Immaculate Conception

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Item icon
Item altar
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Character appearance
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Angel Room Angel Room
Greed mode only Angel Room Angel Room
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Added in Afterbirth †(page 4, column 8, row 3)
Removed in Afterbirth †(page 4, column 8, row 3)
Immaculate Conception Complete the Boss Rush as LilithImmaculate ConceptionImmaculate Conception
Added in Afterbirth

Immaculate Conception is an unlockable passive item added in Afterbirth.

Effect[edit | edit source]

  • Upon picking up enough heart pickups, Isaac gains a permanent angelic familiar and generates a soul heart drop. Possible familiars include:
    • Holy Water Holy WaterCollectible Holy Water Rebirth icon.pngWhen 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.
    • Guardian Angel Guardian AngelCollectible Guardian Angel icon.pngSpawns an orbital familiar that blocks enemy projectiles, deals contact damage to enemies, and increases the speed of all orbital familiars.
    • Sworn Protector Sworn ProtectorSworn Protector Icon.pngAn orbital angel which does 7 contact damage per tick and blocks enemy shots. Upon blocking 10 shots in a room it drops an eternal heart.
    • The Relic The RelicCollectible The Relic icon.pngIsaac is followed by a small blue cross that will drop a Soul Heart every 4 rooms.
    • Seraphim SeraphimSeraphim Icon.pngAn angel familiar which follows Isaac and fires homing tears which deal 10 damage at -25% shot speed and a reduced fire rate.
  • The first and second familiars will spawn after picking up 15 heart pickups each. The third, fourth, and fifth familiars will spawn after picking up 30 heart pickups each. No further familiars will spawn.

Notes[edit | edit source]

  • Red, soul, black, and eternal hearts all count towards spawning a familiar.
  • Items that directly add health such as Yum Heart Yum HeartCollectible Yum Heart icon.png4 roomsRestores 1 whole red heart., Book of Revelations Book of RevelationsCollectible Book of Revelations icon.png6 roomsAdds 1 soul heart, increases the chance for a Devil or Angel Room to appear, and increases the chance for the next boss to be a Horseman (except on XL floors and floors with fixed bosses such as Mom)., Satanic Bible Satanic BibleCollectible Satanic Bible icon.png6 roomsUpon activation, Isaac gains a black heart., and The Nail The NailCollectible The Nail icon.png6 roomsAdds one soul heart and allows the breaking of rocks and damaging enemies by simply walking over them. Increases damage and decreases speed. All effects except for the Soul Heart wear off upon leaving the room. do not count towards spawning a familiar.
  • Only one of each type of familiar can be spawned.
  • This item is the angelic counterpart to Cambion Conception Cambion ConceptionCollectible Cambion Conception Afterbirth icon.pngAfter taking damage a certain amount of times, a permanent demonic familiar spawns..
  • The Lost can pick up soul and black hearts despite having no health and thus can activate Immaculate Conception.
  • Keeper cannot encounter hearts and thus the item is useless for him.

In-game Footage[edit | edit source]

Trivia[edit | edit source]

  • Immaculate Conception refers to the Catholic teaching that the conception of the Virgin Mary was free from original sin.

Lilith Unlocks Lilith Unlocks Lilith Unlocks
Added in Afterbirth †
IncubusIncubusDefeat Hush as LilithBox of FriendsBox of FriendsDefeat Ultra Greed as LilithBig BabyBig BabyDefeat Mega Satan as LilithRune BagRune BagDefeat Isaac as LilithCambion ConceptionCambion ConceptionDefeat ??? as LilithSerpent's KissSerpent's KissDefeat Satan as LilithSuccubusSuccubusDefeat The Lamb as LilithImmaculate ConceptionImmaculate ConceptionComplete the Boss Rush as LilithGoat Head BabyGoat Head BabyDefeat Mom's Heart on hard mode as LilithDark BabyDark BabyEarn all hard mode completion marks as Lilith EuthanasiaEuthanasiaDefeat Delirium as LilithDualityDualityDefeat Ultra Greedier as Lilith
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