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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 Red Heart 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 is self-damaging items like Razor Blade Razor Blade, Devil Beggars and Blood Donation Machines, which always prioritize Red 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.

Red Heart Containers[edit | edit source]

Full red heartHalf red heartEmpty red heart

Red 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 Red 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 Red 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]

Full soul heartHalf soul heart

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 Devil Room or Angel Room appearance chances, but does count as damage taken for the Basement Boy, Spelunker Boy, Dark Boy, Mama's Boy, and Dead Boy achievements.

Black Hearts[edit | edit source]

Full black heartHalf black heart

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 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]

Empty red heart

Eternal Hearts are the rarest variation of a heart. They always appear as half-hearts and, once picked up, can transform into a new Red Heart container in two ways: either by collecting a second Eternal Heart at 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 of overlapping the rightmost Red Heart container. If no Red 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 is 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; making a deal with the Devil which drains all hearts except the Eternal Heart will kill Isaac.

Gold Hearts Added in Afterbirth[edit | edit source]

Empty red heart

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 Pennies 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, Black, or Bone Heart, and pick up a health up. Pennies 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.

Coin Hearts Added in Afterbirth[edit | edit source]

Full coin heartEmpty coin heart

Coin Hearts are a special heart type used exclusively by Keeper. Coin Hearts always take double damage. They can only be replenished by picking up coins, which will consume one cent from the coin pickup for each heart restored. They are treated as Red Hearts for most items and can be sold in Devil deals or Black Markets. See Keeper#Notes for more information.

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

Full bone heartHalf bone heartEmpty bone heart

Bone Hearts are special Red Heart containers unlocked alongside The Forgotten, and are appended to the end of the health bar. Empty containers can be filled with Red Hearts and filled containers take three hits to deplete (or two hits against sources that deal a full heart of damage), but disappear permanently upon depleting. Bone Hearts, empty or full, are considered Red Hearts by most items but cannot be used for Devil deals or Black Markets. Bone Hearts will be emptied when picking up items that remove all Red Hearts, such as Abaddon Abaddon and Brittle Bones Brittle Bones. Losing Bone Hearts or the Red Hearts contained within will not affect the chance to find a Devil Room or Angel Room, with the exception of The Forgotten who receives a penalty for a Bone Heart breaking. Acquiring an empty Red Heart container while you have a filled Bone Heart will fill the new heart and empty the Bone Heart. Blue Baby can pick up Bone Hearts, but cannot fill them with Red Hearts.

Unlockable Achievements[edit | edit source]

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 AfterbirthKidney Stone Kidney Stone, 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.

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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