Familiar

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Familiars are small companions, usually generated by passive items, that follow and assist the character. Effects of familiars include (but are not limited to) pickup generation, shooting familiars that fire their own tears at enemies, and orbitals that act as projectile shields and/or deal contact damage.

Temporary familiars[edit | edit source]

Blue Flies[edit | edit source]

Blue Fly.png

Blue Flies are familiars that will orbit around Isaac and rush towards nearby enemies, dealing damage and dying in the process. Blue flies deal double Isaac's current tear damage.

Name ID Icon Quote Description Recharge
Compost Afterbirth† Indicator.png 480 Compost Icon.png Gain more friends! Spawns a blue spider or fly. Turns pickups in the room into blue spiders or flies. 2
Guppy's Head 145 Guppy's Head Icon.png Reusable fly hive Spawns 2-4 blue flies to damage enemies. 1
Jar of Flies DLC Indicator.png 434 Jar of Flies Icon.png Gotta catch 'em all? Every 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. 0
Name ID Icon Quote Description
Infestation 148 Infestation Icon.png They grow inside 1-3 Blue flies randomly spawn every time Isaac gets hit.
The Mulligan 151 The Mulligan Icon.png They grow inside Tears have a 1/6 chance of spawning allied blue flies when they hit an enemy.
Rotten Baby 268 Rotten Baby Icon.png Infested friend A familiar that spawns blue flies.
Parasitoid Afterbirth† Indicator.png 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.
Name ID Icon Quote Description
Fish Head 29 Fish Head Icon.png It stinks Spawns a blue fly every time Isaac takes damage.
Lil Larva DLC Indicator.png 86 Lil Larva Icon.png The poop is moving... Spawns a blue fly from every pile of poop Isaac destroys.

Other sources of Blue Flies

  • Red Chests: Has a chance to spawn 3 blue flies.
  • Dark Blue Champion: Will create 3 blue flies when defeated.
  • Guppy transformation: Isaac will create blue flies whenever his tears hit enemies.
  • Beelzebub transformation: All enemy flies become blue flies.
  • Rune of Berkano: Spawns 3 blue flies and 3 blue spiders upon use.
  • DLC Indicator.png "Friends Till The End!" Pill: Spawns three blue flies.
  • DLC Indicator.png As Keeper, all heart pickups turn into blue flies.

Locusts Afterbirth† Indicator.png[edit | edit source]

Red Fly.png Green Fly.png Yellow Fly.png Black Fly (Familiar).png White Fly.png

Locusts are variants of Blue Flies that are spawned by Locust trinkets. They behave like regular Blue Flies but have additional special effects.

Name ID Icon Quote Description
Locust of War Afterbirth† Indicator.png 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.
Locust of Pestilence Afterbirth† Indicator.png 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 Famine Afterbirth† Indicator.png 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 Death Afterbirth† Indicator.png 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 Conquest Afterbirth† Indicator.png 117 Locust of Conquest Icon.png I bring conquest Upon entering a room with enemies, spawns 2-5 White Locusts which damage enemies.

Blue Spiders[edit | edit source]

Blue Spider.png

Blue Spiders are familiars similar to blue flies that crawl erratically and rush towards nearby enemies, dealing damage and dying in the process. Blue spiders deal 2.5 times Isaac's current tear damage. Unlike blue flies, blue spiders cannot attack over obstacles such as rocks and pits.

Bug Bug!  3DS  Exiting the game and re-entering will cause all blue spiders to disappear.
Name ID Icon Quote Description Recharge
Box of Spiders 288 Box of Spiders Icon.png It's a box of spiders Summons 2-4 blue spiders. 2
Compost Afterbirth† Indicator.png 480 Compost Icon.png Gain more friends! Spawns a blue spider or fly. Turns pickups in the room into blue spiders or flies. 2
Name ID Icon Quote Description
Dark Bum 278 Dark Bum Icon.png He wants to take your life Spawns 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.
Infestation 2 234 Infestation 2 Icon.png Infestation shot Spawns allied blue spiders from killed enemies.
Juicy Sack 266 Juicy Sack Icon.png Sticky babies A familiar that follows behind Isaac. It drips a trail of creep, which slows enemies, and spawns 1-2 blue spiders after each room.
Louse DLC Indicator.png 70 Louse.png Itchy, tasty... Occasionally spawns a Blue Spider.
Mom's Wig 217 Mom's Wig Icon.png You feel itchy... Adds a chance to spawn blue spiders when firing tears. Restores 1 red heart.
Parasitoid Afterbirth† Indicator.png 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.
Sissy Longlegs 280 Sissy Longlegs Icon.png She loves you Wanders about the room, occasionally spawning blue spiders.
Spider Baby 211 Spider Baby Icon.png Spider revenge When hit, spawns up to 2 blue spiders.
Spider Mod DLC Indicator.png 403 Spider Mod Icon.png Mod buddy! 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.
Sticky Bombs DLC Indicator.png 367 Sticky Bombs Icon.png Egg sack bombs! +5 bombs. Bombs stick to enemies and spawn 2-4 blue spiders if they kill an enemy.

