Item

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Items are an integral part of game-play in The Binding of Isaac: Rebirth. They modify Isaac's attributes, grant or modify tear effects, and much more.

Items are classified into a number of distinct types and groups. Some items are passive, which add an effect permanently to Isaac, while others only activate when used. The original Binding of Isaac had 196 items. Rebirth has as a total of 341 items. Afterbirth added 95 new items, for a total of 436 items. Afterbirth † has added 68 new items, for a total of 504 items. Only 13 items are considered special.

Similar to items are cards and runes, pills, and trinkets.

For a list of which items can potentially appear in a given Special Room, see Item Pool.

For the grids of items that appear in the stats menu, see Collection Page.


Activated Collectibles

Name ID Icon Quote Description Recharge
Anarchist Cookbook 65 Anarchist Cookbook Icon.png Summon bombs Spawns six troll bombs around the room. 3
The Bean 111 The Bean Icon.png Toot on command Isaac releases bad gas, poisoning any enemy in close vicinity. 1
Best Friend 136 Best Friend Icon.png Friends 'till the end Deploys a decoy Isaac that eventually explodes with an increased blast radius. 3
The Bible 33 The Bible Icon.png Temporary Flight Upon activation, Isaac gains flight, allowing him to pass over all obstacles in the current room. Instantly kills Mom, Mom's Heart, and It Lives when activated, but will kill Isaac when activated while fighting Satan. 6
Blank Card 286 Blank Card Icon.png Card Mimic Has the same effect as the card or rune currently held by Isaac. 4
Blood Rights 186 Blood Rights Icon.png Mass enemy damage at a cost Damages all enemies in the room, but deals a heart of damage to Isaac with each use. 0
Bob's Rotten Head 42 Bob's Rotten Head Icon.png Reusable ranged bomb Upon use, Isaac holds a poison bomb which can be thrown towards any of the four cardinal points and explodes on impact. 3
The Book of Belial 34 The Book of Belial Icon.png Temporary DMG up Upon use increases damage by 2 for the current room and by a further +50% if the character also has the Blood of the Martyr.
NoDLC Indicator.png Guarantees a Devil Room or Angel Room will be open after beating a boss while holding it.
DLC Indicator.png Increases the chance for a Devil or Angel Room to appear by 12.5%.
3
Book of Revelations 78 Book of Revelations Icon.png Reusable soul protection Adds 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). 6
Book of Secrets 287 Book of Secrets Icon.png ?????? Upon use, gives the effect of Treasure Map, The Compass, or Blue Map for the duration of the current floor. 6
Book of Shadows 58 Book of Shadows Icon.png Temporary Invincibility Upon use, creates a protective shield nullifying all types of damage for 10 seconds. 3
The Book of Sin 97 The Book of Sin Icon.png Reusable Item Generator Spawns a random pickup, pill, card, or trinket. 4
The Boomerang 338 The Boomerang Icon.png It will never leave you Throws a short-range boomerang which does a bit of damage and has a high chance to stun the enemy for 2 seconds. Can also be used to grab pickups. 4 seconds
Box of Spiders 288 Box of Spiders Icon.png It's a box of spiders Summons 2-4 blue spiders. 2
Breath of Life 326 Breath of Life Icon.png Invincibility at a cost Grants a brief moment of invincibility when the charge bar hits zero. If spacebar is held for an additional second after hitting zero, Isaac will take damage. 6; 1 per second
Butter Bean 294 Butter Bean Icon.png Reusable knock-back Isaac farts and pushes back nearby enemies. 3 seconds
The Candle 164 The Candle Icon.png Reusable flame Throws out a blue flame that can pass over gaps (but not through rocks). The flame damages anything in its path. 4 seconds
Converter 296 Converter Icon.png Convert your soul When used, converts two soul hearts into a heart container. 0
Crack the Sky 160 Crack the Sky Icon.png Holy white death Summons multiple beams of light in random locations around the room, dealing a large amount of damage to any enemy that touches them. 4
Crystal Ball 158 Crystal Ball Icon.png I see my future Reveals the map (except the Super Secret Room) and drops a random Tarot Card or soul heart. 6
D4 284 D4 Icon.png Reroll into something else Rerolls all of Isaac's items. 6
The D6 105 The D6 Icon.png Reroll Your Destiny Allows Isaac to re-roll collectible items in the current room into other items, depending on the current room's Item Pool. 6
D10 285 D10 Icon.png Rerolls enemies Rerolls the enemies in a room. Only rerolls enemies that are still alive (does not spawn new enemies). 1
D20 166 D20 Icon.png Reroll the basics Rerolls all pickups in the current room. 6
D100 283 D100 Icon.png REEROLLLLL! Upon use, rerolls all passive items on Isaac like the D4, every pedestal item in the room like The D6 and every pickup like the D20. 6
Dad's Key 175 Dad's Key Icon.png Opens all doors... Opens all doors in the current room when activated, including doors which require a key to open and entrances to secret rooms. Opens the big doors in the first room of both The Chest and the Dark Room. 2
Dead Sea Scrolls 124 Dead Sea Scrolls Icon.png It's a mystery Triggers the effect of a random activated item from a list of possible options (not every activated item is included). 2
Deck of Cards 85 Deck of Cards Icon.png Reusable Card Generator Gives Isaac a random Tarot Card. 6
Doctor's Remote 47 Doctor's Remote Icon.png Reusable Air Strike Sets a big red target on the ground (similar to the Template loop detected: Template:Item item) which can be controlled with tear controls. After 6 seconds or by pressing space again, a huge explosive missile hits it, which damages all enemies caught in its blast radius. 2
Flush! 291 Flush! Icon.png ... Changes all enemies in the room into poop. Does not work on all enemies (Knights and bosses are immune). Instantly kills Dingle, Dangle, and Brownie. 6
Forget Me Now 127 Forget Me Now Icon.png I don't remember When activated, the level ends and is freshly regenerated with new rooms, monsters, and items. Disappears after use. One time use
The Gamekid 93 The Gamekid Icon.png Temporary Man-Pac Upon use, turns the character into a into a Pac-Man-like creature for 5 seconds, granting invulnerability, inflicting fear on all enemies, and replenishing half a red heart container for every two enemies killed. 6
Guppy's Head 145 Guppy's Head Icon.png Reusable fly hive Spawns 2-4 blue flies to damage enemies. 1
Guppy's Paw 133 Guppy's Paw Icon.png Soul converter Removes one Heart Container in exchange for gaining 3 Soul Hearts. 0
Head of Krampus 293 Head of Krampus Icon.png Krampus Rage Fires a cross-patterned brimstone shot, just like The Fallen and Krampus shoot. 6
How to Jump 282 How to Jump Icon.png It's about time you learned how Gives Isaac the ability to jump (over gaps, spikes, etc.). 0
The Hourglass 66 The Hourglass Icon.png Temporary enemy slowdown Upon activation, enemies and their projectiles are slowed down for a short duration. 2
Isaac's Tears 323 Isaac's Tears Icon.png Collected tears Shoots 8 tears around Isaac, which retain the damage, shot speed, and special effects of his tears. Each tear shot by Isaac increases item charge by one. 6
IV Bag 135 IV Bag Icon.png Portable blood bank Upon activation, Isaac loses a half-heart (one whole heart in The Womb onwards) for a random amount of coins, similar to the blood donation machine. 0
The Jar 290 The Jar Icon.png Save your life When at full health, up to 4 extra hearts can be stored in the jar. 0
Kamikaze! 40 Kamikaze! Icon.png Become the bomb! Creates an explosion in the same area as Isaac, dealing half a heart of damage to him and also damaging all enemies caught in the blast radius. 0
Lemon Mishap 56 Lemon Mishap Icon.png Oops Creates a small yellow pool of creep, which damages enemies that cross it. 2
Magic Fingers 295 Magic Fingers Icon.png Pay to play For 1 Coin, damages all enemies in the room. 0
Mom's Bottle of Pills 102 Mom's Bottle of Pills Icon.png Reusable pill generator Gives Isaac a random pill, and will cause him to drop any held Q-slot item (If any). The player will only receive six different pill types in one playthrough. 6
Mom's Bra 39 Mom's Bra Icon.png Mass Fear Upon use, petrifies all enemies in the current room for approximately 4 seconds. 3
Mom's Pad 41 Mom's Pad Icon.png Gross... Upon use, inflicts fear to all enemies in the room for 5 seconds. 3
Monster Manual 123 Monster Manual Icon.png Temporary buddy generator Summons a random familiar for the current room. Can summon familiars not yet unlocked. 3
Monstro's Tooth 86 Monstro's Tooth Icon.png Summon Monstro Monstro jumps onto a random enemy, doing area damage. Can damage/kill the player if summoned in an room without enemies. 3
Mr. Boom 37 Mr. Boom Icon.png Reusable bomb buddy Drops a large bomb. 2
My Little Unicorn 77 My Little Unicorn Icon.png Temporary badass Upon use, grants invulnerability and increased speed for five seconds, removing the ability to shoot tears and replacing it with the ability to deal contact damage to enemies. 6
The Nail 83 The Nail Icon.png Temporary demon form Adds 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. 6
The Necronomicon 35 The Necronomicon Icon.png Mass room damage Damages all enemies in the room significantly. 6
Notched Axe 147 Notched Axe Icon.png Rocks don't stand a chance Isaac holds the axe above his head for as long as the spacebar button is held (or until he leaves the room). While holding the axe, Isaac can break any rock he touches, but cannot attack or pick up other items. 3
Pandora's Box 297 Pandora's Box Icon.png ?? Upon use, spawns certain pickups or items depending on the floor it is used on. Single-use. One time use
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
The Pony 130 The Pony Icon.png Flight + Dash Attack Passively grants flight and increased speed. Upon use, Isaac charges in the direction the pony is facing, becoming invulnerable during the charge and damaging enemies. 4
The Poop 36 The Poop Icon.png Plop! Spawns a pile of poop where the character is standing and knocks nearby monsters back. May yield pickups like regular poop. 1
Portable Slot 177 Portable Slot Icon.png Gamble 24/7 Upon activation, 1 coin will be consumed, and a random pickup may drop, similar to the slot machine. 0
