| Hold 55 coins at one timeCain|
Cain is unlocked when the player is in possession of 55 or more coins at once in a run. He starts with two red heart containers, the Lucky Foot+1 Luck. Increases chance of winning Shell Game Beggar. (Independent of luck stat), and one key.
Cain will also start with the Paper ClipGolden Chests can be opened without using a key. trinket if 68 coins have been donated to the Greed Machine.
- Cain can only shoot tears from his right eye. This affects certain items: Blood ClotIncreases damage by 1 and range by 5 for tears fired from the left eye. and Chemical PeelTears fired from left eye do increased damage. have a 50% chance to do increased damage and Technology 2Decreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously. will prevent him from firing normal tears, even tear-changing effects like BrimstoneTears 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.. Also, the R U A Wizard? pill will cause Cain to fire tears to his right exclusively.
- Cain appeared in the original Binding of Isaac, and required the same coin count to unlock.
- Cain is a reference to the Biblical story of Cain and Abel, in which Cain commits the first murder by killing Abel.
- AbelA familiar that mirrors the player's movements and shoots in the opposite direction. also appears as an item in Rebirth.
- Glass Baby could be a reference to Cain having a glass eye.