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- Isaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
- Missiles deal 20 times Isaac's damage.
- Missiles benefit from most bomb-enhancing effects.
- Epic Fetus overrides most items in the game and has the highest priority of all of them, over Brimstone and Mom's Knife.
- On PC, using the mouse and keyboard when obtaining this item can be helpful due to the ability to precisely target a specific area in the room, avoiding the sensitivity of a joystick or the limited directions of the arrow keys.
- Isaac's tear delay determines how quickly a new missile or missile set can be fired after the previous one has landed. Barring very high tear delay, this has little effect on damage rate due to the delay of the missiles themselves.
- 20/20Grants double shot.: Makes two missiles drop one after the other.
- Blood ClotIncreases damage by 1 and range by 5 for tears fired from the left eye. / Chemical PeelTears fired from left eye do increased damage.: Each missile has a 50% chance to deal 20 or 40 points more damage, respectively.
- Bob's CurseGives 5 bombs and grants all bombs poison effect.: Grants each missile the poison effect.
- Butt BombsGives +5 bombs and makes all bombs Butt Bombs that fill the room with gas, damaging and confusing all enemies.: Each missile explosion applies the Butt Bombs effect.
- 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.: Fires 10 lasers with each explosion
- Conjoined (Transformation): Makes three missiles drop one after the other.
- The Forgotten: The charge attack is replaced by a missile in the Forgotten's hand and a crosshair that may be moved for an indefinite amount of time. The missile is thrown at the crosshair when all attack buttons are released, with an additional melee swing in the same direction. The melee attack is unaffected.
- HaemolacriaTears 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.: Damage increased by about 31%, though tear delay also increases considerably.
- Host 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.: Isaac becomes immune to his own airstrikes.
- Mysterious LiquidTears leave a small, short lasting pool of creep on impact or when their range is depleted.: Every explosion from a crosshair leave a small, lasting pool of creep.
- : The explosion leaves a large pool of green creep behind.
- Strange AttractorPickups, trinkets, and monsters are magnetically attracted to Isaac's tears.: Enemies get drawn towards the crosshair.
- Spoon BenderGrants Isaac homing tears.: Cursor slides towards enemies
- TechnologyReplaces tears with a piercing laser with unlimited range.: Explosion shoots technology beams in all directions, similar to Tammy's Head. When firing/moving the cursor, you still shoot your Technology laser.
- Technology 2Decreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.: Both the Technology 2 laser, and the Epic Fetus missiles will be active.
- Tech 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.: Explosion shoots technology beams in all directions, similar to Tammy's Head.
- 8 Inch Nails+1.5 Damage Up. Replaces Isaac's tears with nails, which have increased knockback.: Retains damage and knock back boost.
- Anti-Gravity-2 Tear Delay. Tears float in position until firing ceases, after which they will fly off in the direction they were shot in.: Overridden by Epic Fetus.
- Bomber 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.: Overridden by Epic Fetus.
- 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.: Overridden by Epic Fetus.
- : Lasers fire in all directions upon impact of a missile.
- Chocolate MilkGrants charged tears that deal greater damage when fully charged.: Slightly lowers tear delay, which has little impact with Epic Fetus.
- Cursed EyeGrants charged tears that can be fired in a tight burst of four. Getting hit while charging will teleport Isaac into another room.: Overridden by Epic Fetus.
- Dr. FetusTears are replaced by bombs that benefit from bomb-enhancing effects and slide for a fixed time after being fired.: Overridden by Epic Fetus.
- Fire 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.: Creates a fire every time a shot lands.
- Homing tears: Overridden by Epic Fetus.
- : Cross-hair slowly moves towards enemies.
- Hot BombsGrants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact.: Creates a fire every time a shot lands.
- The Inner EyeGrants triple shot but decreases tears.: Slower fire rate, each cross-hair will cause three consecutive air strikes to happen. The cross-hair may still be moved after the first one lands.
- IpecacReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth.: Greatly increases damage and turns missiles poisonous.
- IpecacReplaces tears with explosive and poisoning projectiles fired in an arc from the mouth. + Sad 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.: Tear Blast tears explode and can damage Isaac.
- Lilith: Blindfold is overridden by Epic Fetus.
- Loki's HornsGives a random chance for projectiles to fire in all 4 cardinal directions.: Four cross-hairs are produced around the player, firing four missiles instead of a single one. Having the Mutant Spider or the Inner Eye applies the same effect to each cross-hair.
- The 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.: Overridden by Epic Fetus.
- Monstro's LungIncreases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.: Overridden by Epic Fetus.
- Adds 2 to 4 more crosshairs that orbit the main crosshair and fires a missile onto each crosshair.
- Mom's EyeAllows Isaac to fire tears from the back of his head.: A second missile will be symmetrically fired at the player's opposite side.
- Mom'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.: Overridden by Epic Fetus.
- : Missiles explode into a circle of knives.
- Mutant SpiderGrants quadruple shot but decreases tears.: Slower fire rate, each cross-hair will cause four consecutive air strikes to happen. The cross-hair may still be moved after the first one lands.
- The ParasiteIsaac's tears split in two when they hit something.: No effect.
- Sad 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.: Missiles fire a burst of tears where they land. No effect on the tears fired by other bombs.
- Scatter BombsAdds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs.: Overridden by Epic Fetus.
- ScorpioGrants poison tears, which deal damage over time when inflicted.: Missiles become poisonous.
- Soy MilkTears shrink and do much less damage, but fire in very rapid succession.: Damage of missiles will be decreased accordingly, but unlike normal tears, the fire-rate will not increase.
- Tammy'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.: Fires only normal tears, not missiles.
- Tiny PlanetRange up and makes shot tears revolve around Isaac until they drop.: Overridden by Epic Fetus.
- The 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.: Control of the crosshair is rotated 45 degrees clockwise. Fires 2 missiles in rapid succession.
- Varicose VeinsTaking damage releases a ring of 10 high damage tears.: Fires only normal tears, not missiles.
- In the original game it was possible to control the crosshair with the mouse. This was removed in Rebirth.
- Mouse control can however be re-enabled by editing the
C:\Users\<username>\Documents\My Games\Binding of Isaac Afterbirth/Rebirthand changing the line
MouseControl=1. Also useful for The Ludovico Technique.
- Mouse control can however be re-enabled by editing the
- The Dr. Fetus and Epic Fetus items are based off of Dr. Fetus, the main villain in Super Meat Boy which is a game by Edmund McMillen (the creator of The Binding of Isaac: Rebirth).
- This item is used in Challenge #11 (Glass Cannon).
GOBD W8TB (Treasure Room adjacent to spawn)
8ETR M2M9 (First floor treasure room)
8G4J JFH8 (Treasure Room adjacent to spawn)
|The Binding of Isaac: Rebirth|
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