Prayer Card 146 Prayer Card Icon.png Reusable eternity Grants an eternal heart per use. 6
Razor Blade 126 Razor Blade Icon.png Feel my pain Upon use deals one heart damage and grants +1.2 damage for the current room. 0
Red Candle 289 Red Candle Icon.png Flame on Throws a persistent flame that deals high damage and diminishes as it damages enemies or blocks shots. 4 seconds
Remote Detonator 137 Remote Detonator Icon.png Remote bomb detonation Bombs you place explode only when you use this item. Gives 5 bombs. 0
Satanic Bible 292 Satanic Bible Icon.png Reusable Evil Upon activation, Isaac gains a black heart. 6
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
Shoop Da Whoop! 49 Shoop Da Whoop! Icon.png BLLLARRRRGGG! Fires a laser from Isaac's mouth. 2
Spider Butt 171 Spider Butt Icon.png Mass enemy slowdown + damage Damages all enemies in the room and slows them and their projectiles down. 2
Tammy's Head 38 Tammy's Head Icon.png Reusable tear burst Shoots 10 tears in a circle around Isaac, which retain the damage, shot speed, and special effects (such as poison) of Isaac's tears. 1
Telepathy for Dummies 192 Telepathy for Dummies Icon.png Temporary psychic shot Upon activation, grants homing tears for the current room. 2
Teleport 44 Teleport Icon.png Teleport! Teleports you to a random room on the level. 2
Undefined 324 Undefined Icon.png Undefined Teleports Isaac to either the Secret Room, Super Secret Room, Treasure Room, or I AM ERROR. 6
Unicorn Stump 298 Unicorn Stump Icon.png You feel stumped Upon use, grants invulnerability and increased speed for five seconds, but removes the ability to shoot tears. 1
We Need to Go Deeper! 84 We Need to Go Deeper! Icon.png Reusable level skip Creates a trapdoor to go to the next floor. If used in The Womb, it will create a trapdoor to Sheol, even if the player hasn't unlocked it. 6
White Pony 181 White Pony Icon.png Flight + holy death Passively grants flight and increased speed. Upon use, Isaac charges in the direction the pony is facing, becoming invulnerable during the charge and damaging enemies while also casting the effect of Crack the Sky. 6
Yum Heart 45 Yum Heart Icon.png Reusable Regeneration Restores 1 whole red heart. 4
Box of Friends DLC Indicator.png 357 Box of Friends Icon.png Double your friends Upon use, duplicates all of Isaac's familiars for the current room. 4
D12 DLC Indicator.png 386 D12 Icon.png Rerolls rocks Re-rolls all rocks in the current room into other random objects, such as bomb rocks, metal blocks, TNT, or poops. 3
D7 DLC Indicator.png 437 D7 Icon.png Reroll rewards! Restarts the current room and brings back all enemies, allowing more rewards to be acquired by completing the room. 3
D8 DLC Indicator.png 406 D8 Icon.png Reroll stats Re-rolls Isaac's speed, range, tears and damage. 4
Diplopia DLC Indicator.png 347 Diplopia Icon.png Double item vision Duplicates all pickups and item pedestals in the room. One time use
Friendly Ball DLC Indicator.png 382 Friendly Ball Icon.png Gotta fetch 'em all! Throwing the ball at an enemy instantly kills it and captures it. The captured enemy can later be released and will be charmed until it dies, persisting between floors. 3
Glass Cannon DLC Indicator.png 352 Glass Cannon Icon.png Be gentle... When used, reduces Isaac's health to half a heart (including soul and black hearts) and fires one large piercing spectral tear that does a lot of damage. The damage done by Glass Cannon scales with Isaac's damage (at base damage it does 45 damage). 4 seconds
Glowing Hour Glass DLC Indicator.png 422 Glowing Hour Glass Icon.png Turn back time When used, this item will rewind time, put Isaac back in the previous room, and undo anything that happened in the current room. Any health, pickups, or items gained or lost will be reset back to the previous state. 2
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
Kidney Bean DLC Indicator.png 421 Kidney Bean Icon.png Love toots! Upon use, Isaac farts, charming all nearby enemies. 2
Mega Bean DLC Indicator.png 351 Mega Bean Icon.png Giga fart! When used, the Mega Bean will freeze all enemies in the current room for a couple of seconds, deal 5 damage and poison any enemies near Isaac, and send a wave of spikes that deals 10 damage across the room in the direction Isaac is facing. 3
Mega Blast DLC Indicator.png 441 Mega Blast Icon.png Laser breath Upon use, Isaac fires a laser similar to the one used by Mega Satan. This laser deals massive damage, lasts for approximately 15 seconds, and persists between rooms. Isaac is pushed backwards by the force of the laser while it is active. 12
Mine Crafter DLC Indicator.png 427 Mine Crafter Icon.png Booom! When used, places an explosive TNT barrel that can be pushed and used to destroy rocks or damage enemies. If used a second time in the same room while the previous TNT barrel is still intact, it will remotely explode the TNT. 1
Mom's Box DLC Indicator.png 439 Mom's Box Icon.png What's inside? When used, Mom's Box will drop a random trinket on the ground. While held, increases luck by 1 and doubles the effects of trinkets. 4
Placebo DLC Indicator.png 348 Placebo Icon.png Pill mimic When used, copies the effect of the pill Isaac is currently holding without consuming it. Does not copy the effects of cards or runes. 4
Tear Detonator DLC Indicator.png 383 Tear Detonator Icon.png Remote tear detonation! When used, will detonate any tears currently on the screen and cause each one to split into 6 more tears which will fire in a circle, similar to Tammy's Head. 1
Teleport 2.0 DLC Indicator.png 419 Teleport 2.0 Icon.png I-Teleport! When used, teleports Isaac to a random room that has not been explored yet. If all rooms are explored, including secret rooms, it will teleport Isaac to the Devil or Angel room. If all rooms are explored, including the Devil or Angel room, it will teleport Isaac to the I AM ERROR room. If used in a room with enemies, it will teleport Isaac out and back into the exact same room. 4
Ventricle Razor DLC Indicator.png 396 Ventricle Razor Icon.png Short cutter Can be used to place an orange portal and a blue portal. Upon entering a portal, Isaac is teleported to the other portal. 0
Wooden Nickel DLC Indicator.png 349 Wooden Nickel Icon.png Flip a coin When used, has a 50% chance to drop one random type of coin (penny, nickel or dime). 1
Black Hole Afterbirth† Indicator.png 512 Black Hole Icon.png Nothing can escape Throws a black hole on the ground which sucks in and damages enemies. 4
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
Clicker Afterbirth† Indicator.png 482 Clicker Icon.png Change Transforms Isaac into another random character. 6
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
Coupon Afterbirth† Indicator.png 521 Coupon Icon.png Allow 6 weeks for delivery Upon use, makes a random item from a shop, devil deal, or black market free. 6
Crooked Penny Afterbirth† Indicator.png 485 Crooked Penny Icon.png 50/50 Spawns a penny and has a 50% chance to double all items and pickups in the room. If the effect fails, the items and pickups disappear. 4
D1 Afterbirth† Indicator.png 476 D1 Icon.png What will it be? Duplicates a random pickup in the room. 4
D Infinity Afterbirth† Indicator.png 489 D Infinity Icon.png Reroll forever Grants a random dice item that changes each use. 2
Dataminer Afterbirth† Indicator.png 481 Dataminer Icon.png 109 Displaces enemy sprites for the current room and increases or decreases a random stat. 4
Delirious Afterbirth† Indicator.png 510 Delirious Icon.png Unleash the power! Spawns a random charmed boss. 12
Dull Razor Afterbirth† Indicator.png 486 Dull Razor Icon.png I feel numb... Hurts Isaac without depleting health, activating any items that trigger upon taking damage. 2
Eden's Soul Afterbirth† Indicator.png 490 Eden's Soul Icon.png ... Spawns two item pedestals. 12, one time use
Mama Mega! Afterbirth† Indicator.png 483 Mama Mega! Icon.png BOOOOOOOOOM! Damages all enemies and destroys all obstacles. The effect occurs every time a new room is entered for the rest of the floor. Opens doors to the floor's secret and super secret rooms. One time use
Metronome Afterbirth† Indicator.png 488 Metronome Icon.png Waggles a finger Grants a random item effect for the current room. 2
Moving Box Afterbirth† Indicator.png 523 Moving Box Icon.png Pack and unpack If the box is empty, picks up all items and pickups in a room and stores them. If the box is not empty, places all stored items and pickups in the current room. 4
Mr. ME! Afterbirth† Indicator.png 527 Mr. ME! Icon.png Caaan Do! Summons a controllable ghost that can perform various tasks depending on what it targets. 4
Mystery Gift Afterbirth† Indicator.png 515 Mystery Gift Icon.png Wrapped up nice for you! Upon use, spawns a random item from the current room's item pool, with a chance to spawn A Lump of Coal or The Poop instead. One time use
Plan C Afterbirth† Indicator.png 475 Plan C Icon.png Use with caution Kills all enemies in the room, then kills Isaac three seconds later. One time use
Potato Peeler Afterbirth† Indicator.png 487 Potato Peeler Icon.png A pound of flesh Removes a heart container, increases damage and range, and grants a Cube of Meat. 0
Pause Afterbirth† Indicator.png 478 Pause Icon.png Stop! Freezes all enemies until a fire button is pressed. 2
Sharp Straw Afterbirth† Indicator.png 507 Sharp Straw Icon.png More blood! Damages all enemies in the room. 8 seconds
Smelter Afterbirth† Indicator.png 479 Smelter Icon.png Trinket melter! Consumes Isaac's currently held trinket and applies its effect permanently. 6
Sprinkler Afterbirth† Indicator.png 516 Sprinkler Icon.png Sprinkles. Upon use, spawns a sprinkler that rotates and fires tears. 4
Telekinesis Afterbirth† Indicator.png 522 Telekinesis Icon.png The power of mind! Upon use, for the next two seconds, any enemy shots that come near Isaac are held in place. After the charge is depleted, they are fired back as tears. 3 seconds
Void Afterbirth† Indicator.png 477 Void Icon.png Consume Consumes all pedestal items in the room. Active items will have their effects added to Void, and passive items will grant stat upgrades. 6
Wait What? Afterbirth† Indicator.png 484 Wait What Icon.png I can't believe it's not Butter Bean! Isaac farts, sending out rock waves. 10 seconds

Passive Collectibles

Name ID Icon Quote Description
<3 15 Less Than Three Icon.png HP up Increases available heart containers by 1 and restores all health.
