelerPotato PeelerRemoves a heart container, increases damage and range, and grants a Cube of Meat.MetronomeMetronomeGrants a random item effect for the current room.D InfinityD InfinityGrants a random dice item that changes each use.Eden's SoulEden's SoulSpawns two item pedestals.Acid BabyAcid BabySpawns a familiar that drops random pills every 2 rooms cleared. Upon using a pill, all enemies in the room are poisoned.YO LISTEN!YO LISTEN!+1 luck. Spawns a fairy familiar that points out secret room entrances and tinted rocks.AdrenalineAdrenalineIncreases damage based on how many empty heart containers Isaac has.Jacob's LadderJacob's LadderTears fire sparks of electricity in random directions upon hitting an obstacle or enemy.Ghost PepperGhost PepperAdds a chance to shoot a fire that damages enemies and remains in place until it deals enough damage or the room is left.EuthanasiaEuthanasiaAdds a chance to fire needles. If a needle kills an enemy, it bursts into more needles.Camo UndiesCamo UndiesIsaac becomes camouflaged at the beginning of each room. Enemies will not attack Isaac until he starts firing tears.DualityDualityWhenever a Devil or Angel Room would spawn after defeating a boss, both rooms spawn. Only one can be entered.EucharistEucharistAn Angel Room door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.Sack of SacksSack of SacksSpawns a sack familiar that has a chance to drop a sack upon clearing a room.Greed's GulletGreed's GulletGrants a heart container for every 25 coins Isaac has.Large ZitLarge ZitAdds a chance to fire a creep shot that deals double damage and leaves a trail of slowing white creep.Little HornLittle HornAdds a chance to fire a piercing tear that instantly kills any enemy that it touches.Brown NuggetBrown NuggetSpawns a stationary fly familiar that fires tears at nearby enemies.Poke GoPoke GoUpon entering a room with enemies in it, has a chance to spawn a random friendly enemy that persists across rooms.
BackstabberBackstabberHas a chance to fire tears that inflict bleeding on enemies, causing them to slowly take damage over time.Sharp StrawSharp StrawDamages all enemies in the room.Mom's RazorMom's RazorSpawns an orbiting razor that damages enemies it touches and inflicts bleeding on enemies, causing them to slowly take damage over time.Bloodshot EyeBloodshot EyeSpawns an orbiting eye familiar that fires tears every 2 seconds.DeliriousDeliriousSpawns a random charmed boss.Angry FlyAngry FlySpawns a fly familiar that orbits around a random enemy and deals 5 damage per tick to enemies it comes in contact with.Black HoleBlack HoleThrows a black hole on the ground which sucks in and damages enemies.BozoBozoIncreases 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 ModemBroken ModemEnemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals.Mystery GiftMystery GiftUpon 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.SprinklerSprinklerUpon use, spawns a sprinkler that rotates and fires tears.Fast BombsFast BombsGrants 7 bombs and allows bombs to be placed rapidly.Buddy in a BoxBuddy in a BoxGrants a familiar with a random tear effect. The familiar is randomized at the start of each floor.Lil DeliriumLil DeliriumGrants a familiar that transforms into another random familiar every 10 seconds.Jumper CablesJumper CablesGrants an active item charge every 15 enemies killed.CouponCouponUpon use, makes a random item from a shop, devil deal, or black market free.TelekinesisTelekinesisUpon 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.Moving BoxMoving BoxIf 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.Technology ZeroTechnology ZeroConnects Isaac's tears with electricity that can damage enemies.LeprosyLeprosyUpon 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.
7 Seals7 SealsGrants a random Harbinger familiar that changes every 10 seconds.Mr. ME!Mr. ME!Summons a controllable ghost that can perform various tasks depending on what it targets.Angelic PrismAngelic PrismGrants a prism orbital with a large orbital radius. Tears that pass through the prism split into four multi-colored tears.Pop!Pop!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.Death's ListDeath's ListGrants a reward if all enemies in a room are killed in the order they are marked.HaemolacriaHaemolacriaTears are now fired in an arc. Upon hitting the floor, an obstacle, or an enemy, they burst into many smaller tears in all directions. Increases tear delay.LachryphagyLachryphagyIsaac's tears decelerate as they travel. Upon stopping or hitting an obstacle, they burst into 8 tears in all directions. Tears can be fired into other tears to feed them, increasing their damage.TrisagionTrisagionTears are replaced with piercing white blasts of light.SchoolbagSchoolbagAllows Isaac to hold two active items.BlanketBlanketGrants one soul heart. Upon entering a boss room, grants a shield that blocks one hit, then disappears.Sacrificial AltarSacrificial AltarUpon use, sacrifices up to 2 familiars and spawns an item from the Devil Room Pool for each familiar sacrificed.Lil SpewerLil SpewerSpawns a random pill, and grants a small Spewer familiar that charges up and fires different types of creep.MarblesMarblesSpawns 3 random trinkets. Taking damage has a small chance to swallow Isaac's currently held trinket, gaining its effect permanently.Mystery EggMystery EggSpawns an egg familiar, which cracks and turns into a random friendly enemy when Isaac is hurt. The egg regenerates upon entering a different room.Flat StoneFlat StoneTears bounce off the floor. Tears that hit an enemy after bouncing deal splash damage to all nearby enemies for 25% of Isaac's tear damage.MarrowMarrowGrants one bone heart and spawns three red heart pickups.Slipped RibSlipped RibSpawns a bone familiar that circles around Isaac and reflects enemy shots.Hallowed GroundHallowed GroundSpawns a white poop familiar, which turns into a white poop when Isaac is hurt.Pointy RibPointy RibSpawns a bone familiar that can be aimed with the fire buttons and does contact damage.Book of the DeadBook of the DeadUpon use, spawns a friendly Bony or an orbital bone for each enemy killed in the current room.
Dad's RingDad's RingCreates a ring of light around Isaac that petrifies enemies in contact.Divorce PapersDivorce PapersSpawns a Mysterious Paper, increases tears, and grants a bone heart.Jaw BoneJaw BoneSpawns a familiar that flies the room while firing, dealing double Isaac's tear damage to enemies that come in contact and retrieving pickups.Brittle BonesBrittle BonesReplaces all red hearts with 6 empty bone hearts. Upon losing a bone heart, Isaac fires bones in 8 directions and permanently gains a tears up.Broken ShovelBroken ShovelWhile held, causes multiple Mom's Foots to come down and stomp on Isaac. One of two parts necessary to create Mom's Shovel.Broken ShovelBroken ShovelOne of two parts necessary to create Mom's Shovel.Mom's ShovelMom's ShovelSpawns a trapdoor that leads to the next floor upon activation. Unlocks The Forgotten when used on a mound of dirt that appears in The Dark Room.


  • The item order is based on The Binding of Isaac and its expansion up to item 198.

The Binding of Isaac: Rebirth The Binding of Isaac: Rebirth The Binding of Isaac: Rebirth
Achievements Achievements Attributes Attributes Bosses Bosses TarotCard.png Cards and Runes Challenges Challenges Chapters Chapters
Characters Characters MainPageBabies.png Co-op Items Items Item Pools Item Pools Monsters Monsters Objects Objects
Pickups Pickups Pills Pills Rooms Rooms Seeds Seeds Transformations Transformations Trinkets Trinkets