Other sources of Blue Spiders

  • Rune of Berkano: Spawns 3 blue flies and 3 blue spiders upon use.
  • Infested? pill: Spawns blue spiders equal to the number of enemies in the room.
  • Infested! pill: Spawns a blue spider under Isaac and every pile of poop in the room.

Chasing familiars[edit | edit source]

Familiars in this category actively chase enemies, dealing contact damage to them.

Name ID Icon Quote Description Recharge
The Pinking Shears 107 The Pinking Shears Icon.png Cut and Run Separates 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. 6
Name ID Icon Quote Description
Ball of Bandages 207 Ball of Bandages Icon.png Gotta lick 'em all! Orbiting 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.
Bumbo DLC Indicator.png 385 Bumbo Icon.png Bumbo want coin! Spawns 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.
Cube of Meat 73 Cube of Meat Icon.png Gotta meat 'em all! Orbiting 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.
Daddy Longlegs 170 Daddy Longlegs Icon.png Daddy's love Daddy Long Legs' shadow follows Isaac and stomps on enemies.
Dead Bird 117 Dead Bird Icon.png Protective buddy Spawns a flying familiar for the current room that chases enemies whenever Isaac takes damage.
Eve's Bird Foot 60 Eve's Bird Foot Icon.png Revenge from beyond 5% chance to spawn a Dead Bird familiar for the current room each time an enemy dies.
Gemini 318 Gemini (Item) Icon.png Conjoined friend Suture becomes attached to Isaac, and does touch damage to enemies within its attacking range.
Leech 270 Leech Icon.png Blood sucker Spawns a friendly familiar leech on the ground that hunts down enemies and heals you for half a heart each time it eats one.
Lil Haunt 277 Lil Haunt Icon.png Fear him A familiar that damages enemies by chasing them as well as inducing the fear effect.
Smart Fly 264 Smart Fly Icon.png Revenge fly After 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.

Note: Only third and fourth stage Cube of Meat and Ball of Bandages chase enemies.

Note: Only fourth stage Bumbo chases enemies.

Orbital familiars[edit | edit source]

Familiars that orbit Isaac, absorbing enemy projectiles and dealing contact damage.

Name ID Icon Quote Description
Ball of Bandages 207 Ball of Bandages Icon.png Gotta lick 'em all! Orbiting 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.
Best Bud 274 Best Bud Icon.png Sworn protector When hit, summons a white attack fly similar to Distant Admiration for the current room.
Big Fan 279 Big Fan Icon.png Fat protector Spawns a large orbital familiar that blocks enemy projectiles and deals slight contact damage to enemies.
Bloodshot Eye Afterbirth† Indicator.png 509 Bloodshot Eye Icon.png Bloody friend Spawns an orbiting eye familiar that fires tears every 2 seconds.
Cube of Meat 73 Cube of Meat Icon.png Gotta meat 'em all! Orbiting 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.
Distant Admiration 57 Distant Admiration Icon.png Attack fly A red attack fly circles further out than the Halo of Flies / Pretty Flies, but closer than Forever Alone. Deals more damage than Forever Alone.
Forever Alone 128 Forever Alone Icon.png Attack fly Spawns a blue attack fly that orbits a long distance from Isaac.
Friend Zone DLC Indicator.png 364 Friend Zone Icon.png Friendly fly A 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.
Guardian Angel 112 Guardian Angel Icon.png Extra protection Spawns an orbital familiar that blocks enemy projectiles, deals contact damage to enemies, and increases the speed of all orbital familiars.
Halo of Flies 10 Halo of Flies Icon.png Projectile protection Spawns two pretty fly familiars that block enemy shots and deal contact damage to enemies.
Mom's Razor Afterbirth† Indicator.png 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.
Sacrificial Dagger 172 Sacrificial Dagger Icon.png My fate protects me Dagger orbits Isaac, dealing very high damage.
Smart Fly 264 Smart Fly Icon.png Revenge fly After 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.
Sworn Protector DLC Indicator.png 363 Sworn Protector Icon.png Protective friend An orbital angel which does 7 contact damage per tick and blocks enemy shots. When it blocks a shot, it has a very small chance to drop an eternal heart.