???'s Only Friend 320 Blue Baby's Only Friend Icon.png Controlled friend Summons a big attack fly that can be controlled with the shooting direction-keys.
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!.
20/20 245 20 20 Afterbirth Icon.png Double shot Grants double shot.
3 Dollar Bill 191 3 Dollar Bill Icon.png Rainbow tears Gives Isaac a random tear effect every room.
NoDLC Indicator.png The effect given changes upon entering a room.
DLC Indicator.png The effect changes every 3 seconds.
9 Volt 116 9 Volt Icon.png Quicker charge Reduces the charge of any Activated Items by 1. Any 1 charge items instead have timed recharges.
Abaddon 230 Abaddon Icon.png Evil + DMG up + fear shot Increases damage and speed, removes all red heart containers, grants six black hearts, and adds a chance to shoot fear tears.
Abel 188 Abel Icon.png Mirrored buddy A familiar that mirrors the player's movements and shoots in the opposite direction.
Anemic 214 Anemic Icon.png Toxic blood +5 range. After Isaac is damaged, a trail of red creep will be left behind Isaac until he leaves the current room.
Ankh 161 Ankh Icon.png Eternal life? Upon death, the player will respawn as ??? with 3 soul hearts.
Anti-Gravity 222 Anti-Gravity Icon.png Antigravity tears + tears up -2 Tear Delay. Tears float in position until firing ceases, after which they will fly off in the direction they were shot in.
Aquarius 308 Aquarius Icon.png Trail of tears A trail of blue creep is left behind Isaac, which damages enemies.
Aries 300 Aries Icon.png Ramming speed +0.25 Speed. Running into enemies while at a high speed will deal 18 points of damage. Does not prevent contact damage.
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.
Ball of Tar 231 Ball of Tar Icon.png Sticky feet... Adds a chance to shoot slowing tears and the character leaves a trail of slowing creep behind as he moves, impeding enemies' speed.
The Battery 63 The Battery Icon.png Stores energy Activated Items can be "overcharged" to allow for an additional use.
The Belt 28 The Belt Icon.png Speed up Increases speed by 0.3.
Best Bud 274 Best Bud Icon.png Sworn protector When hit, summons a white attack fly similar to Distant Admiration for the current room.
BFFS! 247 BFFS! Icon.png Your Friends Rule! Increases the size and damage of familiars.
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 Fan 279 Big Fan Icon.png Fat protector Spawns a large orbital familiar that blocks enemy projectiles and deals slight contact damage to enemies.
The Black Bean 180 The Black Bean Icon.png Toot on touch When taking damage, Isaac farts, causing poison damage to all enemies in range.
Black Candle 260 Black Candle Icon.png Curse immunity + evil up Prevents curses. Grants one black heart. Increases the chance for a Devil or Angel Room to appear.
Black Lotus 226 Black Lotus Icon.png HP up x3! Grants the player one red heart container, one soul heart, and one black heart.
Blood Bag 119 Blood Bag Icon.png HP up Grants 1 heart container, restores 5 red hearts, and increases speed.
Blood Clot 254 Blood Clot Icon.png DMG + range up Increases damage by 1 and range by 5 for tears fired from the left eye.
Blood of the Martyr 7 Blood of the Martyr Icon.png DMG up Increases Damage by 1, and turns Isaac's tears into blood tears.
Bloody Lust 157 Bloody Lust Icon.png RAGE! Increases damage as Isaac receives damage. Damage increase stays for the whole floor.
Blue Cap 342 Blue Cap Icon.png HP + tears up + shot speed down Grants 1 heart container and increases tears, but decreases shot speed.
Blue Map 246 Blue Map Icon.png Secrets Shows secret and super secret room locations on the map.
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.
Bob's Curse 140 Bob's Curse Icon.png +5 poison bombs Gives 5 bombs and grants all bombs poison effect.
Bobby-Bomb 125 Bobby-Bomb Icon.png Homing bombs! Gives Isaac 5 Bombs, and causes all dropped bombs to home towards the closest enemy.
The Body 334 The Body Icon.png I feel all Adds 3 heart containers.
Bogo Bombs 250 Bogo Bombs Icon.png 1+1 boom! All standard bomb pickups become 1+1 bomb pickups.
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.
Boom! 19 Boom! Icon.png 10 bombs Gives 10 bombs.
Box 198 Box Icon.png Stuff Spawns 1 of each (non-collectible) item: 1 coin, 1 key, 1 bomb, 1 heart, 1 card, 1 pill, 1 trinket.
Breakfast 25 Breakfast Icon.png HP up Adds 1 heart container.
Brimstone 118 Brimstone Icon.png Blood laser barrage Tears are replaced by a laser beam that pierces through all enemies and obstacles in its path and deals high damage. Can only be fired after a short charge-up period.
Broken Watch 337 Broken Watch Icon.png I think it's broken Chance upon entering a room to slow down or speed up every enemy and their attacks. The chance to slow enemies is quite higher than the chance to speed them up.
Brother Bobby 8 Brother Bobby Icon.png Friends 'till the end Follows Isaac around shooting normal tears.
Bucket of Lard 129 Bucket of Lard Icon.png HP up Grants two empty heart containers and heals Isaac by half a heart, but decreases speed by 0.2.
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.
Butt Bombs 209 Butt Bombs Icon.png Toxic blast +5 bombs Gives +5 bombs and makes all bombs Butt Bombs that fill the room with gas, damaging and confusing all enemies.
Caffeine Pill 340 Caffeine Pill Icon.png Speed up + size down Increases speed and reduces character size. Also gives a random pill.
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.
Cancer 301 Cancer Icon.png HP up + you feel protected Adds 3 soul hearts. Grants The Wafer effect for the current room upon taking damage.
Capricorn 307 Capricorn Icon.png All stats up All stats up.
Cat-O-Nine-Tails 165 Cat-O-Nine-Tails Icon.png Shot speed + damage up Increases Shot Speed and damage.
Celtic Cross 162 Celtic Cross Icon.png You feel blessed Grants a chance to trigger the Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 7 seconds.
Ceremonial Robes 216 Ceremonial Robes Icon.png Sin up Adds 3 black hearts and increases Damage by 1.
Champion Belt 208 Champion Belt Icon.png DMG + Challenge Up Increases damage, but also increases the chance of champion enemies appearing.
Charm of the Vampire 62 Charm of the Vampire Icon.png Kills heal Heals the character for half of a red heart for every 13 monsters killed.
Chemical Peel 154 Chemical Peel Icon.png DMG up Tears fired from left eye do increased damage.
Chocolate Milk 69 Chocolate Milk Icon.png Charge shots Grants charged tears that deal greater damage when fully charged.
The Common Cold 103 The Common Cold Icon.png Poison Damage Adds a chance to shoot poison tears, dealing damage over time when inflicted.
The Compass 21 The Compass Icon.png The end is near Reveals all special rooms (except secret rooms of any kind).
