- Isaac's tears are replaced with a charged blood laser beam that pierces through all enemies and obstacles in its path.
- The laser deals damage equal to Isaac's damage each tick, and ticks a total of 13 times.
- This item belongs to the Leviathan set. Collecting three items from the set will transform Isaac into a Lovecraftian horror.
- Azazel starts the game with a short-ranged, slower charging version of Brimstone. Picking up Brimstone with him will give him the long ranged version. Without the long ranged version, his mini-brimstone won't have enough length to use any homing items. His mini-brimstone's range can be increased with range up items or pills.
- If multiple Brimstones are picked up (via Diplopia, Crooked Penny or on a victory lap), then another beam is added.
- 20/20: Overridden by Brimstone.
- Shoots two Brimstone lasers simultaneously without increasing charge time.
- 8 Inch Nails: Brimstone pushes enemies away in the direction the beam is travelling, but not out of the path of the beam.
- A Lump of Coal: Changes the color, but does not have an effect on damage.
- Beam will gradually increase in size but rapidly increase damage the farther it travels, on a multiplier that is roughly +20% per tile of distance. This allows for a huge damage increase from longer distances.
- Chocolate Milk: Decreases charge time slightly, but does not increase damage.
- Continuum: Overridden by Brimstone.
- Cursed Eye: Overridden by Brimstone.
- Dr. Fetus: Overrides Brimstone.
- Isaac shoots bombs while charging Brimstone.
- Epic Fetus: Overrides Brimstone.
- After the missile hits the ground, it spawns 10 Brimstone beams similar to the effect given by Sad Bombs. Azazel's mini-brimstone does not give the Sad Bombs effect.
- Evil Eye: Overridden by Brimstone.
- Fire Mind: Beam inflicts burning, but cannot cause explosions or leave fires on the ground.
- Flat Worm: No effect.
- Holy Light: Overridden by Brimstone.
- Hook Worm: Beam changes angles while firing straight, but also effectively increases the width of the beam.
- Ipecac: The character gains neither the increased damage nor the decreased tears of Ipecac. They only gain the minor poison effect.
- Isaac shoots Ipecac tears while charging Brimstone. Both Brimstone and Ipecac shots modify Isaac's damage and tear delay stat, meaning that Ipecac fires slower and Brimstone charges slower, but Brimstone does an extra 40*13 damage. Take care to pre-charge Brimstone so that the Ipecac shot is on cooldown as Isaac enters a room.
- Isaac's Tears: Fires normal tears, but nearly instantly charges when charging Brimstone.
- Jacob's Ladder: Overridden by Brimstone.
- Monstro's Lung: Overridden by Brimstone.
- Fires 3-5 additional Brimstone lasers in random directions around Isaac. Does not increase charge time. Charging a new Brimstone laser removes the original from in front of the player, but not the additional ones added by Monstro's Lung. This effectively increases fire rate.
- My Reflection: Overridden by Brimstone.
- Makes the beam curve when moving. Has the same effect on Azazel's mini-brimstone but doubles the range.
- Mysterious Liquid: Overridden by Brimstone.
- When Brimstone hits enemies or walls it leaves creep based on how long it hits.
- Ouija Board: Overridden by Brimstone.
- Pupula Duplex: Overridden by Brimstone.
- Rubber Cement: Lasers ricochet off walls.
- Soy Milk: Greatly reduces Brimstone charge time and damage.
- Technology: Overridden by Brimstone.
- Brimstone beams become surrounded with swiveling Technology laser beams, granting a 1.5x damage multiplier.
- Technology 2: Laser fires while Brimstone is charging.
- The Parasite: Overridden by Brimstone.
- Wiggle Worm: Makes the beam wavy.
- Apple! / Euthanasia / Tough Love: The beam can gain the damage multiplier from each of the items, although there is no visual difference. The bonus applies for the whole beam and not on a per-tick basis. Euthanasia loses its instant kill ability, however.
- Anti-Gravity: An orb of energy expands, then shrinks while firing the beam after a delay. The orb still hurts enemies if they touch it. Makes it harder to hit enemies with Azazel as the laser does not increase in range. Effectively allows a faster firing rate, since Isaac can start charging a new shot immediately after releasing the fire key without cancelling the first shot and is a great combo with soy milk
- Incubus won't fire delayed Brimstone shots and will fire regular Brimstone shots instead.