Pills / Slot Machine[edit | edit source]

Name Description
Pretty Fly Grants 1 fly orbital that circles the player, blocking projectiles and damaging fly-type enemies on touch.

Notes[edit | edit source]

  • A maximum of three Pretty Flies can orbit around Isaac.
  • Cube of Meat, Ball of Bandages, and Sacrificial Dagger take up a pretty fly slot.
    • For example, If Isaac has three pretty flies and picks up a Cube of Meat, the Cube of Meat will replace one of the flies.
    • Only first and second stage Cube of Meat and Ball of Bandages are orbitals. Therefore, upgrading from level 2 to level 3 will free up a pretty fly slot.
  • Duplicated orbitals, such as Forever Alone being copied with the Box of Friends or Diplopia, will fly directly opposite the original (having three copies will cause them to fly 120 degrees apart, four will fly at 90 degrees and so on).

Trivia[edit | edit source]

  • Pretty fly is a play on the phrase "pretty fly" as a descriptor.

Pickup generation familiars[edit | edit source]

Familiars that generate pickups when certain conditions are met.

Name ID Icon Quote Description
Acid Baby Afterbirth† Indicator.png 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.
Bomb Bag 131 Bomb Bag Icon.png Gives bombs Isaac is followed by a small bag that drops a Bomb, 1+1 Free, or a Troll Bomb every 3 rooms.
Bumbo DLC Indicator.png 385 Bumbo Icon.png Bumbo want coin! Spawns 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.
Bum Friend 144 Bum Friend Icon.png He's greedy A portable beggar who follows Isaac, picks up coins for himself, and occasionally drops a pickup after collecting a coin. Does not spawn collectibles.
Charged Baby DLC Indicator.png 372 Charged Baby Icon.png Bbbzzzzzt! A familiar baby that drops a battery every 4 rooms. Has a small chance to freeze all enemies in the room when hit.
Dark Bum 278 Dark Bum Icon.png He wants to take your life Spawns 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.
Key Bum DLC Indicator.png 388 Key Bum Icon.png He wants your keys! Spawns a portable key master that follows Isaac and collects keys, giving random chests in return.
Little C.H.A.D. 96 Little C.H.A.D. Icon.png Gives kisses A familiar who will drop a half Heart every 2 rooms.
Mystery Sack 271 Mystery Sack Icon.png ? Spawns a familiar that follows Isaac around and has a chance to drop a heart, coin, bomb, or key after clearing a room.
The Relic 98 The Relic Icon.png Soul generator Isaac is followed by a small blue cross that will drop a Soul Heart every 4 rooms.
Rune Bag DLC Indicator.png 389 Rune Bag Icon.png Rune generator A bag that follows Isaac and drops a random mystic rune every 3 rooms.
Sack of Pennies 94 Sack of Pennies Icon.png Gives money Isaac is followed by a small bag that drops a coin every 2 rooms.
Sack of Sacks Afterbirth† Indicator.png 500 Sack of Sacks Icon.png Gives Sacks! Spawns a sack familiar that has a chance to drop a sack upon clearing a room.

Spawning familiars[edit | edit source]

Familiars that spawn friendly Blue Spiders or Blue Flies.

Name ID Icon Quote Description
Dark Bum 278 Dark Bum Icon.png He wants to take your life Spawns 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.
Juicy Sack 266 Juicy Sack Icon.png Sticky babies A familiar that follows behind Isaac. It drips a trail of creep, which slows enemies, and spawns 1-2 blue spiders after each room.
Rotten Baby 268 Rotten Baby Icon.png Infested friend A familiar that spawns blue flies.
Sissy Longlegs 280 Sissy Longlegs Icon.png She loves you Wanders about the room, occasionally spawning blue spiders.

Shooting familiars[edit | edit source]

Familiars that attack with their own tears as long as Isaac is attacking or charging a shot.