Contract From Below 241 Contract From Below Icon.png Wealth... but at what cost? Doubles the number of pickups and chests spawned after clearing a room or performing some other triggering action (such as using a blood donation machine), but reduces the chance for any pickups to spawn at all.
Cricket's Body 224 Cricket's Body Icon.png Tears up + splash damage Grants -1 Tear Delay and reduces Range. When tears hit an object or deplete their range, they spawn 4 smaller tears, whose Range and Damage scale with Isaac's.
Cricket's Head 4 Cricket's Head Icon.png DMG up Increases damage by 0.5, and multiplies it by 1.5x.
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.
Cupid's Arrow 48 Cupid's Arrow Icon.png Piercing shots Grants Isaac piercing tears that travel through enemies (but not obstacles) instead of breaking on impact with them.
Cursed Eye 316 Cursed Eye Icon.png Cursed charge shot Grants charged tears that can be fired in a tight burst of four. Getting hit while charging will teleport Isaac into another room.
Daddy Longlegs 170 Daddy Longlegs Icon.png Daddy's love Daddy Long Legs' shadow follows Isaac and stomps on enemies.
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.
Dark Matter 259 Dark Matter Icon.png Fear shot Increases Damage by 1 and adds a chance to shoot fear tears.
Dead Bird 117 Dead Bird Icon.png Protective buddy Spawns a flying familiar for the current room that chases enemies whenever Isaac takes damage.
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.
Dead Dove 185 Dead Dove Icon.png Flight + spectral tears Grants spectral tears and flight.
Dead Onion 336 Dead Onion Icon.png Toxic aura tears Grants piercing and spectral tears. Increases tear size (without increasing damage) while greatly reducing range and shot speed.
Death's Touch 237 Death's Touch Icon.png Penetrative shot + damage up Increases Damage by 1.5, reduces Tears by 0.3 and increases tear size. Grants piercing tears. Tears are replaced by Death's scythes, which is a cosmetic effect only.
Demon Baby 113 Demon Baby Icon.png Auto-turret friend Follows Isaac and automatically fires at enemies in its reach.
Dessert 24 Dessert Icon.png HP Up Adds 1 heart container.
Dinner 23 Dinner Icon.png HP Up Adds 1 heart container.
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.
A Dollar 18 A Dollar Icon.png $$$ Gives Isaac 99 coins. Can be found multiple times in a single playthrough.
Dr. Fetus 52 Dr. Fetus Icon.png ??? Tears are replaced by bombs that benefit from bomb-enhancing effects and slide a fixed range after being fired.
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.
E Coli 236 E Coli Icon.png Turdy touch Gives "Turdy Touch" Effect. Enemies that touch Isaac are changed into poop.
Epic Fetus 168 Epic Fetus Icon.png On-demand air strike Isaac's tears are replaced with guided missiles, like those used by the Doctor's Remote.
Eve's Mascara 310 Eve's Mascara Icon.png Shot speed down + DMG up Doubles damage, halves tears stat, and greatly reduces shot speed.
Experimental Treatment 240 Experimental Treatment Icon.png All stats up, then shuffled Randomly increases and decreases some of the character's stats. There will always be at least one stat increase and one decrease and the same stats can be increased/decreased multiple times.
Fanny Pack 204 Fanny Pack Icon.png It's filled with goodies! Has a chance to drop a random pickup when Isaac takes damage.
Fate 179 Fate Icon.png Flight eternal Grants flight and one eternal heart.
Fire Mind 257 Fire Mind Icon.png Flaming tears Grants flaming tears that deal burning damage over time. Tears have a chance to explode on impact with an enemy, which creates a fire at the location of the explosion.
Forever Alone 128 Forever Alone Icon.png Attack fly Spawns a blue attack fly that orbits a long distance from Isaac.
Gemini 318 Gemini (Item) Icon.png Conjoined friend Suture becomes attached to Isaac, and does touch damage to enemies within its attacking range.
Ghost Baby 163 Ghost Baby Icon.png Spectral buddy Spawns a familiar that follows Isaac around and fires spectral tears.
Gimpy 225 Gimpy Icon.png Sweet Suffering Has a chance of spawning a soul heart or black heart when taking damage. Enemies have a chance to drop a Half Red Heart after being killed.
Gnawed Leaf 210 Gnawed Leaf Icon.png Unbreakable After standing still and not shooting for a short time, Isaac turns invincible until he moves or shoots.
Goat Head 215 Goat Head Icon.png He accepts your offering A Devil Room / Angel Room Door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.
Godhead 331 Godhead Icon.png God tears Increases damage and range while reducing tears and shot speed. Grants homing tears and tears gain a damaging halo.
Growth Hormones 70 Growth Hormones Icon.png Speed + DMG up Increases damage by 1 and speed by 0.4.
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.
Guillotine 206 Guillotine Icon.png An out-of-body experience Isaac's head is removed from his body and floats around him. Increases Damage by 1 and grants -1 Tear Delay.
Guppy's Collar 212 Guppy's Collar Icon.png Eternal Life? Permanent 50% chance to respawn with 1/2 heart after death.
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.
Guppy's Tail 134 Guppy's Tail Icon.png Cursed? Increases chance of finding gold chests and normal chests, but reduces chance of finding pickups.
Habit 156 Habit Icon.png Item Martyr When Isaac is hit, 1 point of an item's charge is filled.
The Halo 101 The Halo Icon.png All stats up Grants one Heart Container, +0.3 Damage, +0.2 Tears, +0.25 Range, +0.3 Speed, and +0.5 Tear Height.
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.
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.
Headless Baby 269 Headless Baby Icon.png Bloody Friend Familiar that follows Isaac, leaving blood creep on the ground.
Hive Mind 248 Hive Mind Icon.png Giant spiders and flies Increases the size of blue spiders and Blue Flies and doubles the amount of damage they deal.
Holy Grail 184 Holy Grail Icon.png Flight + HP up Grants flight and one heart container.
Holy Mantle 313 Holy Mantle Icon.png Holy shield Automatically negates first taken damage in every room.
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.
Hot Bombs 256 Hot Bombs Icon.png Burning blast +5 bombs Grants 5 bombs. Isaac's bombs leave behind fire that damages enemies upon contact.
Humbling Bundle 203 Humbling Bundle Icon.png 1+1 free 4evar! Gives one extra pickup (1+1 Free version) of Red Hearts, pennies, bombs and Keys. Does not work with blue, black and half red hearts, nickels and dimes.
Infamy 242 Infamy Icon.png Damage Reduction Chance to block projectiles coming from any direction.
Infestation 148 Infestation Icon.png They grow inside 1-3 Blue flies randomly spawn every time Isaac gets hit.
Infestation 2 234 Infestation 2 Icon.png Infestation shot Spawns allied blue spiders from killed enemies.
The Inner Eye 2 The Inner Eye Icon.png Triple shot Grants triple shot but decreases tears.
Ipecac 149 Ipecac Icon.png Explosive shots Replaces tears with explosive and poisoning projectiles fired in an arc from the mouth.
Iron Bar 201 Iron Bar Icon.png Concussive tears Increases damage by 0.3 and adds a chance to shoot concussive tears, causing enemies to walk around randomly.
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.
Jesus Juice 197 Jesus Juice Icon.png Damage + range up Increases Damage and Range.
Judas' Shadow 311 Judas' Shadow Icon.png Sweet revenge Adds an extra life; upon death, it respawns Isaac as Black Judas with only two black hearts.
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.
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.
The Ladder 60 The Ladder Icon.png Building bridges Allows Isaac to walk across gaps one square across by automatically placing a ladder between the two walkable sections.
Latch Key 343 Latch Key Icon.png Luck up Increases Luck by 1, grants 1 Soul Heart and spawns 2 Keys.
Lazarus' Rags 332 Lazarus' Rags Icon.png Eternal Life? Upon dying, resurrect as Revived Lazarus with one heart container and Anemic item.
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.
Leo 302 Leo Icon.png Stompy Allows you to crush rocks when you walk over them.
Libra 304 Libra Icon.png You Feel Balanced Gives 6 coins, 6 bombs and 6 keys and balances out all attributes.
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 Haunt 277 Lil Haunt Icon.png Fear him A familiar that damages enemies by chasing them as well as inducing the fear effect.
Little Baggy 252 Little Baggy Icon.png Extra pill room Isaac can hold 2 pills at once and all cards are replaced by pills.
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.
Little Chubby 88 Little Chubby Icon.png Attack Buddy A familiar that charges forward and deals touch damage to any enemies in its path.
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.
Loki's Horns 87 Loki's Horns Icon.png Cross Tears Gives a random chance for projectiles to fire in all 4 cardinal directions.
Lord of the Pit 82 Lord of the Pit Icon.png Demon wings Grants flight and increases speed.
Lost Contact 213 Lost Contact Icon.png Shielded tears Every tear has a small shield which will allow it to block one enemy projectile.
Lucky Foot 46 Lucky Foot Icon.png Luck up +1 Luck. Increases chance of winning Shell Game Beggar. (Independent of luck stat)
The Ludovico Technique 329 The Ludovico Technique Icon.png Controlled Tears Instead of firing tears, Isaac controls one floating tear that hover over obstacles. This tear deals constant damage when held in place over an enemy.
