Health

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Health Damage Tears Range Shot Speed Speed Luck Hidden Attributes

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. If Isaac takes a heart that would heal him for more than his current maximum health (for example, taking a red heart when he is only missing half a red heart worth of health), the excessive health will be wasted. 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.pngHUD Half 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. If Isaac has red hearts and half a soul heart, taking a full heart of damage will not remove any red hearts. 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.pngHUD Half 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. If Isaac has 12 red heart containers and travels to a new floor with an eternal heart, Isaac will heal one red heart but will not gain another heart container. If Isaac is at full health, the eternal heart will simply disappear. 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. An Eternal Heart will be used up the first time Isaac takes red heart damage (but are not lost by taking red heart damage if Isaac has no red heart containers). This means that using a Blood Donation Machine or activated items like the Razor Blade will drain the Eternal Heart, even if Isaac has full health and Soul Hearts. 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 Added in Afterbirth[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 and enemies will be changed to gold statues, similar to Midas Touch effect. 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 still appear if this happens. Losing many hearts at once — for example, by picking up a Dead Cat or using a Hematemesis pill — will correspondingly trigger the Gold Heart effect many times at once and shower you with coins.

Bone Hearts Added in Afterbirth †[edit | edit source]

HUD Bone Heart.pngHUD Half Bone Heart.pngHUD Empty Bone Heart.png Bone hearts are special heart containers. They can be refilled with red hearts and take three hits to deplete, but disappear permanently upon depleting.

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.

Trivia[edit | edit source]

  • Upon entering a room with only half a heart left, a small yellow spot, presumably urine, will appear underneath Isaac.
    • If Isaac has Added in Afterbirth Kidney Stone Kidney Stone
      Kidney Stone Icon.pngRandomly while firing tears, Isaac will stop firing and turn red, where he will charge and release a lot of 'tears' in one go. In the burst of tears is a kidney stone which deals a lot of damage.
      , a bloodstain will appear instead of urine.
    • Added in Afterbirth † As Eve, a red bloodstain will appear instead of urine.
Isaac leaving a urine puddle at low health.


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