Name ID Icon Quote Description Recharge
Scissors 325 Scissors Icon.png Lose your head Upon use, turns Isaac's head into a stationary familiar for the current room which fires normal tears that deal 3.5 damage. NoDLC Indicator.png6
DLC Indicator.png2
Name ID Icon Quote Description
???'s Soul 57 Blue Baby's Soul Icon.png Imaginary Friend Spawns a familiar that floats slowly around the room on a pattern similar to The Peeper and fires spectral and homing tears.
Abel 188 Abel Icon.png Mirrored buddy A familiar that mirrors the player's movements and shoots in the opposite direction.
Ball of Bandages 207 Ball of Bandages Icon.png Gotta lick 'em all! Orbiting 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.
Brother Bobby 8 Brother Bobby Icon.png Friends 'till the end Follows Isaac around shooting normal tears.
Buddy in a Box Afterbirth† Indicator.png 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.
Cain's Other Eye 319 Cain's Other Eye Icon.png Near sighted friend Spawns 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.
Cube of Meat 73 Cube of Meat Icon.png Gotta meat 'em all! Orbiting 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.
Demon Baby 113 Demon Baby Icon.png Auto-turret friend Follows Isaac and automatically fires at enemies in its reach.
Fate's Reward DLC Indicator.png 361 Fate's Reward Icon.png Your fate beside you A blue head familiar that will follow Isaac and fire tears copying his tear effects and damage.
Ghost Baby 163 Ghost Baby Icon.png Spectral buddy Spawns a familiar that follows Isaac around and fires spectral tears.
Harlequin Baby 167 Harlequin Baby Icon.png Double shot buddy Spawns a familiar that follows Isaac around and fires two tears at once in a V-pattern.
Incubus DLC Indicator.png 360 Incubus Icon.png Dark friend A demonic familiar that follows Isaac and shoots tears identical to Isaac's in terms of damage, range, fire rate, and effects.
Isaac's Head 54 Isaac's Head Icon.png Dead friend Gives the player Isaac's severed head as a tear-firing familiar. Fires piercing tears.
Lil Brimstone 275 Lil Brimstone Icon.png Evil Friend A Familiar that shoots a small Brimstone beam. Must charge like the Brimstone Item before shooting.
Lil' Loki DLC Indicator.png 435 Lil' Loki Icon.png 4-way buddy! A Loki familiar that follows Isaac and shoots 4 tears in a cross pattern.
Lil Monstro Afterbirth† Indicator.png 471 Lil Monstro Icon.png Ain't he cute? Spawns a familiar that fires clusters of tears. Must be charged before shooting.
Little Gish 99 Little Gish Icon.png Sticky friend Spawns a familiar that follows Isaac around and fires slowing tears, impeding enemies' speed.
Little Steven 100 Little Steven Icon.png Psychic friend Spawns a familiar that follows Isaac around and fires homing tears.
Mongo Baby 322 Mongo Baby Icon.png Mongo Friend Summons a familiar that copies the tears of Isaac's other familiars.
Rainbow Baby 174 Rainbow Baby Icon.png Random buddy Spawns a familiar that follows Isaac around and fires tears with random effects.
Robo-Baby 95 Robo-Baby Icon.png Friends 'till the bbbbzzzt Follows Isaac around, shooting enemies with an eye laser similar to Technology.
Robo-Baby 2.0 267 Robo-Baby 2.0 Icon.png We worked out all the kinks Fires lasers at any enemy in its line of sight and moves based on the direction Isaac is firing tears.
Seraphim DLC Indicator.png 390 Seraphim Icon.png Sworn friend An angel familiar which follows Isaac and fires homing tears which deal 10 damage at -25% shot speed and a reduced fire rate.
Sister Maggy 67 Sister Maggy Icon.png Friends 'till the end A familiar that follows Isaac around shooting blood tears.
Umbilical Cord 33 Umbilical Cord Icon.png Fetal Protection When Isaac's health is brought to half a red heart and no soul hearts, a Little Steven familiar spawns for the current room.

Note: Only second stage Cube of Meat and Ball of Bandages shoot tears.
Note: Demon Baby shoots tears even when Isaac is not attacking.

Others[edit | edit source]

Familiars that don't fit into any of the above categories or that produce multiple effects.