A Lump of Coal 132 A Lump of Coal Icon.png My Xmas Present The more distance tears travel, the more damage they will do.
Lunch 22 Lunch Icon.png HP Up Adds 1 heart container.
Maggy's Bow 312 Maggy's Bow Icon.png HP up + you feel healthy Gives one heart container and doubles the healing provided by red hearts.
Magic 8 Ball 194 Magic 8 Ball Icon.png Shot speed up Increases Shot Speed, and drops a Tarot Card when picked up.
Magic Mushroom 12 Magic Mushroom Icon.png All Stats Up! Increases all stats and enlargens Isaac.
Magic Scab 253 Magic Scab Icon.png HP + Luck up Increases luck and HP by 1.
Magneto 53 Magneto Icon.png Item snatcher Pulls pickups towards Isaac.
The Mark 79 The Mark Icon.png DMG up Increases Damage and Speed, plus adds one Soul Heart.
Match Book 344 Match Book Icon.png Evil up Grants Isaac 1 Black Heart and 3 bombs. Can also give troll bombs.
MEAT! 193 MEAT! Icon.png DMG + HP up Adds a heart container, and increases damage.
Midas' Touch 202 Midas' Touch Icon.png Golden touch Enemies that touch you are stunned and turn gold. Any enemy killed while in this state will drop a coin.
The Mind 333 The Mind Icon.png I know all Grants the combined effects of the Blue Map, Treasure Map and The Compass, revealing the floor layout and all special rooms, including Secret Rooms and Super Secret Rooms.
Mini Mush 71 Mini Mush Icon.png Speed + range up Increases Speed and Shot Height and decreases Isaac's size, but lowers Range.
Missing Page 2 262 Missing Page 2 Icon.png Evil up. Your enemies will pay! Gives 1 black heart. Upon taking damage that reduces Isaac's health to one heart or less, activates The Necronomicon effect, dealing 40 damage to all enemies in the room.
Missing No. 258 Missing No. Icon.png Syntax error Randomizes all passive items upon pickup and at the start of each succeeding floor.
Mitre 173 Mitre Icon.png You Feel Blessed Grants a chance of converting any red hearts pickups into soul hearts instead.
Mom's Coin Purse 195 Mom's Coin Purse Icon.png What's all this...? Spawns 4 random pills around Isaac.
Mom's Contacts 110 Mom's Contacts Icon.png Freeze effect Adds a chance to shoot petrifying tears, which stop enemies in place and prevent them from moving or attacking. Range up.
Mom's Eye 55 Mom's Eye Icon.png Eye in the back of your head Allows Isaac to fire tears from the back of his head.
Mom's Eyeshadow 200 Mom's Eyeshadow Icon.png Charm tears Tears have a chance to charm enemies.
Mom's Heels 30 Mom's Heels Icon.png Range up Increases range.
Mom's Key 199 Mom's Key Icon.png Less is now more +2 keys Spawns 2 keys. Generates additional pickups from chests.
Mom's Knife 114 Mom's Knife Icon.png Stab stab stab Isaac's tears are replaced by a knife that pierces enemies, can travel through obstacles, and can hurt enemies while Isaac is holding it. Holding down the fire button before firing increases its range and power.
Mom's Lipstick 31 Mom's Lipstick Icon.png Range up Increases range and shot height.
Mom's Perfume 228 Mom's Perfume Icon.png Fear shot Adds a chance to shoot fear tears and decreases tear delay by 1.
Mom's Purse 139 Mom's Purse Icon.png More trinket room Allows Isaac to hold 1 additional trinket.
Mom's Underwear 29 Mom's Underwear Icon.png Range up Increases range.
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.
Money = Power 109 Money = Power Icon.png $$$ = DMG Increases damage by 0.04 for every coin Isaac has up to +3.96 damage at 99 coins.
Mongo Baby 322 Mongo Baby Icon.png Mongo Friend Summons a familiar that copies the tears of Isaac's other familiars.
Monstro's Lung 229 Monstro's Lung Icon.png Charged attack Increases damage and grants a charged shot that fires multiple tears in the same fashion as Monstro.
Mr. Mega 106 Mr. Mega Icon.png Blast damage Gives Isaac 5 bombs, and makes all dropped bombs larger, which have an increased blast radius and increased damage.
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.
Mutant Spider 153 Mutant Spider Icon.png Quad shot Grants quadruple shot but decreases tears.
My Reflection 5 My Reflection Icon.png Boomerang tears Gives Isaac's tears a boomerang effect, and increases range and shot speed.
Mysterious Liquid 317 Mysterious Liquid Icon.png Toxic Splash Damage Tears leave a small, short lasting pool of creep on impact or when their range is depleted.
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.
Number One 6 Number One Icon.png Tears up Tears range is heavily decreased, but the fire rate is greatly increased.
Odd Mushroom (Large) 121 Odd Mushroom (Large) Icon.png DMG up Grants an empty heart container. Increases damage, range and shot height while reducing speed.
Odd Mushroom (Thin) 120 Odd Mushroom (Thin) Icon.png Fire rate up Increases Tears and Speed while reducing Damage.
Old Bandage 219 Old Bandage Icon.png HP up Adds one empty heart container. Whenever Isaac takes damage there's a chance that a Red Heart may drop.
Ouija Board 115 Ouija Board Icon.png Spectral tears Grants spectral tears that travel through obstacles (but not enemies) instead of breaking on impact with them.
The Pact 80 The Pact Icon.png DMG + Tears UP Increases damage by 0.5, tears by 0.7 and grants two soul hearts upon pickup.
Pageant Boy 141 Pageant Boy Icon.png Ultimate grand supreme Spawns several coins around Isaac.
The Parasite 104 The Parasite Icon.png Split Shot Isaac's tears split in two when they hit something.
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.
Pentagram 51 Pentagram Icon.png DMG up Increases damage and increases the chance for a Devil or Angel Room to appear.
PHD 75 PHD Icon.png Better pills Converts all bad pills into good pills, spawns one pill pickup and restores health. Identifies all pills upon pickup.
Pisces 309 Pisces Icon.png Tears up + knock-back shots -1 Tear Delay, adds knock-back shots and increases tear size.
Piggy Bank 227 Piggy Bank Icon.png My life savings Gives 3 pennies on pick-up. Every time Isaac is damaged, he will drop one additional penny.
Placenta 218 Placenta Icon.png HP up + regen Grants a full heart container, and a chance to regenerate a half-heart of health every minute of gameplay.
Polyphemus 169 Polyphemus Icon.png Mega Tears Makes Isaac shoot one huge tear. Also reduces Tears to minimum. Damage increased . If tear does more damage than an enemy's life, the tear continues to travel with the extra remaining damage.
Proptosis 261 Proptosis Icon.png Short range mega tears Tears start out massive with high damage, and then shrink down and become weaker over a short range.
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.
Pyro 190 Pyro Icon.png 99 bombs Adds 99 bombs.
Pyromaniac 223 Pyromaniac Icon.png It hurts so good +5 Bombs Isaac heals 1 heart instead of taking damage by a explosive blast from source. Adds 5 bombs.
A Quarter 74 A Quarter Icon.png +25 coins Adds 25 to Isaac's coin count, capping at 99.
Rainbow Baby 174 Rainbow Baby Icon.png Random buddy Spawns a familiar that follows Isaac around and fires tears with random effects.
Raw Liver 16 Raw Liver Icon.png HP up Grants 2 Heart Containers and completely restores health.
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.
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.
Roid Rage 14 Roid Rage Icon.png Speed and range up Increases speed by 0.6, range by 5.25, and tear height by 0.5.
Rosary 72 Rosary Icon.png Faith up Adds 3 Soul Hearts and increases the chance for The Bible to appear in any item pool.
Rotten Baby 268 Rotten Baby Icon.png Infested friend A familiar that spawns blue flies.
Rotten Meat 26 Rotten Meat Icon.png HP up Adds one heart container.
Rubber Cement 221 Rubber Cement Icon.png Bouncing tears Tears bounce off walls and obstacles (including enemies).
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.
Sacred Heart 182 Sacred Heart Icon.png Homing shots + DMG up Increases damage and range while reducing shot speed and grants homing tears. Grants a Heart Container and replenishes all Red Hearts.
Sacrificial Dagger 172 Sacrificial Dagger Icon.png My fate protects me Dagger orbits Isaac, dealing very high damage.
Sad Bombs 220 Sad Bombs Icon.png Tear blast +5 bombs +5 Bombs. Upon exploding, bombs shoot 8 tears off in every direction, similar to Tammy's Head. The tears are affected by any tear modifiers Isaac has on his own tears.
The Sad Onion 1 The Sad Onion Icon.png Tears up Increases Tears by 0.7.
Safety Pin 339 Safety Pin Icon.png Evil + range + shot speed up Increases range and shot speed, while adding 1 Black Heart.
Sagittarius 306 Sagittarius Icon.png Penetrative shot + speed up Increases speed by +0.2 and grants piercing tears.
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.
Scapular 142 Scapular Icon.png You have been blessed Once per room, when Isaac is reduced to his last half red Heart, the aura around his head temporarily vanishes and he is granted one Soul Heart.
