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Health

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Health Stat Icon.png Health represents the amount of damage the player can take before dying. There are four different types of health in the game, each with their own pickups. The health bar is the visual representation of a player's health on the HUD.

  • The order in which hearts are placed is, from left to right, Red Hearts (and empty containers), Eternal Hearts, then Soul Hearts or Black Hearts (depending on the order in which they were picked up).
  • Hearts are generally lost from right to left: Last grabbed Black/Soul hearts, Eternal Hearts, then Red Hearts.
    • The exception to this rule are self-damaging items like Razor Blade, Devil Beggars and Blood Donation Machines, which always prioritize heart containers. From these sources, health is lost in the following order: Eternal Hearts, Red Hearts, then Soul/Black hearts.
  • The character can only hold a maximum of twelve hearts, and any permutation of the four different types can be used. Picking up a Black or Soul heart will refill a halved Black/Soul heart (the other half is then placed at its right); Soul Hearts can replenish Black hearts and vice versa.

Heart Containers[edit | edit source]

HUD Red Heart.pngHUD Half Red Heart.pngHUD Empty Red Heart.png Heart Containers, or Red Hearts, are the main form of health for the majority of characters. If the player has only Red Hearts, the containers will be unfilled as damage is taken (but the containers themselves remain). Empty Heart Containers can be refilled with red heart pickups. The number of heart containers can be increased with multiple items or Health Up pills or decreased with items, Health Down pills, having another player join a game as a baby, or trading them away in a Devil Room or at an underground Black Market.

Soul Hearts[edit | edit source]

HUD Soul Heart.png Soul Hearts are blue hearts that are appended to the end of the health bar. Unlike red hearts, soul hearts do not have containers, so once they're depleted, new ones must replace them. Losing soul hearts does not count as damage for the purposes of Devil Room or Angel Room appearance chances, but does count as damage taken for the achievements Basement Boy, Spelunker Boy, Dark Boy, Mama's Boy, and Dead Boy.

Black Hearts[edit | edit source]

HUD Black Heart.png Black Hearts are similar to Soul Hearts in that they are appended to the end of the health bar, are not permanent, and that losing them does not count as damage for the purposes of Devil or Angel Room chances. However, when a Black heart is depleted, The Necronomicon's effect is triggered, damaging all enemies in the current room. If Isaac is at his HP cap and any of his hearts are Soul Hearts, the Black Heart will replace the rightmost Soul Heart when picked up.

Eternal Hearts[edit | edit source]

HUD Eternal Red Heart.png Eternal Hearts are the rarest variation of a heart. They always appear as half-hearts and, once picked up, can transform into a new heart container in two ways: either by collecting a second Eternal Heart in the same level, or by traveling to the next floor. Eternal Hearts are not permanent, cannot be refilled when lost and do not count for the limit of twelve hearts, instead overlapping the rightmost red heart container. If no heart containers are available, the eternal heart will take the place of the leftmost soul heart or black heart. Health removal from Devil Room deals will not drain an Eternal Heart; rather, the Eternal Heart is appended onto the end of the next red heart. An Eternal Heart cannot keep Isaac alive on its own; taking a deal with the Devil which drains all hearts except the Eternal Heart will kill Isaac.

Gold Hearts DLC Indicator.png[edit | edit source]

HUD Gold Heart.png Gold Hearts are unlocked by completing the XXXXXXXXL challenge. Once picked up, the Gold Heart surrounds Isaac's rightmost heart. The Gold Heart does not prevent damage, but when the heart that the Gold Heart surrounds is depleted, several coins will spawn. Gold Hearts can be 'pushed off screen' if you have twelve hearts, at least one being a soul or black heart, and pick up a health up. Coins will not appear if this happens and the gold heart is lost.

Unlockable Achievements[edit | edit source]

Bugs[edit | edit source]

Bug Bug! Gold Hearts will be consumed if a self-damaging item is used to remove a Red Heart while the Gold Heart is surrounding a Soul/Black Heart.

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