Name ID Icon Quote Description Recharge
Brown Nugget Afterbirth† Indicator.png 504 Brown Nugget Icon.png Friendly fly Spawns a stationary fly familiar that fires tears at nearby enemies. 7 seconds
Sprinkler Afterbirth† Indicator.png 516 Sprinkler Icon.png Sprinkles. Upon use, spawns a sprinkler that rotates and fires tears. 4
Name ID Icon Quote Description
1up! 11 1up! Icon.png Extra life Gives an extra life. Upon death, you will respawn in the previous room with full health and lose the 1up!.
Angry Fly Afterbirth† Indicator.png 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.
BBF 272 BBF Icon.png Big Beautiful Fly Spawns 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.
Big Chubby Afterbirth† Indicator.png 473 Big Chubby Icon.png Chub chub Spawns a familiar that slowly charges forward and damages enemies in its path.
Bob's Brain 273 Bob's Brain Icon.png Explosive thoughts Spawns a familiar that charges forward when shooting tears, explodes upon contact with an enemy and poisons them. Respawns after few seconds.
Censer DLC Indicator.png 387 Censer Icon.png Peace be with you Gives Isaac a golden censer familiar which creates a huge aura of light that slows down any enemies and enemy shots inside it.
Dead Cat 81 Dead Cat Icon.png 9 lives Sets 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.
Depression Afterbirth† Indicator.png 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.
Dry Baby 265 Dry Baby Icon.png Immortal Friend Spawns a familiar that follows Isaac around and blocks enemy projectiles. Upon blocking a shot, it has a chance of triggering The Necronomicon effect.
Farting Baby DLC Indicator.png 404 Farting Baby Icon.png It farts! A 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.
Finger! Afterbirth† Indicator.png 467 Finger! Icon.png Watch where you point that! Spawns a finger familiar that points at enemies, dealing constant damage.
GB Bug DLC Indicator.png 405 GB Bug Icon.png Game breaking bug, right away! A 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.
Guppy's Hair Ball 187 Guppy's Hair Ball Icon.png Swing it Loosely follows behind Isaac. Can be swung like a flail by rapidly spinning Isaac in a circle. Grows bigger by killing enemies.
Headless Baby 269 Headless Baby Icon.png Bloody Friend Familiar that follows Isaac, leaving blood creep on the ground.
Holy Water 178 Holy Water Icon.png Splash! When 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.
Hushy Afterbirth† Indicator.png 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.
Isaac's Heart 276 Isaac's Heart Icon.png Protect It Isaac himself is now immune to all damage, and a heart familiar appears and follows Isaac. If the heart is hurt, Isaac is hurt.
Key Piece 1 238 Key Piece 1 Icon.png ??? Combined with Key Piece 2, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.
Key Piece 2 239 Key Piece 2 Icon.png ??? Combined with Key Piece 1, unlocks the golden gate in the starting room of The Chest and Dark Room to fight Mega Satan.
King Baby Afterbirth† Indicator.png 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.
Lil Delirium Afterbirth† Indicator.png 519 Lil Delirium Icon.png He's delirious Grants a familiar that transforms into another random familiar every 10 seconds.
Lil Gurdy DLC Indicator.png 384 Lil Gurdy Icon.png A gurd of your own! Gives 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.
Little Chubby 88 Little Chubby Icon.png Attack Buddy A familiar that charges forward and deals touch damage to any enemies in its path.
Lost Fly DLC Indicator.png 365 Lost Fly Icon.png Lost protector A 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.
Milk! DLC Indicator.png 436 Milk! Icon.png Don't cry over it... 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.
Mom's Toenail 16 Mom's Toenail Icon.png ??? Mom's foot randomly stomps down somewhere in the room. 1 minute intervals.
Multidimensional Baby DLC Indicator.png 431 Multidimensional Baby Icon.png ydduB Buddy Spawns 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.
Obsessed Fan DLC Indicator.png 426 Obsessed Fan Icon.png Follows my every move... A purple fly familiar that follows Isaac's movements on a 3 second delay and deals contact damage to enemies.
Papa Fly DLC Indicator.png 430 Papa Fly Icon.png Turret follower A blue fly familiar follows Isaac's movements on a 3 second delay. Papa Fly will fire tears at nearby enemies.
The Peeper 155 The Peeper Icon.png Plop! Spawns a familiar that floats slowly around the room on a zig-zag pattern similar to Boom Flies damaging enemies it passes through.
Punching Bag 281 Punching Bag Icon.png Scape Goat Spawns a Mulligan Familiar that will wander the room randomly. Enemies will attack the Mulligan if it's closer.
Samson's Chains 321 Samson's Chains Icon.png The ol' ball and chain Pull a chain and ball behind you that will damage enemies on contact and is able to break stones.
Shade Afterbirth† Indicator.png 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.
Spider Mod DLC Indicator.png 403 Spider Mod Icon.png Mod buddy! 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.
Succubus DLC Indicator.png 417 Succubus Icon.png Damage booster Spawns 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.
Tonsil Afterbirth† Indicator.png 97 Tonsil Icon.png Sick... When hit, there is a small chance a removed tonsil familiar starts following Isaac, blocking enemy shots.
YO LISTEN! Afterbirth† Indicator.png 492 YO LISTEN! Icon.png Yo listen! Increases luck. Spawns a fairy familiar that points out secret room entrances and tinted rocks.

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