Scorpio 305 Scorpio Icon.png Poison tears Grants poison tears, which deal damage over time when inflicted.
Screw 255 Screw Icon.png Tears + shot speed up Tears and shot speed up.
Sharp Plug 205 Sharp Plug Icon.png Charge with blood Using an activated item while it's not charged will charge it and Sharp Plug does 2 full heart damage to Isaac.
Sissy Longlegs 280 Sissy Longlegs Icon.png She loves you Wanders about the room, occasionally spawning blue spiders.
Sister Maggy 67 Sister Maggy Icon.png Friends 'till the end A familiar that follows Isaac around shooting blood tears.
Skatole 9 Skatole Icon.png Fly love All types of fly except Boom Fly and Red Boom Fly become passive and slowly move towards Isaac. Does not prevent contact damage.
Skeleton Key 17 Skeleton Key Icon.png 99 keys Sets your key count to the maximum of 99.
The Small Rock 90 The Small Rock Icon.png DMG up Increases damage by 1, increases tears by 0.2, and decreases speed by 0.1.
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.
SMB Super Fan 189 SMB Super Fan Icon.png All stats up Increases all stats.
A Snack 346 A Snack Icon.png HP up Adds 1 heart container.
Soy Milk 330 Soy Milk Icon.png DMG Down + Tears Way Up Tears shrink and do much less damage, but fire in very rapid succession.
The Soul 335 The Soul Icon.png I am all Grants two soul hearts. Isaac now repels enemy projectiles.
Speed Ball 143 Speed Ball Icon.png Speed + shot speed up Increases speed by 0.3 and shot speed by 20%.
Spelunker Hat 91 Spelunker Hat Icon.png See-through doors Reveals type of adjacent rooms, including location for secret rooms and super secret rooms.
Spider Bite 89 Spider Bite Icon.png Slow effect Adds a chance to shoot slowing tears, reducing speed of enemy movement and any projectile fired by them.
Spider Baby 211 Spider Baby Icon.png Spider revenge When hit, spawns up to 2 blue spiders.
Spirit of the Night 159 Spirit of the Night Icon.png Scary Grants spectral tears and flight.
Spoon Bender 3 Spoon Bender Icon.png Homing shots Grants Isaac homing tears.
Squeezy 196 Squeezy Icon.png Tears up Increases tears by 0.4, and spawns 2 Soul Hearts pickups.
Starter Deck 251 Starter Deck Icon.png Extra card room Isaac can hold 2 cards at once and all pills are replaced by cards.
Steam Sale 64 Steam Sale Icon.png 50% off Reduces all Shop prices by 50%, rounded down to 7 coins for an item, rounded up to 2-3 coins for a pickup.
Stem Cells 176 Stem Cells Icon.png HP up Adds one filled heart container and increases Shot Speed.
Steven 50 Steven (Item) Icon.png DMG up Increases Damage by 1.
Stigmata 138 Stigmata Icon.png DMG + HP up Increases damage, and adds 1 heart container.
Stop Watch 232 Stop Watch Icon.png Let's slow this down a bit NoDLC Indicator.png Automatically inflicts slow to all enemies in every room.
DLC Indicator.png Upon taking damage, inflicts slow to all enemies for the current room.
Strange Attractor 315 Strange Attractor Icon.png Magnetic tears Pickups, trinkets and monsters are magnetically attracted to Isaac's tears.
Super Bandage 92 Super Bandage Icon.png +2 hearts Grants one Heart Container and gives 2 Soul Hearts.
Synthoil 345 Synthoil Icon.png DMG up + range Increases damage by 1, range by 5.25, and tear height by 0.5.
Taurus 299 Taurus Icon.png Speed down + rage is building Speed down, gains speed while in a room with enemies until gaining My Little Unicorn effect for a few seconds.
Tech.5 244 Tech.5 Icon.png It's still being tested... Grants a unlimited range piercing laser with random rate of fire that does not replace tears. The laser might occasionally fire with the effect of a random item or trinket, such as Hook Worm, Spoon Bender or Tiny Planet.
Technology 68 Technology Icon.png Laser tears Replaces tears with a piercing laser with unlimited range.
Technology 2 152 Technology 2 Icon.png Laser Decreases damage and replaces right eye tears with a unlimited range, piercing laser which fires continuously.
Tiny Planet 233 Tiny Planet Icon.png Orbiting tears + range up Range up and makes shot tears revolve around Isaac until they drop.
The Negative 328 The Negative Icon.png Fate Chosen If the character has half a red heart or no red hearts after taking damage, it triggers The Necronomicon effect, damaging all enemies in the room. Also allows entrance into the Dark Room.
The Polaroid 327 The Polaroid Icon.png Fate Chosen If the character has half a red heart or no red hearts after taking damage, it triggers the Book Of Shadows effect, creating a shield that nullifies all types of damage for 5 seconds. Also allows entrance into The Chest.
There's Options 249 There's Options Icon.png More options There will be 2 items available to choose from after defeating a boss. Choosing 1 item causes the other to disappear.
Thunder Thighs 314 Thunder Thighs Icon.png HP up + speed down + you feel stompy Destroys rocks upon contact with Isaac. Adds one heart container, and lowers Speed.
Toothpicks 183 Toothpicks Icon.png Tears + shot speed up Increases tears and shot speed.
Torn Photo 341 Torn Photo Icon.png Tears + shot speed up Tears + Shot speed up.
Tough Love 150 Tough Love Icon.png Tooth shot Adds a chance to shoot a tooth instead of a tear, which deals greater damage than regular tears.
Transcendence 20 Transcendence Icon.png We all float down here... Grants flight.
Treasure Map 54 Treasure Map Icon.png Full visible map Reveals all rooms for every floor. However, it does not reveal icons or secret rooms.
Trinity Shield 243 Trinity Shield Icon.png "You feel guarded" Isaac gains a shield that protects him from enemy shots.
The Wafer 108 The Wafer Icon.png Damage resistance All sources of damage that would cause more than one half heart of damage are reduced to one half heart instead.
Whore of Babylon 122 Whore of Babylon Icon.png Curse up Increases damage and speed whenever Isaac has half a red heart or less (one red heart for Eve), ignoring any soul or black hearts.
Wire Coat Hanger 32 Wire Coat Hanger Icon.png Tears up Increases Tears by 0.7.
Wooden Spoon 27 Wooden Spoon Icon.png Speed up Increases speed by 0.3.
Virgo 303 Virgo Icon.png You feel refreshed and protected Grants a chance to trigger the Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 10 seconds. Also converts "bad pills" into "good pills".
The Virus 13 The Virus Icon.png Poison touch Inflicts poison to enemies who make contact with Isaac. Speed down.
X-Ray Vision 76 X-Ray Vision Icon.png I've seen everything Reveals and opens all Secret Room and Super Secret Room entrances.
8 Inch Nails DLC Indicator.png 359 8 Inch Nails Icon.png Stick it to 'em! +1.5 Damage Up. Replaces Isaac's tears with nails, which have increased knockback.
Athame DLC Indicator.png 408 Athame Icon.png Call to the void Whenever Isaac takes damage, a black ring briefly appears around Isaac, dealing damage to all nearby enemies.
Betrayal DLC Indicator.png 391 Betrayal Icon.png Turn your enemy Every time Isaac takes damage, a charm effect is applied to every enemy in the room, causing them to attack each other rather than Isaac.
Binky DLC Indicator.png 438 Binky Icon.png Memories... Tears up, adds 1 soul heart, and decreases Isaac's size.
Black Powder DLC Indicator.png 420 Black Powder Icon.png Spin the black circle! Isaac leaves a trail of black powder on the floor. Walking in a circle will spawn a pentagram symbol on the floor, which deals 10 damage per tick to any enemies inside it.
Bomber Boy DLC Indicator.png 353 Bomber Boy Icon.png Explosive blast! +5 bombs. Isaac's bombs will now explode in a large cross-shaped pattern (roughly 5 bombs explosions wide). This also affects troll bombs.
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.
Bursting Sack DLC Indicator.png 377 Bursting Sack Icon.png Spider love Spider enemies no longer target or deal contact damage to Isaac.
Cambion Conception DLC Indicator.png 412 Cambion Conception Icon.png Feed them hate After taking damage a certain amount of times, a permanent demonic familiar spawns.
Car Battery DLC Indicator.png 356 Car Battery Icon.png Double charge! Causes Isaac's activated item to activate twice on each use.
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.
Chaos DLC Indicator.png 402 Chaos Icon.png !!! Chaos causes items to be chosen from random item pools. When picked up, drops between 1-6 random pickups on the floor.
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.
Circle of Protection DLC Indicator.png 423 Circle of Protection Icon.png Protect me from myself Surrounds Isaac with a large white halo around him that pulsates. With each pulse, the halo deals contact damage to enemies equal to Isaac's damage. Each pulse also converts any enemy shots touching the ring into friendly purple homing tears.
Continuum DLC Indicator.png 369 Continuum Icon.png Transcendent tears +2.25 Range Up. +1.5 Tear Height. Isaac's tears travel through walls and appear out of the opposite wall. Isaac's tears also travel over rocks and objects.
Crack Jacks DLC Indicator.png 354 Crack Jacks Icon.png Don't swallow the prize! Adds one heart container and drops a random trinket.