- Dark Matter: Beam will have a chance to cause fear.
- Diplopia: Picking up two Brimstones will make Isaac simultaneously fire two lasers, similar to the 20/20 effect.
- God's Flesh: Chance to shrink enemies and turns the beam indigo.
- Guppy: Flies are spawned at a rate of approximately one fly per tick of damage for each enemy it hits. This causes a lot of flies to spawn very quickly. The spawned flies will also move to attack the targeted enemy immediately.
- Loki's Horns: Occasionally causes Isaac to fire the beam in all four cardinal directions, similarly to Head of Krampus's effect.
- The Ludovico Technique: The laser becomes a large ring that is controllable and does not need to be charged. Enemies inside the ring without touching it are not hurt. Shot speed is ignored. The Tears stat is ignored and damage is dealt very rapidly at a rate equivalent to 2 tear delay.
- The Mulligan: Spawns blue flies constantly when hitting an enemy.
- Mom's Eye: Sometimes shoots a laser from the back of Isaac's head.
- Mom's Knife: Adds a small barrage of knives after the main knife is fired, with each knife doing 80% of Isaac's base damage. The barrage of knives goes all the way across the screen and increases in quantity the longer the charge.
- Mom's Wig: Holding down a fire button to charge the attack very rapidly rolls the probability to spawn blue spiders, releasing to fire the beam however, does not.
- Monstro's Lung - Causes Isaac to fire multiple beams in random directions.
- Mutant Spider: Increases charge time but fires four separate Brimstone beams instead of one. Azazel's beams overlay each other instead of spreading out, causing additional damage.
- Number One: Greatly decreases charge time and turns beam yellow.
- Polyphemus: Significantly increases damage and increases charge duration.
- Proptosis: Damage is doubled with no drop-off at range.
- Range is unchanged, but damage quickly drops further along the beam. This also affects the beams produced by Tammy's Head.
- Sacred Heart: Increases damage and makes laser home in on enemies.
- Sad Bombs: Changes the tears fired by bombs upon their explosions to Brimstone beams, in a manner identical to its synergy with Tammy's Head.
- Spider Bite: Slow effect persists and turns the beam color to light pink.
- Spoon Bender: Turns beam purple and makes it curve towards enemies similar to The Gate's. Azazel's mini-brimstone charge will become purple, but will not home.
- Strange Attractor: Enemies are sucked towards the beam, increasing damage significantly. Consumables will also be moved by the beam.
- Tammy's Head: Fires Brimstone beams in every direction.
- Tech X: Brimstone now becomes a large ring that varies in size depending on how long it is charged before firing.
- The Common Cold: Beam turns green and poisons enemies.
- The Inner Eye: Produces 3 beams and greatly increases charge time.
- Tiny Planet: The beam will wrap around the character and shoot straight forward.
- The term brimstone (burn stone) comes from the King James Bible in reference to burning sulfur. It is used in the phrase "fire and brimstone" to describe the torments of hell.
- Brimstone's item icon originally comes from the alchemical symbol for sulfur, referred to as the Leviathan Cross. It was later adopted by Anton LaVey in The Satanic Bible to represent hell, and is now often associated with Satanism.
- The ram horns gained from picking up Brimstone were added as a cosmetic item to Team Fortress 2 to promote The Binding of Isaac: Rebirth. If the game was purchased before the 10th of December, players were awarded the item in genuine quality
DQY7 QK7M (Basement XL: Second boss's devil room) (Hard Mode)
HM12 QGTW (Curse room adjacent to spawn teleports to devil room)
QW44 N10D (Second floor devil room; Isaac may proceed normally, but all other characters must not enter the first floor treasure room) (Normal and hard mode)
B8TK KNEP (Second floor devil room) (Normal and hard mode)
LHVK 9NTS (Second floor devil room)
SSH7 STDS (Second Floor Devil Room)
DBDR SJGV (First Floor Devil Room) (Hard Mode)
Mac CE2R R2BZ (Second floor devil room) (Normal and hard mode)
The Ludovico Technique with Brimstone
Tiny Planet with Brimstone as Azazel
Skatole, tears, Brimstone and Tiny Planet being tested as promo items in Team Fortress 2
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