Crown of Light DLC Indicator.png 415 Crown of Light Icon.png The untainted gain power Gives Isaac a crown that glows blue when active, and turns gray when inactive. While Isaac has no empty red heart containers, Isaac's tears are replaced with blue diamond tears that deal double damage. Regardless of health, the crown will deactivate for the current room when Isaac takes damage.
Curse of the Tower DLC Indicator.png 371 Curse of the Tower Icon.png You feel cursed... Causes Isaac to spawn 6 troll bombs on the floor every time he gets hit, similar to the Anarchist Cookbook mechanic.
Dead Eye DLC Indicator.png 373 Dead Eye Icon.png Accuracy brings power! Isaac's damage increases each time an enemy is hit. Damage is reset upon missing a shot.
Deep Pockets DLC Indicator.png 416 Deep Pockets Icon.png More stuff to carry! Allows Isaac to carry two cards or pills (or a combination of both) at the same time.
Eden's Blessing DLC Indicator.png 381 Eden's Blessing Icon.png Your future shines brighter Tears up. Grants a random item at the start of the next run.
Empty Vessel DLC Indicator.png 409 Empty Vessel Icon.png I reward an empty vessel While Isaac has no red hearts, this item grants flight and a random chance to activate an invincibility shield for a few seconds. If Isaac gains any red hearts, these benefits will disappear.
Epiphora DLC Indicator.png 368 Epiphora Icon.png Intensifying tears Shooting in one direction increases Isaac's rate of fire until the cap is reached. As soon as Isaac changes direction or stops shooting, rate of fire is reset to its normal amount.
Evil Eye DLC Indicator.png 410 Evil Eye Icon.png Eye shot! While firing tears, Isaac has a chance to fire an eye across the screen with a very slow shot speed, which will fire tears of its own in the same direction as Isaac. The eye will be destroyed if it comes into contact with an enemy or obstacle.
Explosivo DLC Indicator.png 401 Explosivo Icon.png Sticky bomb shot! Isaac's tears have a chance to stick to enemies and explode.
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.
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.
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.
Fruit Cake DLC Indicator.png 418 Fruit Cake Icon.png Rainbow Effects! Isaac's tears gain a random effect that changes every shot.
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.
Glitter Bombs DLC Indicator.png 432 Glitter Bombs Icon.png Prize Bombs! Gives Isaac 5 bombs, and makes Isaac's bombs have a chance to drop random pickups or charm enemies when they explode.
God's Flesh DLC Indicator.png 398 God's Flesh Icon.png Shrink shot Tears now have a random chance to apply a shrinking effect, causing enemies to shrink in size and also run away from Isaac. Shrunk enemies can be crushed and killed by walking over them.
Head of the Keeper DLC Indicator.png 429 Head of the Keeper Icon.png Penny tears! Isaac's tears become coins and now have a chance to drop pennies on the floor upon successfully hitting an enemy.
Holy Light DLC Indicator.png 374 Holy Light Icon.png Holy shot! Isaac has a random chance to fire a Holy tear, which when it hits an enemy, will spawn a Crack the Sky style light beam on the same enemy, dealing damage.
Host Hat DLC Indicator.png 375 Host Hat Icon.png Nice hat! A host familiar that sits on Isaac's head and has a random chance to block enemy shots and retaliate with 3 tears. Grants immunity to explosions.
Immaculate Conception DLC Indicator.png 413 Immaculate Conception Icon.png Feed them love Upon picking up a certain amount of health, spawn a permanent angelic familiar.
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.
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.
Kidney Stone DLC Indicator.png 440 Kidney Stone Icon.png Matt's kidney stone Randomly 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.
Lil Chest DLC Indicator.png 362 Lil Chest Icon.png What's in the box? Spawns a chest familiar that follows Isaac and drops a random pickup every few rooms.
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.
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.
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.
Lusty Blood DLC Indicator.png 411 Lusty Blood Icon.png Their blood brings rage! Each time Isaac kills an enemy, Isaac's damage increases for the current room.
Marked DLC Indicator.png 394 Marked Icon.png Directed tears Isaac will now fire tears automatically directed at a red target on the ground which is controlled by the player. This allows for a full 360 degree tear firing radius. Can be overridden by other tear modifiers such as Mom's Knife or Brimstone.
Maw of the Void DLC Indicator.png 399 Maw of the Void Icon.png Consume thy enemy! +1.0 Damage Up. After continuously firing tears for 2.5 seconds, a red cross appears on Isaac's head that, upon releasing the fire button, creates a black ring that rapidly deals damage equal to Isaac's tear damage to any enemies in contact with it.
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 Pearls DLC Indicator.png 355 Mom's Pearls Icon.png Range + luck up +1.25 Range Up. +0.5 Tear Height. +1 Luck Up.
More Options DLC Indicator.png 414 More Options Icon.png There are even more options! Two items spawn in every Treasure Room. Only one can be taken; the other will disappear.
Mr. Dolly DLC Indicator.png 370 Mr. Dolly Icon.png Range + tears up Tears and Range up. Spawns 3 random types of hearts on the floor when picked up.
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.
My Shadow DLC Indicator.png 433 My Shadow Icon.png Me! And my shaaaadow! Each time Isaac takes damage, inflicts fear on all enemies in the room and spawns a black Charger familiar that will attack enemies. The Charger will be killed if it is damaged too much.
Night Light DLC Indicator.png 425 Night Light Icon.png Scared of the dark? A cone of light shines in the direction Isaac is moving that slows enemies and enemy shots.
No. 2 DLC Indicator.png 378 No. 2 Icon.png Uh oh... Continuously firing tears for several seconds causes Isaac to drop a Butt Bomb. Butt Bombs explode for 50 damage like normal bombs, but also deal 10 damage to all enemies in the room and daze them for a short period of time.
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.
Pay to Play DLC Indicator.png 380 Pay to Play Icon.png Money talks This item turns all doors that require a key into doors which need a coin to enter instead. This affects shops, item rooms, libraries and other key doors.
PJs DLC Indicator.png 428 PJs Icon.png You feel cozy Adds 4 Soul Hearts and fully restores Isaac's red health.
Pupula Duplex DLC Indicator.png 379 Pupula Duplex Icon.png Wide shot Transforms Isaac's tears into a wide arc shape which gives them a much larger hitbox. Gives Isaac spectral tears which allows them to travel through objects in the environment (i.e. rocks).
Purity DLC Indicator.png 407 Purity Icon.png Aura stat boost This item will boost one of Isaac's stats depending on the color of the aura around him. The aura will disappear upon taking damage and will reappear with a random color upon entering a new room. A red aura boosts damage, a blue aura boosts rate of fire, a yellow aura boosts speed, and an orange aura boosts range.
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.
Restock DLC Indicator.png 376 Restock Icon.png Never ending stores! Causes shops to instantly restock their items when they are bought. Granted by default for every character in Greed Mode.
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 Head DLC Indicator.png 424 Sack Head Icon.png More sacks! Greatly increases the chance to find sacks.
Scatter Bombs DLC Indicator.png 366 Scatter Bombs Icon.png 'We put bombs in your bombs!' Adds 5 bombs. Isaac's bombs explode into 2-4 tiny bombs
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.
Serpent's Kiss DLC Indicator.png 393 Serpent's Kiss Icon.png The kiss of death Tears now have a random chance to apply a poison effect, causing 4 or 6 damage per tick to enemies (Similar to The Common Cold item). Isaac now deals poison damage on contact with enemies similar to The Virus item (Damage over time 4 or 6 per tick). Enemies that were poisoned have a chance to drop a black heart when killed.
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.
Spear of Destiny DLC Indicator.png 400 Spear of Destiny Icon.png Your destiny In addition to tears, Isaac now holds a spear in front of him which deals damage equal to 2 times his tear damage, and occasionally inflicts fear. The spear cannot be thrown, but deals damage while it is in contact with an enemy.
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.
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.
Tech X DLC Indicator.png 395 Tech X Icon.png Laser ring tears Tears are replaced with laser rings that pierce through enemies and deal damage to enemies within them. Can be charged to increase the size of the ring.
The Wiz DLC Indicator.png 358 The Wiz Icon.png Double wiz shot! Tears simultaneously fire out of both eyes diagonally, similar to the effect of the R U A Wizard? pill. Isaac's tears also travel above all obstacles.
Toxic Shock DLC Indicator.png 350 Toxic Shock Icon.png Mass poison Upon entering a room, poisons all enemies, dealing double Isaac's tear damage. Killing enemies leaves a small, short lasting pool of green creep on the ground.
Tractor Beam DLC Indicator.png 397 Tractor Beam Icon.png Control your tears Isaac emits a beam from his face. Isaac's tears travel in the path of the beam.
Zodiac DLC Indicator.png 392 Zodiac Icon.png The heavens will change you Zodiac will give Isaac a random zodiac item effect that changes after every floor.
7 Seals Afterbirth† Indicator.png 526 7 Seals Icon.png Lil Harbingers! Grants a random Harbinger familiar that changes every 10 seconds.
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.
Adrenaline Afterbirth† Indicator.png 493 Adrenaline Icon.png Panic - power Increases damage based on how many empty heart containers Isaac has.
Analog Stick Afterbirth† Indicator.png 465 Analog Stick Icon.png 360 tears! Tears up. Allows Isaac to fire tears diagonally.
Angelic Prism Afterbirth† Indicator.png 528 Angelic Prism Icon.png Eclipsed by the moon Grants a prism orbital with a large orbital radius. Tears that pass through the prism split into four multi-colored tears.
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.
Apple! Afterbirth† Indicator.png 443 Apple! Icon.png Trick or treat? Increases tears. Adds a chance to fire a high-damage razor blade.
Backstabber Afterbirth† Indicator.png 506 Backstabber Icon.png Watch your back! Has a chance to fire tears that inflict bleeding on enemies, causing them to slowly take damage over time.
Belly Button Afterbirth† Indicator.png 458 Belly Button Icon.png What's in there? Drops a random trinket. Grants an extra trinket slot.
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.
Bloodshot Eye Afterbirth† Indicator.png 509 Bloodshot Eye Icon.png Bloody friend Spawns an orbiting eye familiar that fires tears every 2 seconds.
Bozo Afterbirth† Indicator.png 513 Bozo Icon.png Party time! Increases damage by a flat 0.1 and grants a soul heart. Enemies can randomly become briefly charmed or feared. Taking damage has a chance to spawn a rainbow poop.
Broken Modem Afterbirth† Indicator.png 514 Broken Modem Icon.png LAG! Enemies, enemy shots, tears, and pickups will briefly freeze in place at random intervals.
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.
Camo Undies Afterbirth† Indicator.png 497 Camo Undies Icon.png Camo kid Isaac becomes camouflaged at the beginning of each room. Enemies will not attack Isaac until he starts firing tears.
Compound Fracture Afterbirth† Indicator.png 453 Compound Fracture Icon.png Bone tears! Increases range. Tears turn into bones, which shatter into 1-3 bone shards upon hitting an enemy or obstacle.
Cone Head Afterbirth† Indicator.png 457 Cone Head Icon.png Hard headed! Grants a soul heart. Adds a chance to block enemy shots.
Contagion Afterbirth† Indicator.png 466 Contagion Icon.png Outbreak! The first enemy killed in a room explodes and poisons nearby enemies. Poisoned enemies will also explode upon death.
Dad's Lost Coin Afterbirth† Indicator.png 455 Dad's Lost Coin Icon.png I remember this... Increases range by 1.5. Drops a lucky penny. Other Effects Unknown
Dark Prince's Crown Afterbirth† Indicator.png 442 Dark Prince's Crown Icon.png Loss is power Increases range, tears, and shot speed when at exactly one red heart.
Dead Tooth Afterbirth† Indicator.png 446 Dead Tooth Icon.png Halitosis While firing, Isaac gains a green aura that poisons nearby enemies.
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.
Dog Tooth Afterbirth† Indicator.png 445 Dog Tooth Icon.png Bark at the moon! Increases damage and speed. Upon entering a room adjacent to a secret room, a howl sound effect will play.
Duality Afterbirth† Indicator.png 498 Duality Icon.png You feel very balanced Whenever a Devil or Angel Room would spawn after defeating a boss, both rooms spawn. Only one can be entered.
Eucharist Afterbirth† Indicator.png 499 Eucharist Icon.png Peace be with you An Angel Room door will always spawn after every boss fight, excluding the first floor and floors after Utero II/Womb II.
Euthanasia Afterbirth† Indicator.png 496 Euthanasia Icon.png Needle shot Adds a chance to fire needles. If a needle kills an enemy, it bursts into more needles.
Eye of Belial Afterbirth† Indicator.png 462 Eye of Belial Icon.png Possessed tears! Grants piercing tears. After piercing one enemy, tears start homing and deal double damage.
Eye of Greed Afterbirth† Indicator.png 450 Eye of Greed Icon.png Gold tears! Adds a chance to fire tears that temporarily stun enemies and turn them into gold. Any enemy killed while in this state will drop coins.
Fast Bombs Afterbirth† Indicator.png 517 Fast Bombs Icon.png Faster bomb drops! Grants 7 bombs and allows bombs to be placed rapidly.
Finger! Afterbirth† Indicator.png 467 Finger! Icon.png Watch where you point that! Spawns a finger familiar that points at enemies, dealing constant damage.
Ghost Pepper Afterbirth† Indicator.png 495 Ghost Pepper Icon.png Flame tears Adds a chance to shoot a fire that damages enemies and remains in place until it deals enough damage or the room is left.
Glaucoma Afterbirth† Indicator.png 460 Glaucoma Icon.png Blind tears! Adds a chance to shoot concussive tears, causing enemies to walk around randomly.
Glyph of Balance Afterbirth† Indicator.png 464 Glyph of Balance Icon.png A gift from above Grants 2 soul hearts and modifies drops from Champion Monsters based on certain conditions.
Greed's Gullet Afterbirth† Indicator.png 501 Greed's Gullet Icon.png Money = Health! Grants a heart container for every 25 coins Isaac has.
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.
Jacob's Ladder Afterbirth† Indicator.png 494 Jacob's Ladder Icon.png Electric tears Tears fire sparks of electricity in random directions upon hitting an obstacle or enemy.
Jumper Cables Afterbirth† Indicator.png 520 Jumper Cables Icon.png Bloody Recharge! Grants an active item charge every 15 enemies killed.
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.
Large Zit Afterbirth† Indicator.png 502 Large Zit Icon.png Creep shots Adds a chance to fire a creep shot that deals double damage and leaves a trail of slowing white creep.
Lead Pencil Afterbirth† Indicator.png 444 Lead Pencil Icon.png He's a bleeder! After every 15 tears fired, Isaac will fire a high-damage cluster of tears.
Leprosy Afterbirth† Indicator.png 525 Leprosy Icon.png You're tearing me apart! Upon taking damage, grants a body part as an orbital, which blocks enemy shots and deals 7 damage per tick to enemies it comes in contact with. The orbitals will be destroyed if they take enough damage from enemies or enemy shots.
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 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.
Linger Bean Afterbirth† Indicator.png 447 Linger Bean Icon.png Crying makes me toot Adds a chance to fire a gas cloud that damages nearby enemies.
Little Horn Afterbirth† Indicator.png 503 Little Horn (Item) Icon.png Science! Adds a chance to fire a piercing tear that instantly kills any enemy that it touches.
Metal Plate Afterbirth† Indicator.png 449 Metal Plate Icon.png It itches... Adds a chance to reflect enemy shots. Grants one soul heart.
Moldy Bread Afterbirth† Indicator.png 456 Moldy Bread Icon.png Midnight snack! Grants a heart container.
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.
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.
Poke Go Afterbirth† Indicator.png 505 Poke Go Icon.png Gotta catch em... Upon entering a room with enemies in it, has a chance to spawn a random charmed enemy that persists across rooms.
Polydactyly Afterbirth† Indicator.png 454 Polydactyly Icon.png Hold me! Allows Isaac to carry two cards, pills, or any combination of both at the same time. Drops a random card or pill.
Pop! Afterbirth† Indicator.png 529 Pop! Icon.png Eyeball tears! Replaces Isaac's tears with eyeballs that can bounce off of each other. The eyeballs are not limited by range, and will instead dissipate when they stop moving or when hitting an enemy or obstacle.
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.
Shade Afterbirth† Indicator.png 468 Shade Icon.png It follows Spawns a shadow familiar that follows Isaac's movements on a 3 second delay and deals contact damage to enemies.
Shard of Glass Afterbirth† Indicator.png 448 Shard of Glass Icon.png Blood and guts! Upon taking damage, Isaac has a chance to drop a full red heart, gain 5 range, and leave a trail of damaging red creep for the current room.
Sinus Infection Afterbirth† Indicator.png 459 Sinus Infection Icon.png Booger tears! Adds a chance to fire a booger which sticks to enemies and poisons them.
Sulfuric Acid Afterbirth† Indicator.png 463 Sulfuric Acid Icon.png Acid tears! Increases damage. Adds a chance to fire acidic tears which can destroy obstacles.
Tarot Cloth Afterbirth† Indicator.png 451 Tarot Cloth Icon.png I see the future Drops a random card or rune. Doubles the effects of cards and runes.
Technology Zero Afterbirth† Indicator.png 524 Technology Zero Icon.png Static tears! Connects Isaac's tears with electricity that can damage enemies.
Varicose Veins Afterbirth† Indicator.png 452 Varicose Veins Icon.png I'm leaking... Taking damage releases a ring of 10 high damage tears.
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.

SmallIsaac.png The Binding of Isaac: Rebirth SmallIsaac.png

MainPageAchievements.png Achievements MainPageAttributes.png Attributes MainPageBosses.png Bosses TarotCard.png Cards and Runes MainPageChallenges.png Challenges MainPageChapters.png Chapters
Isaac App.png Characters MainPageBabies.png Co-op Magic Mushroom Icon.png Items Isaac's Tears Icon.png Item Pools MainPageMonsters.png Monsters MainPageObjects.png Objects
Red heart.png Pickups BlueBlue.png Pills MainPageRooms.png Rooms MainPageSeeds2.png Seeds Guppy App.png Transformations The Left Hand Icon.png Trinkets